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Background: Primary tumour biology and axillary lymph node status are key prognostic factors in breast cancer treatment. The LowMag trial introduced a magnetic sentinel lymph node biopsy procedure using a superparamagnetic iron oxide (SPIO) tracer and a handheld magnetometer as a radiation-free alternative for axillary staging. The trial aimed to assess a low-dose magnetic tracer for non-invasive preoperative evaluation of lymph node metastases and intraoperative sentinel lymph node detection. Methods: Patients with confirmed invasive breast cancer or ductal carcinoma in situ, eligible for sentinel lymph node biopsy, were included in the LowMag trial. The sentinel lymph nodes were detected perioperatively using Sentimag® and inked to maintain spatial orientation between MRI and histopathology. The amount of iron was estimated using two magnetic devices: SPaQ and Sentimag®. Additional ex vivo MRI was performed with a low-field MRI system. After being buffered in formalin, the sentinel lymph nodes were sectioned perpendicular to the MRI planes, consecutively sliced at 2 μm intervals, and stained with H&E, Perls Prussian blue, CK8/18, and CD68. Results: In an interim assessment of 20 sentinel lymph nodes, two contained metastases. The analysis revealed good concordance in uptake between the magnetic and radioactive tracers, with a median iron content of 19.21 µg. In healthy sentinel lymph nodes, iron particles were found in both the subcapsular space and sinusoids, with macrophages nearby. Healthy regions within metastatic lymph nodes showed similar behaviour to healthy nodes. In metastatic sites, iron pigment presence was reduced, especially in areas occupied by tumour cells. A healthy lymph node with low iron content displayed a large central fatty region without iron uptake but confirmed iron in sinusoidal macrophages. The metastatic lymph node had subcapsular and parenchymal tumour cells in the central region, with limited infiltration into nearby adipose tissue and no local iron enhancement. However, iron deposits were detected within the sinusoids. Discussion: The MRI images effectively distinguish between fat, nodal tissue, and the SPIO tracer, either through signal intensity or texture. This demonstrates the potential for sentinel lymph node imaging using a low-field MRI system. [ABSTRACT FROM AUTHOR]

Apigenin, a naturally derived flavonoid, is increasingly being acknowledged for its potential therapeutic applications, especially in oncology. This research explores apigenin's capacity to modulate cancer cell viability, emphasizing its roles beyond its minimal antioxidant activity attributed to its basic molecular structure devoid of hydroxyl groups. We investigated apigenin's effects on two breast cancer cell lines, estrogen-dependent MCF-7 and non-estrogen-dependent MDA-MB-231 cells. Our findings reveal that apigenin exerts a dose-dependent cytotoxic and anti-migratory impact on these cells. Interestingly, both apigenin and doxorubicin—a standard chemotherapeutic agent—induced lipid droplet accumulation in a dose-dependent manner in MDA-MB-231 cells. This phenomenon was absent in MCF-7 cells and not evident when doxorubicin and apigenin were used concurrently, suggesting distinct cellular responses to these treatments that imply that their synergistic effects might be mediated through mechanisms unrelated to lipid metabolism. A further chemoinformatics analysis indicated that apigenin and doxorubicin might interact primarily at the level of ATP-binding cassette (ABC) transporter proteins, with potential indirect influences from the AKT and MYC signaling pathways. These results highlight the importance of understanding the nuanced interactions between apigenin and conventional chemotherapeutic drugs, as they could lead to more effective strategies for cancer treatment. This study underscores apigenin's potential as a modulator of cancer cell dynamics through mechanisms independent of its direct antioxidant effects, thereby contributing to the development of flavonoid-based adjunct therapies in cancer management. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common malignant tumour in women worldwide, as well as the leading cause of death from malignant tumours. All across the world, the incidence of breast cancer is steadily rising. Although numerous drugs acting through various mechanisms of action are available in the market as conventional formulations for the treatment of breast cancer, they face significant challenges in terms of bioavailability, dosing, and associated adverse effects, which severely limit their therapeutic efficacy. Several studies have shown that nanocarriers can significantly improve the drug's bioavailability, reducing the need for frequent dosing and reducing the toxicity linked to high drug doses. The current review provides insight into the challenges associated with conventional breast cancer formulations and the need for oral nanoparticulate systems to overcome problems associated with conventional formulations. This review focuses on various topics, such as an in-depth analysis of potential anticancer drugs that have used nanocarrier technology to treat breast cancer successfully. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy, the mainstay treatment for metastatic cancer, presents serious side effects due to off-target exposure. In addition to the negative impact on patients' quality of life, side effects limit the dose that can be administered and thus the efficacy of the drug. Encapsulation of chemotherapeutic drugs in nanocarriers is a promising strategy to mitigate these issues. However, avoiding premature drug release from the nanocarriers and selectively targeting the tumour remains a challenge. Results: In this study, we present a pioneering method for drug integration into nanoparticles known as mesoporous organosilica drugs (MODs), a distinctive variant of periodic mesoporous organosilica nanoparticles (PMOs) in which the drug is an inherent component of the silica nanoparticle structure. This groundbreaking approach involves the chemical modification of drugs to produce bis-organosilane prodrugs, which act as silica precursors for MOD synthesis. Mitoxantrone (MTO), a drug used to treat metastatic breast cancer, was selected for the development of MTO@MOD nanomedicines, which demonstrated a significant reduction in breast cancer cell viability. Several MODs with different amounts of MTO were synthesised and found to be efficient nanoplatforms for the sustained delivery of MTO after biodegradation. In addition, Fe3O4 NPs were incorporated into the MODs to generate magnetic MODs to actively target the tumour and further enhance drug efficacy. Importantly, magnetic MTO@MODs underwent a Fenton reaction, which increased cancer cell death twofold compared to non-magnetic MODs. Conclusions: A new PMO-based material, MOD nanomedicines, was synthesised using the chemotherapeutic drug MTO as a silica precursor. MTO@MOD nanomedicines demonstrated their efficacy in significantly reducing the viability of breast cancer cells. In addition, we incorporated Fe3O4 into MODs to generate magnetic MODs for active tumour targeting and enhanced drug efficacy by ROS generation. These findings pave the way for the designing of silica-based multitherapeutic nanomedicines for cancer treatment with improved drug delivery, reduced side effects and enhanced efficacy. [ABSTRACT FROM AUTHOR]

Breast cancer is an issue of concern with increasing incidence among women worldwide. Propranolol, as an antihypertensive drug, exerts anticancer effects too. We conducted this study to analyze the in vitro apoptotic and antiproliferative effects of propranolol in human MCF-7 breast cancer cells. MCF-7 cells were seeded into 6-well plates and treated with 50 µL propranolol for 24 hours. After cell homogenization, the levels of pro-apoptotic proteins BCL2 associated X (BAX), apoptosis inducing factor (AIF), C/-EBP homologous protein (GADD153), and glucose-regulated protein 78 (GRP78), anti-apoptotic protein BCL2 apoptosis regulator (BCL-2), and cycle-regulator WEE1 G2 checkpoint kinase (WEE1) were measured with ELISA. Propranolol significantly upregulated pro-apoptotic proteins AIF, BAX, GADD153, and GRP78 while downregulated anti-apoptotic protein BCL2. The level of WEE1, as the main regulatory cell cycle protein at the G2/M checkpoint, significantly increased after propranolol treatment. Propranolol inhibited the proliferation of MCF-7 human breast cancer cells by upregulating pro-apoptotic factors AIF, BAX, GADD153 and GRP78 and by downregulating antiapoptotic BCL2. Elevated WEE1 levels after propranolol treatment might lead the tumor cells into a sustained cell-cycle arrest which eventually resulted in caspase-dependent or -independent mitochondrial or endoplasmic-reticulum stress-induced apoptosis. So, propranolol can be utilized as a potential therapeutic agent in breast cancer therapy. [ABSTRACT FROM AUTHOR]

The black cumin, Nigella sativa L. is known to be effective against various diseases including cancer. Thymoquinone (TQ), active ingredient of N. sativa extracts, can inhibit proliferation metastasis and regulating immune system in different cancers as with breast cancer (BC). The mechanisms of action behind TQ are not clearly understood yet. The purpose of the current study is to investigate the effects of TQ, water (WE) and alcohol extracts (AE) of N. sativa on BC cells by focusing attention on the following genes; CDK4, MYC, NF-κB1, VEGFA, FGF1, N-cadherin, ULBP1, ULBP2 and CD155. Conventional protocols were performed in order to obtain extracts. Cell viability was measured by RTCA and MTT assay, and gene expressions were analyzed by qRT-PCR. Association was significant for CDK4 (P =0.07), MYC (P <0.001), NF-κB1 (P =0.011), VEGFA (P =0.013), FGF1 (P <0.001), and ULBP1 (P =0.021) genes. CDK4 and MYC genes may be candidate genes for mechanisms involved in reduced cell proliferation induced by AE and TQ. Increased ULBP1 expression through AE and TQ indicates that N. sativa may trigger ULBP1-mediated NK cell cytotoxicity. Our results support the idea that active ingredients in N. sativa promise an encouraging therapeutic approach in the future. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, breast cancer became the most common cancer in the world in 2020 and accounted for 685,000 deaths globally. In this article, breast cancer risk factors, considerations for genetic testing for BRCA1 and BRCA2 variants, signs and symptoms, and treatment are briefly discussed. Factors that impact the well-being and quality of life of women who have or have had breast cancer are also explored in depth, and practice implications for primary care providers are noted. According to the World Health Organization, breast cancer became the most common cancer in the world in 2020 and accounted for 685,000 deaths globally. In this article, breast cancer risk factors, considerations for genetic testing, signs and symptoms, and treatment are briefly discussed. Factors that impact the well-being and quality of life of women who have or have had breast cancer are also explored in depth, and practice implications for primary care providers are noted. [ABSTRACT FROM AUTHOR]

Background Prophylactic lymphatic bypass or LYMPHA (LYmphatic Microsurgical Preventive Healing Approach) is increasingly offered to prevent lymphedema following breast cancer treatment, which develops in up to 47% of patients. Previous studies focused on intraoperative and postoperative lymphedema risk factors, which are often unknown preoperatively when the decision to perform LYMPHA is made. This study aims to identify preoperative lymphedema risk factors in the high-risk inflammatory breast cancer (IBC) population. Methods Retrospective review of our institution's IBC program database was conducted. The primary outcome was self-reported lymphedema development. Multivariable logistic regression analysis was performed to identify preoperative lymphedema risk factors, while controlling for number of lymph nodes removed during axillary lymph node dissection (ALND), number of positive lymph nodes, residual disease on pathology, and need for adjuvant chemotherapy. Results Of 356 patients with IBC, 134 (mean age: 51 years, range: 22–89 years) had complete data. All 134 patients underwent surgery and radiation. Forty-seven percent of all 356 patients (167/356) developed lymphedema. Obesity (body mass index > 30) (odds ratio [OR]: 2.7, confidence interval [CI]: 1.2–6.4, p = 0.02) and non-white race (OR: 4.5, CI: 1.2–23, p = 0.04) were preoperative lymphedema risk factors. Conclusion Patients with IBC are high risk for developing lymphedema due to the need for ALND, radiation, and neoadjuvant chemotherapy. This study also identified non-white race and obesity as risk factors. Larger prospective studies should evaluate potential racial disparities in lymphedema development. Due to the high prevalence of lymphedema, LYMPHA should be considered for all patients with IBC. [ABSTRACT FROM AUTHOR]

Background: Ductal carcinoma in situ (DCIS) is the most common form of noninvasive breast cancer and is associated with an excellent prognosis. As a result, there is concern about overdiagnosis and overtreatment of DCIS because most patients with DCIS are treated as though they have invasive breast cancer and undergo either breast‐conserving surgery (BCS)—most commonly followed by radiation therapy (RT)—or mastectomy. Little research to date has focused on nonclinical factors influencing treatments for DCIS. Methods: Population‐based data were analyzed from five state cancer registries (California, Florida, New Jersey, New York, and Texas) on women aged 65 years and older newly diagnosed with DCIS during the years 2003 to 2014 using a retrospective cohort design and multinominal logistic modeling. The registry records with Medicare enrollment data and fee‐for‐service claims to obtain treatments (BCS alone, BCS with RT, or mastectomy) were merged. Surgeon practice structure was identified through physician surveys and internet searches. Results: Patients of surgeons employed by cancer centers or health systems were less likely to receive BCS with RT or mastectomy than patients of surgeons in single specialty or multispecialty practices. There also was substantial geographic variation in treatments, with patients in New York, New Jersey, and California being less likely to receive BCS with RT or mastectomy than patients in Texas or Florida. Conclusions: These findings suggest nonclinical factors including the culture of the practice and/or financial incentives are significantly associated with the types of treatment received for DCIS. Increasing awareness and targeted efforts to educate physicians about DCIS management among older women with low‐grade DCIS could reduce patient harm and yield substantial cost savings. There is concern about overdiagnosis and overtreatment of ductal carcinoma in situ, the most common form of noninvasive breast cancer, because it is associated with an excellent prognosis. Nonclinical factors, including practice structure and geography, are associated with the receipt of surgery with radiation therapy and of mastectomy. [ABSTRACT FROM AUTHOR]

This paper presents a fast antenna phase optimization scheme to enable microwave power focusing for breast cancer hyperthermia. The power focusing is achieved through the maximization of the deposited electric field on the target malignant tumor tissue. To do so, a malignant breast tumor, the surrounding breast medium, and the skin of the breast are modeled as a cylindrical structure composed of eccentric cylinders, and electric field distribution is computed analytically in terms of cylindrical harmonics. This approach minimized the computational cost and simplified the breast medium model. To ensure applicability across various breast types, the dielectric properties (DPs) of the main cylinder, symbolizing healthy breast tissue, are averaged from pixel DPs of digital breast phantoms. The hyperthermia problem is posed as maximizing the total electric field at the central point of the tumor which is simply represented as a vector sum of complex quantities in terms of antenna phases. That is, one antenna phase is selected as a reference and the remaining ones are adjusted accordingly. The approach is validated using a circular applicator with eight TMz polarized line sources surrounding realistic digital breast phantoms. Testing involved eight scenarios using two distinct breast media. In the optimal scenario, the peak temperature is achieved 1.3 mm away from the focus point. [ABSTRACT FROM AUTHOR]

Progesterone receptors (PRs) are biomarkers used as prognostic and predictive factors in breast cancer, but they are still not used as therapeutic targets. We have proposed that the ratio between PR isoforms A and B (PRA and PRB) predicts antiprogestin responsiveness. The MIPRA trial confirmed the benefit of 200 mg mifepristone, administered to patients with tumors with a high PRA/PRB ratio, but dose-ranging has not been conducted. The aim of this study was to establish the plasma mifepristone levels of patients from the MIPRA trial, along with the resultant steroid profiles, and compare these with those observed in mifepristone-treated mice using therapeutic schemes able to induce the regression of experimental mammary carcinomas with high PRA/PRB ratios: 6 mg pellets implanted subcutaneously, or daily doses of 12 mg/kg body weight. The plasma levels of mifepristone and other 19 plasma steroids were measured by liquid chromatography-tandem mass spectometry. In mifepristone-treated mice, plasma levels were lower than those registered in mifepristone-treated patients (i.e. day 7 after treatment initiation, pellet-treated mice: 8.4 ± 3.9 ng/mL; mifepristone-treated patients: 300.3 ± 31.7 ng/mL (mean ± s.d.; P < 0.001)). The increase in corticoid related steroids observed in patients was not observed in mifepristone-treated mice. The increase in progesterone levels was the most significant side effect detected in mifepristone-treated mice after 14 or 21 days of treatment, probably due to an ovarian compensatory effect not observed in postmenopausal patients. We conclude that in future clinical trials using mifepristone, the possibility of lowering the standard daily dose of 200 mg should be considered. [ABSTRACT FROM AUTHOR]

The incidence rate of breast cancer is high, and endocrine therapy for breast cancer frequently causes bone loss. We conducted a systematic review and meta-analysis to review the effect of TCM on bone loss associated with endocrine therapy in patients with breast cancer. Medline (Ovid), EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), VIP full-text Database, Wanfang Database, Chinese Biomedical Literature data (CBM), relevant Chinese and foreign periodicals, conference papers, degree papers, and supplemented by literature tracing were searched. Data from randomized controlled trials (RCTs) on the effects of TCM on bone loss associated with endocrine therapy in patients with breast cancer were collected according to the inclusion and exclusion criteria from the establishment of each database to May 2022. Twenty-two clinical controlled studies were eventually selected. The results of the meta-analysis showed effectiveness (RR (Risk Ratio): 1.22, 95% CI (confidence interval): 1.10-1.36, I² = 0%), improvement of lumbar bone mineral density (BMD) (WMD (weighted mean difference): 0.07, 95% CI: 0.06-0.08, I² = 23%), improvement of BMD T value (WMD: 0.37, 95% CI: 0.28-0.46, I² = 66%), and improvement of BMD in the femoral neck (WMD: 0.07, 95% CI: 0.05-0.09, I² = 33%). The funnel chart suggested that a publication bias was observed in the literature, which may be explained by the heterogeneity in the study data and the limited number of included examples. Sensitivity analysis was conducted to confirm that the differences among the studies were acceptable. No study reported adverse effects. Our results indicated that TCM is helpful for bone loss associated with endocrine therapy in patients with breast cancer based on the effectiveness, lumbar BMD, BMD T value, and BMD of the femoral neck. The use of TCM is thus safe. [ABSTRACT FROM AUTHOR]

Les anesthésiques locaux adrénalinés sont largement utilisés en pratique courante et ont depuis longtemps prouvé leurs bénéfices et leur sécurité. Les rares complications dues à leur utilisation concernent essentiellement des mécanismes immuno-allergiques et vasculaires. Nous présentons dans cet article quatre cas similaires de nécroses cutanées transfixiantes précoces survenues après biopsie mammaire radioguidée sous anesthésie locale utilisant des anesthésiques adrénalinés dans le cadre d'une démarche diagnostique de cancer du sein. Bien que la littérature se veuille rassurante sur l'utilisation de produits anesthésiques locaux, même sur les extrémités, des complications cutanées sévères continuent d'être rapportés sporadiquement. L'analyse et la compréhension de ces phénomènes permettrait, à terme, de les éviter et de diminuer leur importance. La survenue de nécrose cutanée après biopsie mammaire sous contrôle radiographique est rare et semblerait liée au geste d'anesthésie locale. Bien que des cas similaires aient été rapportés dans la littérature, il ne semble pas être possible aujourd'hui de conclure sur la physiopathologie exacte de ces complications. Une meilleure connaissance de celle-ci permettrait à l'avenir d'éviter la survenue de ces complications. Local anesthetics with adrenaline are widely used in routine practice and have long proven their benefits and safety. The rare complications due to their use mainly concern immuno-allergic and vascular mechanisms. In this article, we present four similar cases of early transfixing skin necrosis occurring after radioguided breast biopsy under local anesthesia using epinephrine local anesthetics in the context of a diagnostic approach to breast cancer. Although the literature is comforting about the use of local anesthetics, even on the extremities, severe skin complications continue to be reported sporadically. The analysis and understanding of these phenomena would allow, in the long run, to avoid them and to reduce their importance. The occurrence of skin necrosis after breast biopsy under radiographic control is rare and seems to be related to the local anesthetic procedure. Although similar cases have been reported in the literature, it does not seem possible today to conclude on the exact physiopathology of these complications. A better knowledge of the pathophysiology of these complications would help to avoid their occurrence in the future. [ABSTRACT FROM AUTHOR]

La cytostéatonécrose (CTN) ou nécrose graisseuse, est une complication postopératoire fréquente des reconstructions mammaires par lambeau graisseux type DIEP (deep epigastric perforator flap). Confirmée à l'imagerie, elle se présente sous diverses formes, nodules ou plages étendues de nécrose, peut s'infecter et mimer une récidive tumorale. Sa survenue est liée à l'ischémie peropératoire subie par le lambeau, et aucune méthode ne permet de la prévenir actuellement. Le préconditionnement ischémique mécanique (PCIM) des lambeaux libres est une méthode dérivée de la chirurgie de transplantation d'organe qui améliore la tolérance du greffon à l'ischémie reperfusion de la chirurgie. Le procédé consiste à effectuer de brefs cycles consécutifs d'ischémie reperfusion par clampage déclampage au niveau du pédicule du lambeau in situ. L'objectif de cette étude rétrospective observationnelle était d'analyser les effets du PCIM sur la survenue de CTN après reconstruction par DIEP, en comparant le taux de CTN postopératoire parmi les DIEP non preconditionnés, versus DIEP préconditionnés en peropératoire. Toutes les patientes opérées par DIEP avec ou sans PCIM entre novembre 2020 et mai 2022, présentant une échographie mammaire du sein reconstruit réalisée dans le service de radiologie hospitalier à 6 mois postopératoires ont été incluses. Le critère de jugement principal était la présence de CTN sur l'échographie à 6 mois, avec classification de cette CTN selon la classification de Wagner. Les caractéristiques cliniques des patientes, les complications postopératoires (hématome infection), les durées d'hospitalisation étaient recueillis. 29 patientes ont été incluses, dont 8 avec PCIM peropératoires. Le taux de CTN retrouvé après PCIM (25 %) était inférieur a celui retrouvé sans PCIM (71,4 %), sans différence significative (p = 0,088). Le taux des autres complications postopératoires n'était pas différent avec ou sans PCIM. Le PCIM semble avoir un effet bénéfique sur la survenue de CTN post opératoire en améliorant la tolérance de la graisse du lambeau de DIEP à l'ischémie peropératoire. Ces résultats préliminaires doivent être confirmés par une étude clinique prospective. Cytosteatonecrosis (CTN) is a frequent postoperative complication after breast autologous reconstruction using DIEP (deep inferior epigastric perforator) flap. CTN radiological diagnostic reveals different types of lesions, as nodes or extended fat necrosis, which become in some cases infected, or pass for tumor recurrence after breast cancer treatment. CTN is caused by intraoperative ischemia of the flap, and no current method can prevent postoperative CTN development after DIEP breast reconstruction. Mechanical ischemic preconditioning, consisting in intraoperative briefs consecutive cycles of ischemia reperfusion using vascular clamp upon the graft pedicle, is used in transplantation surgery. This procedure improves the graft tolerance towards ischemic surgical lesions. The aim of this retrospective observational study was to assess PCIM effects on CTN development after DIEP surgery, comparing CTN occurrence after breast reconstruction using DIEP flap with or without intraoperative PCIM. All patients breats reconstructed using DIEP flap between novembre 2020 and may 2022, presenting 6 months postoperative breast echography were retrospectively included. Primary outcome was the ultrasonic existence of CTN, according to the Wagner classification. Clinical data, postoperative outcomes such as infection, hematoma or surgical revision, and length of stay in hospital were also recorded. Twenty nine patients among which 8 PCIM were included. CTN occurrence rate after PCIM (25%) was quite lower than CTN rate without PCIM (71,4%), although the difference was not significant (P = 0,088). Other postoperative complications rates were not significantly different with or without PCIM. PCIM seems to improve CTN occurrence after DIEP breast reconstruction, improving fat flap tolerance to ischemic perioperative lesions. Those preliminary results need to be confirmed with clinical prospective study. [ABSTRACT FROM AUTHOR]

Objective • This research aims to assess the clinical efficacy of neoadjuvant chemotherapy (NACT) in combination with modified radical mastectomy (MRM) for stage II-III breast cancer (BC) patients and its impact on serum tumor markers (STMs). Methods • The study included 119 stage II-III BC patients treated between June 2018 and June 2021. Among them, 55 cases underwent MRM (reference group), while 64 cases received NACT followed by MRM (research group). We compared intraoperative parameters (blood loss, operation time, hospital stay), clinical outcomes, the incidence of postoperative adverse events (AEs), changes in STMs (CA125, CA153, CEA), and one-year postoperative quality of life (QOL). Results • In comparison to the reference group, the research group exhibited significantly lower intraoperative blood loss, shorter operation times, reduced hospital stays, and higher rates of disease remission. Notably, the research group experienced a lower overall incidence of AEs, including skin flap necrosis, subscalp effusion, infection, and upper limb lymphedema. Postoperatively, all STMs in the research group exhibited statistically significant reductions and were lower than those in the reference group. Additionally, all QOL subscales demonstrated improvements and higher scores in the research group. Conclusions • NACT followed by MRM represents an effective approach for enhancing surgical outcomes and clinical efficacy in stage II-III BC patients. This combination therapy also reduces the risk of postoperative AEs and leads to favorable changes in STMs and postoperative QOL levels. [ABSTRACT FROM AUTHOR]

Objective: Breast conserving surgery is an excellent option in the treatment of breast cancer. To achieve a good result with this modality, a surgeon needs to identify and excise the tumor with adequate margins. The radiofrequency identification (RFID) technique is a wireless localization technique used for intraoperative breast lesion identification. We assessed the efficacy and outcomes of the RFID technique in breast cancer patients at our institution. Materials and Methods: This is a single institution, retrospective study (BSMH 22-02X-MWH) of 73 patients. We analyzed the medical records of women with biopsy-proven breast cancer from June 2020 to August 2022; participants received surgical care at Mercy Health West Hospital. Data collected included demographics, clinicopathological characteristics, and surgical procedure. The primary objective was to determine the safety and efficacy of RFID. The secondary objective was to assess the impact of obesity and breast density on the RFID outcomes. Results: A total of 73 female patients met the eligibility criteria with stage I (59%) and grade 1 (51%) breast cancer with mean age of at diagnosis of 66.8 years and mean body mass index of 31.4 kg/m2. Patients had invasive ductal carcinoma (61%), hormonal positive (56%), and human epidermal growth factor receptor 2 negative (68%) disease. All RFID tags were placed under image guidance with 100% accuracy of placement with no evidence of migration or procedure revision. Ninety percent of patients had free surgical margins and only seven patients needed margin re-excision with successful removal of the lesion and the tag. Conclusion: RFID localization technique is a safe, effective and reliable procedure that results in favorable patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is an important topic worldwide, posing morbidity and mortality to women. Considerable efforts have been put in the early recognition of malignancy through different screening methods, such as mammography and ultrasound. The precise localization of infraclinical malignant lesions is key in surgical management and magnetic seeds gather particular interest for this purpose. As with other systems, a need for reintervention may be needed to obtain adequate surgical margins. This work evaluated the relation between the need for surgical reintervention in order to obtain negative margins and geodimensional and histological parameters. The main objective was the identification of parameters significantly associated with reintervention for margin widening. Materials and Methods: A retrospective analysis of 198 patients from a single centre was performed. The association between pre-defined geodimensional and histological parameters and the need for margin widening in infraclinical lesions marked with magnetic seed was evaluated. Results: Results showed that reintervention to widen margins was significantly higher in patients with ductal carcinoma in situ (DCIS) in the pre-operative biopsy when compared with invasive carcinoma (p = 0.03) in the bivariate analysis. No statistically significant differences were observed between the need for reintervention and lesion size (p = 0.197), breast quadrant location (p = 0.626) and distance of skin to lesion (p = 0.356). Conclusion: This work suggests that a more invasive margin clearance in lesions with a pre-operative DCIS diagnosis might obviate the need for reintervention to obtain negative margins. On the other hand, it is not necessary to be surgically more invasive in larger lesions, deeply located or that are present in a certain quadrant, since there are no significant differences regarding the need for reintervention. [ABSTRACT FROM AUTHOR]

Objective: Local recurrence rate may show no significant differences between women aged 60 and older who receive breast-conserving surgery followed by radiotherapy and those in the same age group who undergo breast-conserving surgery without subsequent radiotherapy. Materials and Methods: Retrospective cohort study from a single practice with median follow-up time 44 months (interquartile range: 16, 82), comparing women older than 60 years old at diagnosis of breast cancer, treated with breast conserving surgery and either receiving or not receiving radiation therapy postoperatively. The primary endpoint was local recurrence difference between the two groups. Results: Local recurrence did not differ significantly between the two groups in terms of radiotherapy or not [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.89-1.02, Fisher's exact test p = 0.388], nor between two age groups with cut-off at 65 years of age (OR: 0.99, 95% CI 0.92-1.07, Fisher's Exact test p = 0.6). Local recurrence also did not differ when subgroups of age (60-65 years and >66 years) were considered. All patients received 5 years of hormonal therapy. Conclusion: Omission of radiotherapy in selected patients is not inferior to radiotherapy after breast conserving surgery in terms of preventing local recurrence. [ABSTRACT FROM AUTHOR]

Determining pathological complete response (pCR) could be an important step in planning individual treatment, hence improving the prognosis in terms of survival. Achieving breast pCR not only improves survival but is also linked to a disease-free axilla, therefore increasing the likelihood of avoiding axillary surgery safely. The current trend in de-escalating axillary management surgically or in applying radiotherapy to the axilla is dependent primarily on breast cancer (BC) patients achieving pCR. Studies have demonstrated that certain characteristics can predict pCR, even though it is still difficult to identify these elements. A review of the literature was carried out to determine these factors and their clinical applications. A search was carried out in the MEDLINE database using PubMed, Google Scholar, and EMBASE. This yielded 1368 studies, of which 60 satisfied the criteria. The studies were categorized according to the subject they dealt with. These parameters included age, race, subtypes, clinicopathological, immunological, imaging, obesity, Ki-67 status, vitamin D, and genetics. These factors, in combination, can be used for specific subtypes to individualize treatment and monitor response to therapy. The predictors of pCR are diverse and should be utilized to personalize patient treatment, ultimately inducing the best outcomes. These determinants can also be employed for monitoring responses to neoadjuvant therapy, thereby adjusting treatment. The development of standardized markers for the diversity of BC subtypes still needs additional future research. These factors must be applied in concert in order to provide optimal results. [ABSTRACT FROM AUTHOR]

Objective: Mastalgia is the most common breast-related complaint. A multitude of hormonal changes and lifestyle associated factors have been implicated in its causation. A long list of treatment modalities have been tried with varying success rates. To identify the most common risk factors and the most effective management strategies for mastalgia in our clinic population. Materials and Methods: A total of 100 women between 18-65 years of age presenting to the breast clinic with mastalgia were followed throughout their course of diagnosis and management. Stepwise treatment was provided, starting with reassurance and breast support and progressing to include pharmacological measures, when necessary. The risk factors and outcomes of treatment were analysed. Results: The majority (66%) were aged 25-47 years and the left breast was found to be most frequently involved. Involvement of the upper outer quadrant was significantly more common. Lump/nodularity was the most prevalent risk factor. Most patients showed a positive response to non-steroid anti-inflammatories (NSAIDs) in addition to reassurance, breast support and dietary changes. Conclusion: A detailed history and clinical examination helps to identify the risk factors and the best approach for the management of mastalgia. Educating women regarding breast self-examination at regular intervals helps in early presentation and diagnosis of the underlying condition. Reassurance, breast support and lifestyle changes are the first line treatment and have good results in a significant number of patients. In our practice topical and oral NSAIDs, evening primrose oil and vitamin E were frequently used as additional treatments to non-pharmacological methods. [ABSTRACT FROM AUTHOR]

Breast cancer stands as the most prevalent malignancy, necessitating a well-established approach to its management due to its sustained prevalence over decades. The implementation of intensive treatments, combining various modalities, has yielded excellent survival outcomes. Consequently, the optimization of quality of life and the mitigation of long-term side effects emerge as critical considerations for clinicians. As a result, discussions regarding treatment deintensification strategies have been initiated for all treatment modalities, including surgery, radiotherapy (RT), and chemotherapy. RT plays a crucial role in adjuvant therapy. The efficacy of RT in disease control and overall survival across all stages of breast cancer has been demonstrated in numerous clinical trials and meta-analyses utilizing extensive datasets. However, advancements in genetic tumor profiling and improved identification of disease subgroups have prompted a reevaluation of RT omission in low-risk groups as a strategy for treatment de-intensification. Conversely, technological improvements and shortened total treatment times with hypofractionation make RT a secure and feasible option for enhancing local control and survival with minimal impact on the quality of life. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of menopausal hormone therapy (MHT) on skin aging in menopausal women. Methods: Studies were identified by searching PubMed, Cochrane Library, Google Scholar, and ClinicalTrials.gov databases using the key words "hormone replacement therapy" AND "skin" AND "menopausal." Studies that used and compared oral/transdermal MHT with placebo or another type of treatment in menopausal women aged 45-55 years were selected. Results: From 1,526 studies identified, 15 studies comprising 1,589 patients were included in the final analysis. Our meta-analysis aimed to compare skin elasticity (standard [Std] mean difference = 0.28; 95% confidence interval [CI], 0.03-0.54; P = 0.03), skin thickness (Std. mean difference = 1.27; 95% CI, 0.88-1.66; P < 0.00001), collagen content (Std. mean difference = 2.01; 95% CI, 1.42-2.61; P < 0.00001), and skin dryness (Std. mean difference = 0.15; 95% CI, -0.05 to 0.35; P = 0.14). Conclusions: MHT increases elasticity and collagen content in the skin, thereby reducing the severity of wrinkles and increasing skin thickness. Nevertheless, more well-conducted clinical trials are required to answer all questions in an evidence-based manner. [ABSTRACT FROM AUTHOR]

The aim of the paper is to study effectiveness of the different treatments of early-stage breast cancer through analysis of a stochastic model. The early-stage breast cancer is a term used to describe breast cancer that is detected at an early stage of development, typically before it has spread to other parts of the body. Early detection of breast cancer is critical as it greatly increases the chances of successful treatment and saves lives. At early-stage breast cancer of the patient, two types of treatment namely, tamoxifen and tamoxifen combined with radiation therapy are commonly used. As it is essential to consider innovative and cost-effective strategies for early detection and treatment. Investigations through analysis of the stochastic model on early-stage breast cancer with these two types of treatments may help the stakeholders. Keeping this in view, in the present paper, a stochastic model is developed for the early-stage breast cancer considering two treatment types, namely tamoxifen and tamoxifen combined with radiation therapy. The model is analyzed by Markov process and regenerative point technique. Mean sojourn time refers to the average amount of time spent by a patient in a particular state before transitioning to another state and mean survival time refers to the average time a patient survives after diagnosis of breast cancer. Mean sojourn time and mean survival time have been calculated. Sensitivity analysis is a technique to understand how changes in input variables or parameters affect the output or outcome of a model and it helps assess the robustness, reliability, and stability of a model by quantifying the impact of variations in input factors. The paper also includes sensitivity and relative sensitivity analyses of the model which explore the impact of different parameters on the survivability of the patient. The MATLAB software has been used for numerical computing and plotting various graphs. The investigation through our analysis of the stochastic model shows that the mean survival time lessens with the rise in the rates of transition and mean survival time from the treatment, tamoxifen plus radiation is higher than the treatment, tamoxifen only. It is concluded that tamoxifen plus radiation is more effective and useful than only tamoxifen for treatment of early-stage breast cancer. [ABSTRACT FROM AUTHOR]

Breast cancer is a complex disease for which pharmacological treatment does not guarantee success or cure. In addition, current pharmacological therapies induce unwanted side effects due to their lack of specificity or selectivity. Therefore, it is necessary to develop new therapeutic options to improve these aspects. Currently, phytochemicals with antineoplastic properties have been identified from a wide variety of plant sources, and new therapeutic options have been developed based on the conjugation of drugs with polymeric matrices, resulting in nanoparticles or hydrogels with improved properties. Some antineoplastic drugs have been conjugated with antibodies to improve their selectivity and specificity. One of the most important advances in the treatment of breast cancer has been the development of cyclin inhibitors and gene therapy. This review provides an overview of drugs derived from medicinal plants and polymeric matrices with high potential for use in the treatment of breast cancer. We also highlight the clinical evidence for the use of anti-HER2 monoclonal antibodies and cyclin inhibitors in breast cancer, as well as the advantages of using conjugated antibodies. Finally, we mention some considerations that should be taken into account in the search for new therapeutic agents from phytochemicals, polymers, antibodies, cyclin inhibitors, and gene therapy focused on the treatment of breast cancer. [ABSTRACT FROM AUTHOR]

Breast cancer (BCa) is a type of malignancy; however, the exact mechanisms responsible for breast cancer have yet to be elucidated. Rhotekin 2 (RTKN2) is a member of the Rhotekin family. Previous studies demonstrated that RTKN2 is highly expressed in numerous tumors. Previous analysis of the The cancer genome altas (TCGA) database demonstrated that PRKN2 was overexpressed in BCa. However, RTKN2 is rarely reported in BCa and the mechanisms remain unclear. The aim of this study was to elucidate the effect of RTKN2 on the growth of breast cancer cells and investigate the mechanisms involved. Our analysis revealed high expression of RTKN2 in human BCa. The depletion of RTKN2 suppressed the growth of breast cancer cells. In addition, the knockout of RTKN2 restrained the progression of BCa. We also revealed that the knockdown of RTKN2 stimulated cell cycle arrest in BCa. Mechanistically, RTKN2 mediated the Wnt/β-catenin axis to affect the progression of breast cancer. In conclusion, RTKN2 promotes the growth and migration of breast cancer cells by mediating the Wnt/β-catenin axis. [ABSTRACT FROM AUTHOR]

Objectives: Triple-negative breast cancer (TNBC) poses a significant challenge due to the lack of reliable prognostic gene signatures and an understanding of its immune behavior. Methods: We analyzed clinical information and mRNA expression data from 162 TNBC patients in TCGA-BRCA and 320 patients in METABRIC-BRCA. Utilizing weighted gene coexpression network analysis, we pinpointed 34 TNBC immune genes linked to survival. The least absolute shrinkage and selection operator Cox regression method identified key TNBC immune candidates for prognosis prediction. We calculated chemotherapy sensitivity scores using the "pRRophetic" package in R software and assessed immunotherapy response using the Tumor Immune Dysfunction and Exclusion algorithm. Results: In this study, 34 survival-related TNBC immune gene expression profiles were identified. A least absolute shrinkage and selection operator-Cox regression model was used and 15 candidates were prioritized, with a concomitant establishment of a robust risk immune classifier. The high-risk TNBC immune groups showed increased sensitivity to therapeutic agents like RO-3306, Tamoxifen, Sunitinib, JNK Inhibitor VIII, XMD11-85h, BX-912, and Tivozanib. An analysis of the Search Tool for Interaction of Chemicals database revealed the associations between the high-risk group and signaling pathways, such as those involving Rap1, Ras, and PI3K-Akt. The low-risk group showed a higher immunotherapy response rate, as observed through the tumor immune dysfunction and exclusion analysis in the TCGA-TNBC and METABRIC-TNBC cohorts. Conclusion: This study provides insights into the immune complexities of TNBC, paving the way for novel diagnostic approaches and precision treatment methods that exploit its immunological intricacies, thus offering hope for improved management and outcomes of this challenging disease. [ABSTRACT FROM AUTHOR]

Background: Music therapy is often used to relieve anxiety and depression in breast cancer patients, but the clinical effect of music therapy on breast cancer patients is still controversial. This study was a systematic review to investigate the effects of music intervention on anxiety, depression, pain, and quality of life in breast cancer patients. Method: A computer search of PubMed, Embase, Web of Science, and The Cochrane Library repositories was conducted. We searched for randomized controlled trials (RCTs), published in English until October 2023, on the effects of music interventions on anxiety, depressive symptoms, pain levels, and quality of life in breast cancer patients. The Cochrane Manual of Systematic Review 5.3 was used to evaluate the quality of the included references, and Stata15.0 software was selected for meta-analysis of the study indicators. Results: A total of 10 articles were included in this study, including 593 patients. Meta-analysis showed that music intervention could effectively alleviate anxiety symptoms [standardized mean difference (SMD) = -2.12, 95% confidence interval (CI): -3.17-1.07], depression symptoms (SMD: -0.77, 95% CI: -1.47-0.07), and pain degree (SMD: -3.47, 95% CI: -6.45--0.48). There was no significant difference in the improvement of patients' quality of life (SMD: -0.07, 95% CI: -0.48-0.34). Conclusion: Music intervention can effectively relieve anxiety and depression symptoms in patients with breast cancer, and reduce the degree of pain, but demonstration of its ability to improve the quality of life of patients requires additional research. [ABSTRACT FROM AUTHOR]

The curry leaf extract is known to have anticancer property against breast cancer. Identification of the specific compound therein the curry leaf and its validation is essential for successful discovery of drugs. In that content, here, we extracted oleoresin from the mature curry leaves was subjected to antioxidant fractionation using column chromatography. Fraction obtained using 60:40 hexane and ethyl acetate solvent system, showing the maximum inhibition of DPPH, was subfractionated and those with the highest antioxidant property was analyzed in LC-MS/MS. Spectrum of molecules identified, along with FDA approved drugs, were docked with target proteins for breast cancer. In vitro screening of candidate phytocompounds doxylamine, histidinol and pheniramine, in their commercially available form, through Trypan blue exclusion assay against murine cancer cell lines EAC and DLA had shown that they have no cytotoxicity. Pheniramine maleate salt (PMS), doxylamine succinate salt (DSS) and L-histidinol dihydrochloride (LHD) have shown dose-dependent inhibition of proliferation of MCF-7 cells, with 280 µg/mL PMS at 72 h of incubation giving the maximum of 98.46%. Acute toxicity studies in Swiss albino mice (100 mg PMS/kg body wt.) have confirmed that the drug has no toxicity. Mouse mammary pad tumour model has shown that PMS significantly reduces the WBC count in the tumour induced mice. Liver function tests, histopathological analyses of liver, mammary pad and kidney tissues and expression analysis of oncogenes ER-α1, Bcl-2, c-Myc and Pin1 have confirmed the drug candidature of PMS. [ABSTRACT FROM AUTHOR]

At 2023 Annual Meeting of European Society of Medical Oncology (ESMO), Several latest research achievements in the field of breast cancer were announced. For early-stage breast cancer, immune checkpoint inhibitor has not only continued to prove their value in the neoadjuvant treatment of triple-negative breast cancer (KEYNOTE-522 and NeoTRIP), but also shown their potential benefit in the neoadjuvant therapy of hormone receptor+/human epidermal growth factor receptor 2 (HER2)- breast cancer (KEYNOTE-756 and CheckMate 7FL). Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors (as shown in the MONARCHE and NATALEE studies) have also solidified an important position in the adjuvant intensive treatment of hormone receptor+/HER2-breast cancer. In advanced breast cancer treatment, new endocrine therapy options and antibody-drug conjugate (T-DXd and Dato-DXd) have opened up new therapeutic opportunities for hormone receptor+/HER2- patients. Pooled analyses suggest that T-DXd has demonstrated outstanding efficacy in brain metastases of HER2+ breast cancer. Dato-DXd in combination with immunization and the new targeted antibody-drug conjugate HS-20089 produced promising efficacy in first-line treatment of and post-line triple-negative breast cancer, respectively. [ABSTRACT FROM AUTHOR]

This article from the Qatar Medical Journal discusses a case of pneumonitis, a type of interstitial lung disease, induced by the breast cancer drugs paclitaxel and trastuzumab. The case involves a 51-year-old woman who experienced acute shortness of breath, cough, and chest pain after undergoing mastectomy and starting adjuvant treatment with the chemotherapy drugs. The patient was diagnosed with drug-induced pneumonitis and treated with prednisolone, resulting in significant clinical improvement. The article emphasizes the importance of recognizing and investigating the rare occurrence of pneumonitis as a side effect of these medications. [Extracted from the article]

Objective: Sentinel lymph node biopsy (SLNB) represents the gold standard for axillary surgical staging. The aim of this study was to assess the proportion of axillary lymph node dissection (ALND) that could be avoided after retrospective application of the ACOSOG Z0011 criteria and to evaluate the shortterm complications associated with axillary surgery. Materials and Methods: We reviewed breast cancer (BC) patients treated by primary breast-conserving surgery from 2012 to 2015. The percentage of SLNB vs ALND performed before and after the application of the ACOSOG Z0011 criteria was calculated. Complications were analyzed using crosstabs, with p < 0.05 considered significant. Results: Two hundred fifty one patients with a median age of 59.3 years were included. BC tumors had a median size of 13 mm and were mostly unifocal (83.9%). There were 30.3% with 1-2 metastatic lymph nodes (MLN). ALND was performed in 44.2%. The patients with 1-2 MLN, had only SLNB in 14.5% of cases. By applying the ACOSOG Z0011 criteria, ALND would have been avoided in 40.2% of patients. At least one postoperative complication was reported after SLNB or ALND for 45.7% and 74.7% of patients respectively. Seroma was the most frequent complication, and occurred in 29.3% of cases after SLNB and in 59.5% after ALND. Conclusion: SNLB is the most commonly used axillary surgical staging procedure in this series (55.8%). With a retrospective application of the ACOSOG Z0011 criteria in our population, ALND could have been avoided for 40.2% patients. Post-operative complications rate was higher after ALND, with a seroma rate at 59.5%. [ABSTRACT FROM AUTHOR]

Objective: Breast imaging for male patients is a controversial topic due to the high prevalence of gynecomastia compared to male breast cancer. Worldwide, men are undergoing more breast imaging despite the low incidence of male breast cancer. Gynecomastia is a benign condition, but the anxiety it causes and unnecessary medical costs are still high. Materials and Methods: In accordance with Royal College of Radiology guidelines, a retrospective study was performed in two cycles to determine if mammography or ultrasound should be included in the workup of male patients who were referred to a breast care unit for a lump that was deemed benign by doctors. Results: There was 100% concordance between clinical diagnosis and imaging findings. Conclusion: In this population imaging was not necessary in cases of probable gynecomastia and benign conditions found during a clinical assessment. Standardised patient assessment methods can improve care and ensure accurate evaluation. [ABSTRACT FROM AUTHOR]

Objective: Breast-conserving surgery (BCS) followed by radiotherapy (RT) is the standard treatment for early-stage breast cancer. The use of an additional RT dose (boost) to the tumour bed improves local control but may worsen quality of life (QOL) and cosmetic results. Multifocal/multicentric tumours (MMTs) pose a challenge as they require larger boost volumes. This study investigated the impact of RT volumes on late-term cosmetic outcomes and QOL in patients with unifocal and MMTs who underwent adjuvant RT after BCS. Materials and Methods: Retrospective data of 367 patients who underwent BCS between 2012 and 2014 were reviewed. A cohort of 121 patients with at least six months of completed RT were prospectively included in the study. Cosmetic results were evaluated using a modified scoring system, and QOL was assessed using The European Cancer Treatment and Organization Committee tools. Results: The results showed that the inclusion of regional lymphatics in the RT treatment field significantly affected QOL, particularly in terms of role functioning and social functioning. Higher boost volume ratios were associated with increased pain-related symptoms. However, the presence of MMTs did not significantly affect cosmetic outcomes compared to unifocal tumours. Conclusion: The size of the boost and inclusion of regional lymphatics in RT significantly impact QOL in patients undergoing BCS. Tumour foci number does not affect cosmetic outcomes. These findings emphasize the need for careful consideration of RT volumes to minimize long-term adverse effects on QOL. Future prospective studies should evaluate early side effects and baseline QOL scores to provide a comprehensive assessment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the mediating role of psychological resilience as part of the effect of spiritual well-being in the supportive care needs of women with breast cancer. Materials and Methods: Cross-sectional design. The Connor-Davidson Resilience Scale Short Form, the Spiritual Well-Being Scale, and the Supportive Care Needs Survey Short Form were completed women with breast cancer treated at the oncology clinic of a university hospital. For the mediation model, Bootstrap methods with PROCESS Macro were used. Results: The study was conducted with 126 breast cancer patients. A significant negative, moderate relationship was found between supportive care needs and psychological resilience (r = -0.560). There was a significant negative, but weak relationship between supportive care needs and spiritual well-being (r = -0.385). The indirect effect of spiritual well-being on supportive care needs was significant, thus, psychological resilience was shown to have a mediating effect on the relationship between spiritual well-being and supportive care needs [b = -0.370, 95% confidence interval (- 0.5568, -0.1911)]. Conclusion: Psychological resilience appears to contribute to a reduction in supportive care needs of breast cancer patients by affecting spiritual well-being. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the extent of worry about breast cancer (BC) amongst a sample of women and to examine the effect of this on behavior to prevent BC. Materials and Methods: This cross-sectional study was conducted in 271 women aged 18 years and above who attended the Family Medicine Outpatient Clinic of a tertiary hospital and met the inclusion criteria. Data were collected using the following tools: Patient Information Form; Breast Cancer Worry Scale (BCWS); Breast Cancer Prevention Behaviors Identification Scale (BCPBIS); and Mammography Processes of Change Scale (MPCS). Results: When evaluated according to BCWS scores (mean 8.43 ± 3.36), the BC worry levels were found to be low. The behavior adopted for prevention was also found to be positive according to BCPBIS (mean 119 ± 15.26) and MPCS (mean 82.38 ± 12.81) scores. A significant correlation was found between the BCWS and both the BCPBIS and MPCS scores, and again between the BCPBIS and MPCS scores (p < 0.001 for all). There was a correlation with three scale scores in those who had knowledge about BC, and those who had regular clinical breast examination (BE) (p < 0.05 for all). The BCPBIS score was found to be higher in those aged between 41-65 years, those who had mammography, and performed p self-BE (p = 0.002; p < 0.001; p < 0.001, respectively). According to the MPCS score, mammography behaviors was found to be more positive in those who had regular gynecological examinations and those who had mammography (p = 0.08 and p = 0.011). Conclusion: The participants generally had low BC worry levels and had adopted positive behavior for prevention. Being informed about BC and screening and having regular BE increased BC worry. Those with high BC worry, those who had mammography before, those who had knowledge about BC and screening, and those who regularly performed BE showed more positive behaviors toward preventing BC. [ABSTRACT FROM AUTHOR]

Objective: Risk-reducing therapy with selective estrogen receptor (ER) modulators and aromatase inhibitors reduce breast cancer risk. However, the effects are limited to ER-positive breast cancer. Therefore, new agents with improved toxicity profiles that reduce the risk in ER-negative breast cancers are urgently needed. The aim of this prospective, short-term, prevention study was to evaluate the effect of dasatinib, an inhibitor of the tyrosine kinase Src, on biomarkers in normal (but increased risk) breast tissue and serum of women at high risk for a second, contralateral primary breast cancer. Materials and Methods: Women with a history of unilateral stage I, II, or III ER-negative breast cancer, having no active disease, and who completed all adjuvant therapies were eligible. Patients underwent baseline fine-needle aspiration (FNA) of the contralateral breast and serum collection for biomarker analysis and were randomized to receive either no treatment (control) or dasatinib at 40 or 80 mg/day for three months. After three months, serum collection and breast FNA were repeated. Planned biomarker analysis consisted of changes in cytology and Ki-67 on breast FNA, and changes in serum levels of insulin-like growth factor 1 (IGF-1), IGF-binding protein 1, and IGF-binding protein 3. The primary objective was to evaluate changes in Ki-67 and secondary objective included changes in cytology in breast tissue and IGF-related serum biomarkers. Toxicity was also evaluated. Results: Twenty-three patients started their assigned treatments. Compliance during the study was high, with 86.9% (20/23) of patients completing their assigned doses. Dasatinib was well tolerated and no drug-related grade 3 and 4 adverse events were observed. Since only one patient met the adequacy criteria for the paired FNA sample, we could not evaluate Ki-67 level or cytological changes. No significant change in serum biomarkers was observed among the three groups. Conclusion: Dasatinib was well tolerated but did not induce any significant changes in serum biomarkers. The study could not fulfill its primary objective due to an inadequate number of paired FNA samples. Further, larger studies are needed to evaluate the effectiveness of Src inhibitors in breast cancer prevention. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer is the most common malignancy in women all over the World. It is in the first line, causing deaths because of cancer in women worldwide. However, its progress differs regarding the counties’ socioeconomic and cultural features. The aim of this study is to estimate breast cancer mortality rates in Turkish women by geographic region and to evaluate 11-year mortality trends. Materials and Methods: Joinpoint Regression Analysis was used to estimate the trends of mortality from breast cancer by gender and age groups for every geographic region. Also, we used the world standard population (100,000 women) was used to estimate the age-standardized mortality rates as a reference to calculate age-standardized mortality rates. Results: We found that nearly 39,000 women died from breast cancer between the years 2009-2019. During this 11-year period, the age-standardized mortality rate in Turkey was 6.84 per 100,000 women in 2009, while it rose up to 8.16 in 2019 with a significant increase of 1.78 per year (Confidence Interval: 0.57:3.00) p=0.009). This change was observed especially in TR2, TR7, TR9, TRA, TRB and TRC regions. According to the age groups examined, significant increases were observed in all age groups in Turkey. Conclusion: Breast cancer is still a very important health problem in Turkish women of all ages. It is essential to take measures to reduce the breast cancer mortality rate and increase early diagnosis opportunities in our country. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is a major cancer threatening the health of women globally. To elucidate the effect of the circHIAT1/miR-19a-3p/phosphatase and tensin homolog (PTEN) axis on regulating the malignant phenotype of breast cancer cells. Methods: The mRNA expression pattern of circHIAT1, miR-19a-3p, and PTEN was checked by real-time quantitative polymerase chain reaction. Then, the knockdown assay was carried out to explore the effect of circHIAT1 and miR-19a-3p on breast cancer. The relative cell experiments, including MTT assay, scratch assay, transwell invasion assay, and flow cytometry analysis, were conducted to verify the influence of circHIAT1 and miR- 19a-3p on breast cancer cells. Results: The levels of PTEN and circHIAT1 were reduced, while that of miR-19a-3p was elevated in breast cancer tissues and cells. MiR-19a-3p was proved to be the target gene of circHIAT1 via a dual luciferase experiment, which could also modulate the PTEN mRNA level. Overexpression of circHIAT1 was able to undermine the growth, migratory ability, and invasiveness in breast cancer cells, which could be antagonized by miR- 19a-3p mimic. The inhibition of miR-19a-3p in vitro also impaired the malignancy of breast cancer, which depended on the modulation of PTEN expression. Conclusion: CircHIAT1 controls the PTEN expression level in cells of breast cancer by negatively regulating miR-19a-3p. This mechanism controls the growth, invasion, and migration of breast cancer. [ABSTRACT FROM AUTHOR]

Background: The protein encoded by ring finger protein 157 (RNF157) is known to function as an E3 ubiquitin ligase. However, whether the level of RNF157 expression in breast cancer correlates with prognosis and immune cell infiltration among breast cancer patients remains to be further explored. Methods: In this study, publicly available datasets were used for evaluating RNF157 expression in different tumors compared with normal samples. Several independent datasets were screened for investigating the relationship between RNF157 and breast cancer survival, different mutation profiles, and tumor immune cell infiltration. We conducted a pathway enrichment analysis to identify signaling pathways associated with RNF157. Results: Analysis of public and online databases revealed that RNF157 expression markedly decreased in breast cancer tissue samples compared to non-carcinoma counterparts. Consistently, immunohistochemistry assays also demonstrated this RNF157 down-regulation in breast cancer samples. RNF157 up-regulation could predict the improved survival of breast cancer cases. Further, different RNF157 expression level groups exhibited different mutational profiles. Pathway enrichment profiling of RNF157-related genes suggested its possible involvement in regulating breast cancer via the mitogen-activated protein kinase (MAPK) pathway. RNA sequencing (RNA-seq) data and genomic enrichment analysis showed that RNF157 downregulated several genes positively associated with the MAPK signaling pathway. We also explored RNF157 expression and immune cell infiltration in breast cancer and found that RNF157 mRNA levels were negatively related to non-T immune cell infiltration. Conclusion: According to our work, RNF157 may be a promising diagnostic biomarker and therapeutic target for breast cancer. [ABSTRACT FROM AUTHOR]

To compare the dosimetric parameters considering the Radiation Therapy Oncology Group (RTOG) and European Society for Radiotherapy and Oncology (ESTRO) guidelines for breast cancer radiotherapy. Two radiotherapy techniques, intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT), were considered. Twenty-eight patients with left-sided medially-located TanyN2M0 tumors were contoured based on RTOG and ESTRO guidelines. 9-field IMRT, 10-field IMRT, 11-field IMRT, and VMAT treatment plans were applied as radiotherapy (RT) techniques for both contouring sets. The dosimetric parameters of the RT plans were extracted and compared. Comparing dose-volume histogram (DVH) parameters, equivalent uniform dose (EUD), and normal tissue complication probability (NTCP) of OARs across the contouring guidelines and considering each RT technique showed that the only significant differences were higher D max , D mean , V 30 , and V 45 , EUD, and NTCP of the thyroid in all treatment modalities when the RTOG guideline had been adopted. Using the VMAT technique, PTV's EUD and the tumor control probability (TCP) were considerably higher when the ESTRO guideline was adopted. Moreover, the conformity index (CI) of VMAT plans was significantly higher when the ESTRO guideline was used. Unless having higher doses to thyroid when the RTOG guideline was adopted, the doses to other organs-at-risk (OAR) were similar between the two considering guidelines. Moreover, except for higher EUD, TCP, and CI for VMAT when the ESTRO guideline was used, no other significant differences were obtained between dosimetric parameters of target volumes considering the RT techniques and contouring guidelines. [ABSTRACT FROM AUTHOR]

Deep inspiration breath hold (DIBH) is used to decrease the dose of radiotherapy delivered to the heart. There is a need to define criteria to select patients with the potential to derive a real clinical benefit from DIBH treatment. Our study's main goal was to investigate whether two CT-scan cardiac anatomical parameters, cardiac contact distance in the parasagittal plane (CCDps) and lateral heart-to-chest distance (HCD), were predictive of unmet dosimetric cardiac constraints for left breast and regional nodal irradiation (RNI). This retrospective single-institution dosimetric study included 62 planning CT scans of women with left-sided breast cancer (BC) from 2016 to 2021. Two independent radiation oncologists measured HCD and CCDps twice to assess inter- and intra-observer reproducibility. Dosimetric constraints to be respected were defined, and dosimetric parameters of interest were collected for each patient. Mean heart dose was 7.9 Gy. Inter-rater reproducibility between the two readers was considered excellent. The mean heart dose constraint < 8 Gy was not achieved in 25 patients (40%) and was achieved in 37 patients (60%). There was a significant correlation between mean heart dose and HCD (r s = –0.25, P = 0.050) and between mean heart dose and CCDps (r s = 0.25, P = 0.047). The correlation between HCD and CCDps and unmet cardiac dosimetric constraints was not statistically significant. Our dosimetric analysis did not find that the cardiac anatomical parameters HCD and CCDps were predictive of unmet dosimetric cardiac constraints, nor that they were good predictors for cardiac exposure in left-sided BC radiotherapy comprising RNI. [ABSTRACT FROM AUTHOR]

Despite the advancements in breast cancer (BrC) diagnosis and treatment, a considerable proportion of patients with early-stage disease still experience local recurrence or metastasis. This study aimed to assess the levels of specific angiogenic parameters in the EDTA plasma of BrC patients before and after treatment and to explore their clinical and prognostic significance. The levels of vascular endothelial growth factor A (VEGF-A), soluble form of vascular endothelial growth factor receptor type 1 (sVEGFR1), and soluble form of vascular endothelial growth factor receptor type 2 (sVEGFR2) were measured in 84 early BrC patients, both prior to surgery and within a median time of nine months post-treatment. Prognostic significance was evaluated using Kaplan-Meier survival and Cox regression analyses. Linear regression models were employed to examine the independent impact of selected angiogenic factors on DFS in breast cancer patients. The results of uni- and multivariate analyses indicated that a pre-treatment concentration of sVEGFR1 above 30.99 pg/mL was associated with improved disease-free survival (DFS) (p < 0.0001 for both analyses), while a pre-treatment concentration of sVEGFR2 above 9475.67 pg/mL was associated with an increased risk of BrC relapse (p < 0.0001 for both analyses). Additionally, a post-treatment concentration of sVEGFR2 above 7361.71 pg/mL was associated with better overall survival (OS) based on the Kaplan-Meier survival analysis (p = 0.0141). Furthermore, linear regression models revealed a significant inverse association between pre-treatment levels of sVEGFR1 and the risk of relapse (standardized β −0.2578, p = 0.0499) and a significant positive association of VEGF-A levels with the risk of recurrence (standardized β 0.2958, p = 0.0308). In conclusion, the findings suggest that both pre- and post-treatment levels of sVEGFR1 and sVEGFR2 may hold promise as potential prognostic markers for BrC patients. [ABSTRACT FROM AUTHOR]

Purpose: In recent years, several new targeted therapies have emerged for advanced breast cancer (aBC). However, real-life data specific to aBC and different breast cancer subtypes are scarce. This retrospective cohort study was designed to describe the distribution of aBC subtypes, incidence, treatment patterns, survival, and PIK3CA hotspot mutation frequency. Methods: The study included all patients in the Hospital District of Southwest Finland diagnosed with aBC between 2004 and 2013 and with a sample available in Auria Biobank. In addition to registry-based data collection, 161 HR+/HER2− aBCs were screened for PIK3CA mutations. Results: Altogether, 54.7% of the 444 patients included in the study had luminal B subtype. The smallest representations were in HR−/HER2+ (4.5%) and triple-negative (5.6%) subgroups. The percentage of aBC among all diagnosed breast cancers increased until 2010, after which it remained stable. The triple-negative cancers were associated with shorter median overall survival (5.5 months) compared to other subgroups (16.5–24.6 months). Most (84%) triple-negative cancers also metastasized during the first two years, whereas this was more evenly distributed over time in other subgroups. Of the HR+/HER2− tumors, 32.3% harbored a PIK3CA hotspot mutation. These patients, however, did not have inferior survival compared to patients with PIK3CA wild-type cancers. Conclusion: This study described real-world aBC subgroups and indicated that the clinical outcomes of subgroups vary. Although PIK3CA hotspot mutations did not lead to inferior survival, they are relevant as possible treatment targets. Overall, these data could be utilized to further evaluate the subgroup-specific medical needs in breast cancer. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most commonly diagnosed neoplasms affecting women worldwide, and it remains a leading cause of both mortality and morbidity. While genetic predisposition plays a critical role in the development of this neoplasm, significant epigenetic dysregulations accompany existing variants. The emergence of acquired drug resistance to current chemotherapeutics poses a significant challenge in managing therapy. However, progress has been made in developing novel agents that directly target epigenetic modifications. These agents, called "epi-drugs," can be used alone in the clinic or in combination with current treatment regimens, offering the potential to create diversified effects on the disease's predictive process. Within the scope of this review, general information about the major epigenetic dysregulations in breast cancer will be provided, and their effects on the molecular mechanisms in the carcinogenesis process will be discussed. Furthermore, current treatment approaches for breast cancer will be explored, classifying these epi-drugs, such as DNA methyltransferase inhibitors (DNMTIs), histone deacetylase inhibitors (HDACIs), histone acetyltransferases (HATIs), and others that have been developed to target these mechanisms. Predictions regarding the future prospects of these epi-drugs are highlighted, and their contributions to the field of personalized medicine are emphasized based on the results obtained from clinical studies. [ABSTRACT FROM AUTHOR]

Developing a living prosthetic breast to inhibit potential breast cancer recurrence and simultaneously promote breast reconstruction would be a promising strategy for clinical treatment of breast cancer after mastectomy. Here, a living prosthetic breast in the form of injectable gelatin methacryloyl microspheres is prepared, where they encapsulated zeolitic imidazolate framework (ZIF) nanoparticles loaded with small molecules urolithin C (Uro‐C) and adipose‐derived stem cells (ADSCs). Taking advantage of the acidic tumor microenvironment, the ZIF triggered a pH‐sensitive drug release in situ so that Uro‐C can induce tumor cell apoptosis via reactive oxygen species (ROS) generation. Meanwhile, the ADSCs proliferate in situ to promote tissue regeneration. Using such a design, our data showed that the ADSCs maintained viable and proliferate under the inhibitory effect of Uro‐C in vitro. Through ROS generation, Uro‐C also activated a suppressive tumor microenvironment in mice by both re‐polarizing M2 macrophages to M1 macrophages for elevated inflammatory responses, and increasing the ratio between CD8 and CD4 T cells for tumor recurrence inhibition, significantly promoting new adipose tissue formation. Altogether, our results demonstrate that the prepared living prosthetic breast with bifunctional properties can be a promising candidate in clinic involving tumor treatment and tissue engineering in synergy. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer (BC) occurs more frequently in white (W) women than in African American (AA) women, but AA women die at a greater rate from BC than W women. Disparities exist in all aspects of the disease, from screening and early detection, to access to and completion of treatment. There are reports that adverse events from treatment also occur more frequently in AA patients. Here, we showed differences in treatments administered to AA women using the SEER-Medicare dataset. We found that AA women receive universally less treatment in every category of cancer and stage in the setting of the National Claims History database of Oncology practice providers. The drugs used to treat BC were relatively similar between the two races. Still, there were small differences in rates of administration of drugs that caused higher rates of side effects, which caused higher overall rates of adverse events in AA patients. The data suggest that the setting where AA patients receive care affects their treatment rate and adverse events. It is possible that higher rates of recorded adverse events result in lower rates of treatment or completion of treatment in AA women with BC. Despite lower incidence rates, African American (AA) patients have shorter survival from breast cancer (BC) than white (W) patients. Multiple factors contribute to decreased survival, including screening disparities, later presentation, and access to care. Disparities in adverse events (AEs) may contribute to delayed or incomplete treatment, earlier recurrence, and shortened survival. Here, we analyzed the SEER-Medicare dataset, which captures claims from a variety of venues, in order to determine whether the cancer care venues affect treatment and associated adverse events. We investigated a study population whose claims are included in the Outpatient files, consisting of hospital and healthcare facility venues, and a study population from the National Claims History (NCH) files, consisting of claims from physicians, office practices, and other non-institutional providers. We demonstrated statistically and substantively significant venue-specific differences in treatment rates, drugs administered, and AEs from treatments between AA and W patients. We showed that AA patients in the NCH dataset received lower rates of treatment, but patients in the Outpatient dataset received higher rates of treatment than W patients. The rates of recorded AEs per treatment were higher in the NCH setting than in the Outpatient setting in all patients. AEs were consistently higher in AA patients than in W patients. AA patients had higher comorbidity indices and were younger than W patients, but these variables did not appear to play roles in the AE differences. The frequency of specific anticancer drugs administered in cancer- and venue-specific circumstances and their associated AEs varied between AA and W patients. The higher AE rates were due to slightly higher frequencies in the administration of drugs with higher associated AE rates in AA patients than in W patients. Our investigations demonstrate significant differences in treatment rates and associated AEs between AA and W patients with BC, depending on the venues of care, likely contributing to differences in outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Constituting 15 to 20% of breast cancer cases, the triple-negative subtype lacks effective treatments as being less responsive to hormone-associated therapies. Alternatively, a more powerful immunotherapeutic vaccination can trigger immune recognition and destruction against breast cancer by incorporating oncological antigens such as human epidermal growth factor receptor 2 (HER2/neu). Currently, HER2/neu-based vaccines have finished three phases with breast cancer patients, in conjunction with granulocyte-macrophage colony-stimulating factor (GM-CSF) that was proven to be a promising vaccine adjuvant in other cancer trials previously. Methods: Completed HER2/neu-based vaccine trials with GM-CSF immunoadjuvants for breast cancer were summarised, and additionally, the article discussed prominent findings of vaccine effectiveness in triple-negative breast cancer, regarding li-Key hybrid in vaccine design and co-administration of anti-HER2/neu trastuzumab. Results: Nine clinical trials of three HER2/neu epitopes, one with li-Key hybrid, were analysed with or without the presence of trastuzumab. Immunological responses and minimal toxicities were observed in these epitopes, and disease-free survival was especially improved in the triple-negative population. Conclusion: HER2/neu-based peptide vaccine is a safe and effective approach against breast cancer, and its benefits can be potentially furthered by combining the li-Key hybrid vaccine with targeted drugs and adjuvants selected to enhance cross-presentation for exogenous vaccine antigens. [ABSTRACT FROM AUTHOR]

In recent years, laser photothermal therapy of cancers, as a new adjuvant treatment, has attracted a lot of attention. Nanoparticles have been applied to increase the effect of plasmonic photothermal therapy (PPTT) with decreasing side effects. Plasmonic photothermal therapy using gold nanoparticles (Au NPs) has been employed as a novel approach for PPTT. In this research, Au NPs were green synthesized by utilizing Rutin extract as a stabilizing and reducing agent. Afterward, structural and physical characteristics were evaluated by the use of transmission electron microscopy (TEM), and visible–ultraviolet spectrophotometer (UV–Vis). Biocompatibility and cytotoxicity of nanoparticles are tested using the MTT method. The therapeutic effect of this nanoparticle on breast cancer cells was investigated in vitro using a laser with a power of 500 mW and a wavelength of 532 nm. Microscopic images revealed that the synthesized Au NPs had the mean size of 40 nm and a roughly spherical form. The results indicate the selective and effective anticancer function of Ru-Au NPs, in addition to low cytotoxicity and better biocompatibility for normal cells. Also, the findings demonstrate the significant efficacy of Ru-Au NPs coupled with laser radiation (150 J/cm2 of laser energy for 300 s) in the treatment of breast cancer MCF-7 cells. As a result of the study, an ecoenvironmental nanoplatform for PPTT against MCF-7 human breast cancer cell line with excellent anticancer function and acceptable biocompatibility has been developed. [ABSTRACT FROM AUTHOR]