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Abstract Background Female breast cancer stands as the prime type of cancer in the Kingdom of Saudi Arabia (KSA), with a high incidence and mortality rates. This study assessed the burden of female breast cancer in KSA by analyzing and forecasting its incidence, mortality, and disability-adjusted life years (DALYs). Methods We retrieved data from the Global Burden of Disease (GBD) about female breast cancer from 1990 to 2021. Time-series analysis used the autoregressive integrated moving average (ARIMA) model to forecast female breast cancer statistics from 2022 to 2026. Results From 1990 to 2021, KSA reported 77,513 cases of female breast cancer. The age groups with the highest number of cases are 45–49 years, followed by 40–44 years, 50–54 years, and 35–39 years. The analysis also showed fewer cases in the younger age groups, with the lowest number in the less than 20-year-old age group. From 1990 to 2021, KSA reported 19,440 deaths due to breast cancer, increasing from 201 cases in 1990 to 1,190 cases in 2021. The age-standardized incidence rate/100,000 of breast cancer increased from 15.4 (95% confidence interval (CI) 11.2–21.0) in 1990 to 46.0 (95%CI 34.5–61.5) in 2021. The forecasted incidence rate of female breast cancer will be 46.5 (95%CI 45.8–46.5) in 2022 and 49.6 (95%CI 46.8–52.3) in 2026. The age-standardized death rate per 100,000 Saudi women with breast cancer increased from 6.73 (95%CI 6.73–9.03) in 1990 to 9.77 (95%CI 7.63–13.00) in 2021. The forecasted female breast cancer death rate will slightly decrease to 9.67 (95%CI 9.49–9.84) in 2022 and to 9.26 (95%CI 8.37–10.15) in 2026. DALYs increased from 229.2 (95%CI 165.7–313.6) in 1990 to 346.1 (95%CI 253.9–467.2) in 2021. The forecasted DALYs of female breast cancer will slightly decrease to 343.3 (95%CI 337.2–349.5) in 2022 reaching 332.1 (95%CI 301.2–363.1) in 2026. Conclusions Female breast cancer is still a significant public health burden that challenges the health system in KSA, current policies and interventions should be fashioned to alleviate the disease morbidity and mortality and mitigate its future burden.

Background Female breast cancer remains the most common malignant disease and a leading cause of death worldwide. We aim to follow up on the annual dynamics of its incidence, prevalence and mortality rates in the region of Varna, Bulgaria. Methods Data for the recent retrospective analyses was accessed through the information system of Marko Markov Specialized Hospital for Oncological Diseases of Varna for 2017-2021 and two most recent publications for 2013-2017, in accordance with the Medical University-Varna Ethical committee guidelines. Results The total number of newly registered cases of breast cancer in women aged between 24 and 95 years amounted to 1,341. Mean crude incidence rate in 2017-2021 was 108.83 per 100,000, ranging from 119.89 to 105.25 per 100,000 in 2017 and 2020, respectively. The age group of 61-70 years was most affected (26.55% of the cases). Mean crude prevalence rate during this period was 1496.32 per 100,000, varying from 1447.75 to 1549.71 per 100 000 in 2017 and 2020, respectively. The total number of deaths until the end of 2022 reached 310 with 2018 being the greatest in mortality rate (30.22% of the cases). In 2017-2021, bilateral breast cancer was diagnosed as synchronous in 15 women and metachronous in 9 women. Conclusions The regular regional epidemiological investigations could contribute to the enhancement of the effectiveness and quality of prevention, timely diagnosis and adequate complex treatment.

Background: Female breast cancer stands as the prime type of cancer in the Kingdom of Saudi Arabia (KSA), with a high incidence and mortality rates. This study assessed the burden of female breast cancer in KSA by analyzing and forecasting its incidence, mortality, and disability-adjusted life years (DALYs). Methods: We retrieved data from the Global Burden of Disease (GBD) about female breast cancer from 1990 to 2021. Time-series analysis used the autoregressive integrated moving average (ARIMA) model to forecast female breast cancer statistics from 2022 to 2026. Results: From 1990 to 2021, KSA reported 77,513 cases of female breast cancer. The age groups with the highest number of cases are 45–49 years, followed by 40–44 years, 50–54 years, and 35–39 years. The analysis also showed fewer cases in the younger age groups, with the lowest number in the less than 20-year-old age group. From 1990 to 2021, KSA reported 19,440 deaths due to breast cancer, increasing from 201 cases in 1990 to 1,190 cases in 2021. The age-standardized incidence rate/100,000 of breast cancer increased from 15.4 (95% confidence interval (CI) 11.2–21.0) in 1990 to 46.0 (95%CI 34.5–61.5) in 2021. The forecasted incidence rate of female breast cancer will be 46.5 (95%CI 45.8–46.5) in 2022 and 49.6 (95%CI 46.8–52.3) in 2026. The age-standardized death rate per 100,000 Saudi women with breast cancer increased from 6.73 (95%CI 6.73–9.03) in 1990 to 9.77 (95%CI 7.63–13.00) in 2021. The forecasted female breast cancer death rate will slightly decrease to 9.67 (95%CI 9.49–9.84) in 2022 and to 9.26 (95%CI 8.37–10.15) in 2026. DALYs increased from 229.2 (95%CI 165.7–313.6) in 1990 to 346.1 (95%CI 253.9–467.2) in 2021. The forecasted DALYs of female breast cancer will slightly decrease to 343.3 (95%CI 337.2–349.5) in 2022 reaching 332.1 (95%CI 301.2–363.1) in 2026. Conclusions: Female breast cancer is still a significant public health burden that challenges the health system in KSA, current policies and interventions should be fashioned to alleviate the disease morbidity and mortality and mitigate its future burden. [ABSTRACT FROM AUTHOR]

PurposeTo identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership.MethodsWomen with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles.ResultsThree distinct EI profiles (i.e., None - 26.2% (n = 101), Low - 42.6% (n = 164), High - 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function.ConclusionsThis study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.

IntroductionIn Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, few associations have been reported between environmental factors and breast cancer mortality in women. The aim of this study was to investigate the relationships between residence in areas with high environmental pressures, female breast cancer characteristics, and death rate.MethodsData from the Taranto Cancer Registry were used, including all women with invasive breast cancer diagnosed between 01 January 2015 and 31 December 2020 and with follow-up to 31 December 2021. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics.ResultsA total of 10,445 person-years were observed. Variables associated with higher death rate were residence in the contaminated site of national interest (SIN) (HR 1.22, 95% CrI 1.01–1.48), pathological/clinical stage III (HR 2.77, 95% CrI 1.93–3.97) and IV (HR 17.05, 95% CrI 11.94–24.34), histological grade 3 (HR 2.50, 95% CrI 1.20–5.23), Ki-67 proliferation index of 21–50% (HR 1.42, 95% CrI 1.10–1.83) and > 50% (HR 1.81, 95% CrI 1.29–2.55), and bilateral localization (HR 1.65, 95% CrI 1.01–2.68). Variables associated with lower death rate were estrogen and/or progesterone receptor positivity (HR 0.61, 95% CrI 0.45–0.81) and HER2/neu oncogene positivity (HR 0.59, 95% CrI 0.44–0.79).DiscussionThe findings confirmed the independent prognostic values of different female breast cancer characteristics. Even after adjusting for patients and disease characteristics, residence in the SIN of Taranto appeared to be associated with an increased death rate.

This study aimed to use Artificial Intelligence (AI) Deep Learning (DL) techniques to predict female breast cancer detected by ultrasound based on clinical data and Breast Imaging Reporting and Data System (BI-RADS) Ultrasound (US) descriptors. We retrospectively gathered data on clinical information and BI-RADS US descriptors of breast lesions from 1051 female patients, forming a comprehensive dataset. Two datasets (A and B) were derived by selecting different variables. A BI-RADS DL-based Network (BD-Net) was developed and trained on Dataset A and B, and its performance was evaluated on an external test set. Radiologists also classified Dataset B and the external test set using BI-RADS US. Performance in predicting the probability of malignancy was evaluated by calculating the Area Under Curve (AUC), accuracy, sensitivity, and specificity. BD-Net achieved an accuracy of 92.5% (95%CI, 90.5–94.2) in predicting breast cancer with a sensitivity of 93.0% (95%CI, 90.3–95.4), a specificity of 92.1% (95%CI, 89.7–94.6), and an AUC of 0.97 (95%CI, 0.96–0.98) on the training data set of dataset A. On the external dataset, the BD-Net showed a sensitivity of 93.8% (95%CI, 87.5–98.8), a specificity of 91.0% (95%CI, 85.0–96.0), and an AUC of 0.92 (95%CI, 0.88–0.97) for predicting breast cancer. The radiologists predicted breast cancer on Dataset B and the external test set with AUC values between 0.75 (95%CI, 0.75–0.79) and 0.82 (95%CI, 0.77–0.87). These results indicate that the BD-Net is effective for predicting ultrasound-detected female breast cancer.

Letrozole is a non steroidal, highly selective oral third-generation aromatase inhibitor, which can counter combine with aromatase to inhibit the transformation of testosterone into estradiol and androstenedione into estrone, thereby significantly reducing the level of peripheral estrogen. Letrozole can be used to treat postmenopausal women with breast cancer. It has obvious curative effect on hormone dependent diseases in gynecology and obstetrics, and has few adverse reactions. The article reviews the research on letrozole in the treatment of ovulatory infertility, endometriosis, adenomyosis, precocious puberty, estrogen related gynecological tumors and the prevention of ovarian hyperstimulation syndrome. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore the determinants of time to presentation of women with breast cancer symptoms within a rural setting in Kenya. Design: A critical ethnographic study. Methods: Data were collected between July 2019 and April 2020 using semi‐structured interviews and focus groups with 12 women and 23 disclosure recipients, respectively. Interviews and focus group discussions were audio recorded, transcribed verbatim, translated into English and thematically analysed. Further analysis using an intersectional lens added new insights into the data. Ethics approval was obtained in both Kenya and United Kingdom. Results: Participants narrated their experiences from the time they self‐discovered breast cancer symptoms to the time they first came into contact with a healthcare professional. The core themes identified included local cancer knowledge, embodied experience, women's responses, social networks, cultural cancer schemas, gendered social structures and healthcare system experiences. Conclusion: The findings revealed that symptomatic women predominantly faced multiple intersecting barriers to timely presentation. The key drivers of timeliness to presentation of women with breast cancer symptoms were identified. Several proximal and distal determinants, including economic, social, psychological and cultural determinants intersected to shape women's timeliness to symptomatic presentation. Impact: This study identified intersectional structural determinants to timely symptomatic presentation of women with breast cancer symptoms. The findings have global health implications for social inequalities in female breast cancer and may inform the development of intersectional interventions to promote timely symptomatic presentation. Furthermore, this study identified an additional interval, precursory interval and revision of the Model of pathway to treatment may be needed should this interval be validated by future studies. Patient or public contribution: To ensure the interview guides were culturally sensitive, they were co‐designed with a female breast cancer survivor, nurses providing reproductive health care to women and a bilingual expert. Both women and disclosure recipients participated in scheduling for the interviews, including the mutually agreeable days and time. Participants were frequently contacted during data analysis and report writing to clarify meaning of certain words or pieces of data. [ABSTRACT FROM AUTHOR]

Abstract Background Breast cancer is a widespread disease in women worldwide. Aim We aimed to explore the global epidemiological trends of female breast cancer (FBC) between 1990 and 2044. Methods and Results Disease burden, population, and socio‐demographic index (SDI) data were obtained from the Global Health Data Exchange (GHDx) database. We analyzed temporal trends, age differences, risk factors, and geographic patterns of FBC disease burden globally and explored the association between age‐standardized incidence rate (ASIR) of FBC and SDI. Bayesian age‐period‐cohort model was also performed to predict the changes in FBC incidence worldwide from 2020 to 2044. First, the global ASIR of FBC increased by 14.31% from 1990 to 2019 (95% Uncertainty Interval 4.75% to 23.98%). The death rate presented a falling trend. Second, alcohol use is the most‐highlighted risk factor for FBC in some high‐income regions such as Europe. A high fasting plasma glucose levels is the most prominent risk factor for FBC in Latin America and Africa. Third, the ASIR of the FBC increases with the SDI. Fourth, the incidence is expected to increase faster among women aged 35–60 years and fastest for those aged 50–54 years from 2020 to 2044. Countries with a high incidence of FBC that is expected to increase significantly include Barbados, Burkina Faso, Senegal, Monaco, Lebanon, Togo, and Uganda. Conclusion The disease burden of FBC varies worldwide; the findings suggest attaching importance to the control of middle and low‐middle SDI regions. Public health as well as cancer prevention experts should pay more attention to regions and populations at an increased risk of developing FBC, focusing on their prevention and rehabilitation while conducting further epidemiological studies to investigate the risk factors of their increase.

In mammalian cells, DNA damage response initiates repair by error-free homologous recombination (HRR) or by error-prone non-homologous end joining (NHEJ). DNA damage is detected by PARP proteins that facilitate this repair, both in normal cells and in cancer cells. Cells containing BRCA1/2 mutations have an HRR-deficient repair mechanism which may result in unrepaired one-ended double-strand breaks and stalled replication forks, considered as the most lethal cell damage. Here, we review the state of the art of the role of Poly (ADP-ribose) polymerase (PARP) inhibitors as a precision-targeted anticancer drug in BRCA1/2-mutated female breast cancer. Although knowledge is incomplete, it is assumed that the main role of the archetype PARP1 in the cell nucleus is to detect and adhere to single-strand breaks. This mediates possible damage repair, after which cells may continue replication; this process is called synthetic lethality. As for PARP clinical monotherapy, progression-free survival has been observed using the FDA- and EMA-approved drugs olaparib and talazoparib. In the case of combined drug therapy, a synergy has been demonstrated between veliparib and platinum drugs. Information regarding adverse effects is limited, but hematological effects have been described. However, there is need for multicenter trials, preferably conducted without commercial guidance and funding. Some of the available trials reported resistance to PARP inhibitors. In this review, we also describe the various causes of resistance to PARP inhibitors and research indicating how resistance can be overcome. [ABSTRACT FROM AUTHOR]

Abstract Purpose To identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership. Methods Women with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles. Results Three distinct EI profiles (i.e., None – 26.2% (n = 101), Low – 42.6% (n = 164), High – 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function. Conclusions This study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.

Abstract Background Female breast cancer (FBC) is a malignancy involving multiple risk factors and has imposed heavy disease burden on women. We aim to analyze the secular trends of mortality rate of FBC according to its major risk factors. Methods Death data of FBC at the global, regional, and national levels were retrieved from the online database of Global Burden of Disease study 2017. Deaths of FBC attributable to alcohol use, high body-mass index (BMI), high fasting plasma glucose (FPG), low physical activity, and tobacco were collected. Estimated average percentage change (EAPC) was used to quantify the temporal trends of age-standardized mortality rate (ASMR) of FBC in 1990–2017. Results Worldwide, the number of deaths from FBC increased from 344.9 thousand in 1990 to 600.7 thousand in 2017. The ASMR of FBC decreased by 0.59% (95% CI, 0.52, 0.66%) per year during the study period. This decrease was largely driven by the reduction in alcohol use- and tobacco-related FBC, of which the ASMR was decreased by 1.73 and 1.77% per year, respectively. In contrast, the ASMR of FBC attributable to high BMI and high FPG was increased by 1.26% (95% CI, 1.22, 1.30%) and 0.26% (95% CI, 0.23, 0.30%) per year between 1990 and 2017, respectively. Conclusions The mortality rate of FBC experienced a reduction over the last three decades, which was partly owing to the effective control for alcohol and tobacco use. However, more potent and tailored prevention strategies for obesity and diabetes are urgently warranted.

Introduction: Due to the lack of randomized controlled trial, the effectiveness and oncological safety of nipple-excising breast-conserving therapy (NE-BCT) for female breast cancer (FBC) remains unclear. We aimed to explore and investigate the prognostic value of NE-BCT versus nipple-sparing breast-conserving therapy (NS-BCT) for patients with early FBC. Methods: In this cohort study, data between NE-BCT and NS-BCT groups of 276,661 patients diagnosed with tumor–node–metastasis (TNM) stage 0–III FBC from 1998 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching analysis, Kaplan–Meier, X-tile, Cox proportional hazards model, and competing risk model were performed to evaluate the effectiveness and oncological safety for patients in NE-BCT and NS-BCT groups. Results: A total of 1,731 (0.63%) patients received NE-BCT (NE-BCT group) and 274,930 (99.37%) patients received NS-BCT (NS-BCT group); 44,070 subjects died after a median follow-up time of 77 months (ranging from 1 to 227 months). In the propensity score matching (PSM) cohort, NE-BCT was found to be an adversely independent prognostic factor affecting overall survival (OS) [hazard ratio (HR), 1.24; 95% CI, 1.06–1.45, p =0.0078]. Subjects in NE-BCT group had similar breast-cancer-specific survival (BCSS) (HR, 1.15; 95%CI, 0.88–1.52, p =0.30) and worse other-causes-specific death (OCSD) (HR, 1.217; 95%CI, 1.002–1.478, p =0.048<0.05) in comparison with those in the NS-BCT group. Conclusions: Our study demonstrated that the administration of NE-BCT is oncologically safe and reliable and can be widely recommended in clinics for women with non-metastatic breast cancer. [ABSTRACT FROM AUTHOR]

Study of socioeconomic factors can play an important role in the spatial distribution of breast cancer by leading to a better understanding of its spatial pattern and assist breast cancer screening and early diagnosis. Taking Nanchang, a major city in central China, as an example, spatial autocorrelation and stratified heterogeneity were applied using a 10 10 km grid division to analyse breast cancer risk and socioeconomic factors. The research results showed that the median incidence rate of female breast cancer in Nanchang from 2016 to 2018 was 6.6/100,000 with a standard deviation of 12.3/100,000. Areas with higher incidence rates were mainly located in the central urban area and the major county towns. Spatial regression analysis showed that there was a statistically significant correlation between the spatial patterns of breast cancer incidence on the one hand, and on the other socioeconomic factors, such as total gross domestic product (GDP), per capita GDP and density of places of social and economic activities, i.e. points of interest. In addition, the normalized difference vegetation index also played a part in this respect. This research could serve as a reference for regional public health policy formulation and breast cancer screening.

IntroductionDue to the lack of randomized controlled trial, the effectiveness and oncological safety of nipple-excising breast-conserving therapy (NE-BCT) for female breast cancer (FBC) remains unclear. We aimed to explore and investigate the prognostic value of NE-BCT versus nipple-sparing breast-conserving therapy (NS-BCT) for patients with early FBC.MethodsIn this cohort study, data between NE-BCT and NS-BCT groups of 276,661 patients diagnosed with tumor–node–metastasis (TNM) stage 0–III FBC from 1998 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching analysis, Kaplan–Meier, X-tile, Cox proportional hazards model, and competing risk model were performed to evaluate the effectiveness and oncological safety for patients in NE-BCT and NS-BCT groups.ResultsA total of 1,731 (0.63%) patients received NE-BCT (NE-BCT group) and 274,930 (99.37%) patients received NS-BCT (NS-BCT group); 44,070 subjects died after a median follow-up time of 77 months (ranging from 1 to 227 months). In the propensity score matching (PSM) cohort, NE-BCT was found to be an adversely independent prognostic factor affecting overall survival (OS) [hazard ratio (HR), 1.24; 95% CI, 1.06–1.45, p=0.0078]. Subjects in NE-BCT group had similar breast-cancer-specific survival (BCSS) (HR, 1.15; 95%CI, 0.88–1.52, p=0.30) and worse other-causes-specific death (OCSD) (HR, 1.217; 95%CI, 1.002–1.478, p=0.048

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Female breast cancer, ovarian cancer, cervical cancer, and endometrial cancer are the most common tumors and the most common causes of cancer-related mortality worldwide in women. Drugs derived from natural plants play important roles in malignant tumor therapy. Salvia miltiorrhiza is a commonly used Chinese herb which has been used in the treatment of liver diseases and cardiovascular diseases because of its positive effect of promoting blood circulation, increasing oxidative stress, and removing blood stasis. Recently, studies have found that fat-soluble components of Salvia miltiorrhiza such as tanshinone II, tanshinone I, cryptotanshinone, and dihydrotanshinone I displayed good antitumor activity in vivo and in vitro for gynecological cancer by different molecular mechanisms. In this study, the latest research progress on the antitumor effect and mechanism of tanshinone compounds in breast cancer and gynecological cancer was reviewed to provide references for the research and clinical application of these compounds (tanshinone II, tanshinone I, cryptotanshinone, and dihydrotanshinone I). [ABSTRACT FROM AUTHOR]

Female breast cancer, ovarian cancer, cervical cancer, and endometrial cancer are the most common tumors and the most common causes of cancer-related mortality worldwide in women. Drugs derived from natural plants play important roles in malignant tumor therapy. Salvia miltiorrhiza is a commonly used Chinese herb which has been used in the treatment of liver diseases and cardiovascular diseases because of its positive effect of promoting blood circulation, increasing oxidative stress, and removing blood stasis. Recently, studies have found that fat-soluble components of Salvia miltiorrhiza such as tanshinone II, tanshinone I, cryptotanshinone, and dihydrotanshinone I displayed good antitumor activity in vivo and in vitro for gynecological cancer by different molecular mechanisms. In this study, the latest research progress on the antitumor effect and mechanism of tanshinone compounds in breast cancer and gynecological cancer was reviewed to provide references for the research and clinical application of these compounds (tanshinone II, tanshinone I, cryptotanshinone, and dihydrotanshinone I).

Competing Interests: Conflicts of interest None disclosed.

Background: Previous studies found that the long-term survival of male breast cancer patients differed from those of female patients, however, the conclusions were contradictory. We conducted the study to examine the sex disparity in breast cancer survival by carefully controlling demographic and clinical factors using data from the Shanghai Cancer Registry (SCR)., Methods: Every male breast cancer patient was matched with four female patients by the diagnosis year, age, stage, and histology. We used Kaplan-Meier survival estimates to calculate the cumulative observed overall survival (OS) and cancer-specific survival (CSS) rates and log-rank tests to compare the survival rates by sex. We used Cox proportional-hazards regression models to assess the association between sex and risk of death., Results: A total of 50,958 patients with breast cancer (0.85% male) were registered in the SCR between 2002 and 2013. After matching, 434 male and 1,736 female patients were included in the study. With a median follow-up of 10 years, men with breast cancer showed worse OS (P<0.001) and CSS (P<0.001) than did women. The 5- and 10-year OS rates for male and female patients were 67.27% and 77.75%, and 45.95% and 62.60%, respectively; the 5- and 10-year CSS rates for male and female patients were 70.19% and 79.79%, and 50.57% and 67.20%, respectively. Compared with women, men had 65% increased risk of overall death [95% confidence interval (CI): 1.42-1.92] and 70% increased risk of cancer-specific death (95% CI: 1.44-2.00)., Conclusions: This study found male patients with breast cancer had poorer long-term survival than women in China., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tbcr.amegroups.org/article/view/10.21037/tbcr-24-3/coif). Y.Z. serves as the unpaid editorial board member of Translational Breast Cancer Research from May 2023 to April 2025. The other authors have no conflicts of interest to declare., (2024 Translational Breast Cancer Research. All rights reserved.)

Background: Obesity is a known risk factor for many cancers. Although bariatric surgery has been associated with a decrease in the risk of developing cancer, data on the effect of bariatric surgery on female-specific cancers are limited. This study aimed to assess the impact of bariatric interventions on the development of endometrial, ovarian and breast cancer. Methods: The New York Statewide Planning and Research Cooperative System database was used to identify all female patients without a pre-existing cancer diagnosis who had a diagnosis of obesity between 2006 and 2012. The risk of having female-specific cancer diagnosis in patients who underwent bariatric surgery were compared with those who had no bariatric interventions using multivariable proportional sub-distribution hazard regression analysis. Subsequent cancer diagnoses were followed up to 2016. Results: We identified 55,781 and 247,102 obese female patients who had and did not have bariatric surgery, respectively. The overall incidence of female-specific cancer was 2.69% and 2.09% for the non-surgery and surgery groups, respectively (p < 0.0001). Surgery patients were less likely to develop female-specific cancers [hazard ratio (HR) 0.78; 95% CI 0.73–0.83; p < 0.0001]. Patients undergoing Roux-en-Y gastric bypass had a lower risk of developing female-specific cancer than laparoscopic sleeve gastrectomy (HR 0.66; 95% CI 0.51–0.87; p = 0.0056) and laparoscopic adjustable gastric banding (HR 0.83; 95% CI 0.69–0.99; p = 0.0056) patients. Conclusions: Patients undergoing bariatric surgery have a lower incidence of endometrial, female breast and ovarian cancer than non-surgery obese patients. These data suggest that bariatric interventions may reduce the risk of female-specific cancers. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer among women worldwide and 14.2% of deaths in Iranian women were due to breast cancer. Objectives: The present study aimed at investigating the survival of females with breast cancer diagnosed over 14 years and its related factors in Kerman Province. Methods: This is a longitudinal study. Information about 2851 females diagnosed with breast cancer was inquired from the Cancer Registry of Kerman University of Medical Sciences from March 2001 to March 2015. Data analysis was performed by Stata 14 and SPSS 22. Results: Totally, 8511 women diagnosed with breast cancer were enrolled in this study. The median survival time among patients with grade 3 at diagnosis was 0.51 of patients with grade 1 (P = 0.016). The median survival time among patients with stage 4 at diagnosis was 0.11 of patients with stages 0 and 1 (P < 0.001). The median survival time among post-menopause patients at diagnosis was 0.65 of pre-menopause patients (P = 0.014). The median survival time among patients with secondary metastasis was 0.22 of patients without it (P < 0.001) and the median survival time among patients with hormonotherapy was 1.52 of patients without this treatment (P = 0.013). Conclusions: Early diagnosis can improve the survival of patients with breast cancer. Periodic checkups especially in menopause ages are recommended. Hormone therapy has been successful in increasing patients' survival. [ABSTRACT FROM AUTHOR]

Surgical management of breast cancer often results in the absence of the breast. However, existing breast reconstruction methods may not meet the need for a replacement tissue. Tissue engineering with the use of emerging materials offers the promise of generating appropriate replacements. Three-dimensional (3D) printing technology has seen a significantly increased interest and application in medically-related fields in the recent years. This has been especially true in complex medical situations particularly when abnormal or complicated anatomical surgical considerations or precise reconstructive procedures are contemplated. In addition, 3D bio-printing which combines cells with bio-material scaffolds offers an exciting technology with significant applications in the field of tissue engineering. The purpose of this manuscript was to review a number of studies in which 3D printing technology has been used in breast reconstructive surgical procedures, and future directions and applications of 3D bio-printing.

Male breast cancer (MBC) accounts for < 1% of all breast cancers. The available data on male breast cancer is mainly retrospective institution-based studies. Due to the scarcity of the disease, randomized controlled trials have not been feasible. Conducting a multicenter study is the next best option to assess the effectiveness of the treatment which is currently followed as per the guidelines on female breast cancer (FBC). Under the aegis of Delhi Breast Oncology Group (DBOG), data of 106 MBC patients was collected from 11 leading hospitals of Delhi and analyzed from January 2010 to April 2017. The age of the patients ranged from 35 to 82 years with a median of 59 years. The commonest presentation was a lump in the breast (98%). There was a delay in presentation of 1–6 months in the majority (86%) of cases. of the total number of patients, 51% had Stage II, 25% Stage III, 18% Stage I, 4% Stage 0, and 2% Stage IV breast cancer at the time of presentation. Infiltrating ductal carcinoma was the commonest histopathological finding. IHC receptor studies revealed ER positivity in 81% and PR positivity in 76%. HER2 neu positivity was seen in 25% of cases. Modified radical mastectomy was the commonest (92%) surgical procedure. Of the total number of cases, 18% received neoadjuvant chemotherapy, 35% received adjuvant chemotherapy, 32% underwent radiotherapy, and 74% received hormonal therapy. The 5-year cumulative disease-free survival was 60.7%. MBC is rare and unique. There are differences from FBC with respect to time of presentation, aggressiveness, histopathology, IHC markers, and response to treatment with a poorer outcome. Multicentric prospective studies are recommended for future research. [ABSTRACT FROM AUTHOR]

Background: Female breast cancer (FBC) is a malignancy involving multiple risk factors and has imposed heavy disease burden on women. We aim to analyze the secular trends of mortality rate of FBC according to its major risk factors.Methods: Death data of FBC at the global, regional, and national levels were retrieved from the online database of Global Burden of Disease study 2017. Deaths of FBC attributable to alcohol use, high body-mass index (BMI), high fasting plasma glucose (FPG), low physical activity, and tobacco were collected. Estimated average percentage change (EAPC) was used to quantify the temporal trends of age-standardized mortality rate (ASMR) of FBC in 1990-2017.Results: Worldwide, the number of deaths from FBC increased from 344.9 thousand in 1990 to 600.7 thousand in 2017. The ASMR of FBC decreased by 0.59% (95% CI, 0.52, 0.66%) per year during the study period. This decrease was largely driven by the reduction in alcohol use- and tobacco-related FBC, of which the ASMR was decreased by 1.73 and 1.77% per year, respectively. In contrast, the ASMR of FBC attributable to high BMI and high FPG was increased by 1.26% (95% CI, 1.22, 1.30%) and 0.26% (95% CI, 0.23, 0.30%) per year between 1990 and 2017, respectively.Conclusions: The mortality rate of FBC experienced a reduction over the last three decades, which was partly owing to the effective control for alcohol and tobacco use. However, more potent and tailored prevention strategies for obesity and diabetes are urgently warranted. [ABSTRACT FROM AUTHOR]

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IntroductionKnowledge of the association between isolated tumor cells (ITCs) in breast cancer patients and the outcome is very limited. We aimed to determine the prognostic value of axillary lymph node ITCs for T1N0M0 female breast cancer (FBC) patients.MethodsData for T1N0M0 FBC patients staged ITCs negative [pN0(i−)] and positive [pN0(i+)] were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Prognostic predictors were identified by Kaplan–Meier analysis, competing risk model, and Fine–Gray multivariable regression model.ResultsA total of 94,599 subjects were included, 88,632 of whom were staged at pN0(i−) and 5,967 were pN0(i+). Patients staged pN0(i+) had worse breast cancer-specific survival (BCSS) [hazard ratio (HR): 1.298, 95% CI = 1.069–1.576, P = 0.003] and higher breast cancer-specific death (BCSD) rate (Gray’s test, P = 0.002) than pN0(i−) group. In the Fine–Gray multivariable regression analysis, the pN0(i+) group had higher BCSD rate (HR: 1.321, 95% CI = 1.109–1.575, P = 0.002) than pN0(i−) group. In subgroup analyses, no significant difference in BCSD was shown between the chemotherapy and non-chemotherapy subgroup (Gray’s test, P = 0.069) or radiotherapy and non-radiotherapy subgroup (Gray’s test, P = 0.096).ConclusionITC was independently related to the increase of the BCSD rate and could be identified as a reliable survival predictor for T1N0M0 FBC patients.

Purpose: The prevalence of breast cancer survivors has increased due to dissemination of population-based mammographic screening and improved treatments. Recent changes in anti-hormonal therapies for breast cancer may have modified the risks of subsequent urological and genital cancers. We examine the risk of subsequent primary urological and genital cancers in patients with incident breast cancer compared with risks in the general population. Methods: Using population-based Danish medical registries, we identified a cohort of women with primary breast cancer (1990–2017). We followed them from one year after their breast cancer diagnosis until any subsequent urological or genital cancer diagnosis. We computed incidence rates and standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) as the observed number of cancers relative to the expected number based on national incidence rates (by sex, age, and calendar year). Results: Among 84,972 patients with breast cancer (median age 61 years), we observed 623 urological cancers and 1397 genital cancers during a median follow-up of 7.4 years. The incidence rate per 100,000 person-years was stable during follow-up (83 for urological cancers and 176 for genital cancers). The SIR was increased for ovarian cancer (1.37, 95% CI 1.23–1.52) and uterine cancer (1.37, 95% CI 1.25–1.50), but only during the pre-aromatase inhibitor era (before 2007). Moreover, the SIR of kidney cancer was increased (1.52, 95% CI 1.15–1.97), but only during 2007–2017. The SIR for urinary bladder cancer was marginally increased (1.15, 95% CI 1.04–1.28) with no temporal effects. No associations were observed for cervical cancer. Conclusion: Breast cancer survivors had higher risks of uterine and ovarian cancer than expected, but only before 2007, and of kidney cancer, but only after 2007. The risk of urinary bladder cancer was moderately increased without temporal effects, and we observed no association with cervical cancer. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge of the association between isolated tumor cells (ITCs) in breast cancer patients and the outcome is very limited. We aimed to determine the prognostic value of axillary lymph node ITCs for T1N0M0 female breast cancer (FBC) patients. Methods: Data for T1N0M0 FBC patients staged ITCs negative [pN0(i−)] and positive [pN0(i+)] were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Prognostic predictors were identified by Kaplan–Meier analysis, competing risk model, and Fine–Gray multivariable regression model. Results: A total of 94,599 subjects were included, 88,632 of whom were staged at pN0(i−) and 5,967 were pN0(i+). Patients staged pN0(i+) had worse breast cancer-specific survival (BCSS) [hazard ratio (HR): 1.298, 95% CI = 1.069–1.576, P = 0.003] and higher breast cancer-specific death (BCSD) rate (Gray's test, P = 0.002) than pN0(i−) group. In the Fine–Gray multivariable regression analysis, the pN0(i+) group had higher BCSD rate (HR: 1.321, 95% CI = 1.109–1.575, P = 0.002) than pN0(i−) group. In subgroup analyses, no significant difference in BCSD was shown between the chemotherapy and non-chemotherapy subgroup (Gray's test, P = 0.069) or radiotherapy and non-radiotherapy subgroup (Gray's test, P = 0.096). Conclusion: ITC was independently related to the increase of the BCSD rate and could be identified as a reliable survival predictor for T1N0M0 FBC patients. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer is a major public health concern worldwide and shows significant heterogeneity between male and female. Knowing the global incidence landscape in both sexes is critical for the breast cancer prevention and the reduction in disease burden. Methods: We retrieved the incidence data of breast cancer in both sexes from the Global Burden of Disease 2017 database. Average annual percentage change was used to quantify the temporal trends of breast cancer incidence. Results: Between 1990 and 2017, the number of newly diagnosed female breast cancer (FBC) cases increased from 870.2 thousand to 1937.6 thousand, with the age-standardized incidence rate (ASR) significantly increased from 39.2/100,000 to 45.9/100,000. A total of 166 countries experienced a significant increase in FBC-ASR. The most pronounced increase was mainly found in developing countries. The decrease was mostly detected in several developed countries, such as the USA and the UK. Male breast cancer (MBC) is a rare carcinoma and has no evident cluster across the world. Worldwide, the number of newly diagnosed MBC cases increased from 8.5 thousand in 1990 to 23.1 thousand in 2017, with the ASR significantly increased from 0.46/100,000 to 0.61/100,000. A total of 123 countries showed a significant increasing trend in MBC-ASR. Conclusions: Breast cancer incidence rates are increasing in most countries in both sexes, although the epidemiological features were not completely shared between FBC and MBC. More emphases should be placed on breast cancer primary prevention and the prevention strategies might need to be tailored for both FBC and MBC. [ABSTRACT FROM AUTHOR]

Male breast cancer (MBC) is extremely rare, with an incidence of about 1% but the incidence has increased over the past 25 years. Most data on MBC come from small single-institution studies, and because of the paucity of data, the optimal treatment for MBC is not known. In the present article, we reviewed MBC and its risk factors, recommendations for screening and diagnosis, and management of patients with MBC.

Introduction: In Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, few associations have been reported between environmental factors and breast cancer mortality in women. The aim of this study was to investigate the relationships between residence in areas with high environmental pressures, female breast cancer characteristics, and death rate., Methods: Data from the Taranto Cancer Registry were used, including all women with invasive breast cancer diagnosed between 01 January 2015 and 31 December 2020 and with follow-up to 31 December 2021. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics., Results: A total of 10,445 person-years were observed. Variables associated with higher death rate were residence in the contaminated site of national interest (SIN) (HR 1.22, 95% CrI 1.01-1.48), pathological/clinical stage III (HR 2.77, 95% CrI 1.93-3.97) and IV (HR 17.05, 95% CrI 11.94-24.34), histological grade 3 (HR 2.50, 95% CrI 1.20-5.23), Ki-67 proliferation index of 21-50% (HR 1.42, 95% CrI 1.10-1.83) and > 50% (HR 1.81, 95% CrI 1.29-2.55), and bilateral localization (HR 1.65, 95% CrI 1.01-2.68). Variables associated with lower death rate were estrogen and/or progesterone receptor positivity (HR 0.61, 95% CrI 0.45-0.81) and HER2/neu oncogene positivity (HR 0.59, 95% CrI 0.44-0.79)., Discussion: The findings confirmed the independent prognostic values of different female breast cancer characteristics. Even after adjusting for patients and disease characteristics, residence in the SIN of Taranto appeared to be associated with an increased death rate., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Giannico, Carone, Tanzarella, Galluzzo, Bruni, Lagravinese, Rashid, Bisceglia, Sardone, Addabbo, Minerba and Mincuzzi.)

Abstract The male breast encompasses a number of benign and malignant breast conditions. The commonest cause of male breast enlargement is gynaecomastia. This can be physiological, idiopathic or pathological. Male breast cancer (MBC) is a rare disease comprising less than 1% of all breast cancers. The commonest histology is grade 2 ductal no special type carcinoma. Unlike the female breast, papillary in situ and invasive carcinomas are not uncommon in the male breast. MBC is often of the luminal A phenotype, similar to the post menopausal female breast cancer. Here we review a range of benign and malignant lesions of the male breast with a special emphasis on the two most common lesions: gynaecomastia and MBC. We describe the risk factors, pathogenesis, diagnostic criteria and management of those lesions. [ABSTRACT FROM AUTHOR]

Background: Clusters of breast cancer with varied incidence or mortality are known to exist. No national scale of analysis of geographical variation in breast cancer incidence has been published before for the contiguous USA.Methods: This was a spatial cluster analysis of incidence and mortality data on breast cancer in the contiguous USA at the county resolution. Data for the years 2000-2014 were downloaded and analyzed with the software SaTScan with the goal to identify significant spatial clusters of breast cancer. Regression analysis was used to then adjust breast cancer incidence and mortality for several key risk factors such as age, smoking, particulate matter air pollution, physical inactivity, urban living, education level, and race.Results: Spatial clusters of counties for higher than expected breast cancer incidence and also for breast cancer mortality were identified. All identified clusters have p < 0.05. The mortality clusters show the mean breast cancer rates inside the cluster, while the incidence clusters show the relative risk inside each cluster. This is the first study of the contiguous USA for breast cancer mortality and incidence together. The clustering for mortality is quite different from the clustering for incidence. Using the software JOINPOINT, it is shown that the annual US downward trend for breast cancer mortality slowed down in recent years.Conclusions: There exist several significant clusters in the contiguous USA, both for breast cancer incidence and for breast cancer mortality. Some of the clusters persisted even after adjusting for several key risk factors. These geographic areas warrant further investigation to potentially identify additional local concerns or needs to further address female breast cancer in those specific sites. [ABSTRACT FROM AUTHOR]

Purpose: To provide dermatologists and oncologists with a foundation for practical understanding and uses of 5α-reductase inhibitors and spironolactone for breast cancer patients and survivors receiving endocrine therapies (ETs), including the effect of these treatments on sex hormone levels, any reported drug interactions, and any risk of malignancy.Methods: All published studies from January 1978 through April 2018 were considered, using databases such as PubMed, Google Scholar, and Science Direct. Forty-seven studies were included in this review.Results: There is no evidence of interactions between 5α-reductase inhibitors and spironolactone with ETs used in breast cancer. Sex hormone alteration with 5α-reductase inhibitor or spironolactone use is variable. Three randomized controlled trials, 1 case-control study, and 6 retrospective cohort studies, including 284 female patients, studied the effects of 5α-reductase inhibitors on serum estrogen levels. Levels were increased in 97 of 284 (34%) patients, decreased in 15 of 284 (5.3%) patients, and unchanged in 162 of 284 (57%) patients. Four retrospective cohort studies, 1 case study, and 1 double-blinded crossover study, including 95 female patients, assessed the effect of spironolactone on estrogen levels. Levels were increased in 25 of 95 (26%) patients, decreased in 6 of 95 (6.3%) patients, and unchanged in 64 of 95 (67%) patients. Ultimately, most patients did not have a significant alteration in the level of estrogen when using 5α-reductase inhibitors or spironolactone. No consistent evidence of increased risk of female breast cancer while on spironolactone was reported in 3 studies including 49,298 patients; the risk of breast cancer with the use of 5α-reductase inhibitors has not been studied.Conclusions: Most patients did not show increased estrogen levels with spironolactone and there were no data suggesting increased risk of breast cancer. Based on hormonal and pharmacological activity, spironolactone may be considered for further research on alopecia and hirsutism in breast cancer patients. [ABSTRACT FROM AUTHOR]