Apoptotic activity in Libyan breast cancer

ABSTRACT: BACKGROUND: We evaluated the relationship of the apoptotic activity index (AI) and the standardized mitotic-apoptotic ratio (SMI/AI) with clinicopathological features and prognosis in Libyan female breast cancer (BC) patients. We then compared our results with corresponding results in Finnish and Nigerian female BC patients. METHODS: Histological samples of breast carcinoma from 130 patients were retrospectively studied: an estimation of the apoptotic activity per square millimeter (expressed as apoptotic activity index (AI)), and standardized mitotic-apoptotic ratio (SMI/AI) was made, and the results compared with the clinicopathological features and the patient's survival. RESULTS: There was a statistically significant correlation between the AI and most of the clinicopathological features; the strongest association was observed for clinical stage lymph node (LN) status (P = 0.005). There were also correlations between AI and histological grade (P = 0.035), large tumor size (P = 0.011) and the clinical stage (P = 0.009). There were, however, prominent AI differences between Libyan, Nigerian and Finnish populations. The mean values of AI and SMI/AI in Libyan BC patients were 12.8 apoptotic figures per square millimeter and 2.8, respectively. The Libyan AI is slightly higher than in Nigeria, but much higher than in Finland. The differences between countries are seen throughout the samples as well as being present in certain subgroups. The survival analysis indicated that short survival time was associated with high apoptotic indices values and so can identify aggressive tumors and provide significant prognostic support. The cutoff (4 and 18 apoptosis/mm2) of AI might be applied as a quantitative criterion for Libyan BC to separate the patients into good, moderate and bad prognosis groups. CONCLUSIONS: The results indicated that the differences in AI among the three countries may be due to the known variation in the distribution of genetic markers in these populations. Improvement in health care and introduction of screening programs, however, could be very helpful in the Libyan population.     

Risk-adjusted female breast cancer incidence rates in the United States

A method has been previously proposed for estimating risk-adjusted incidence rates (RAIRs) from cancer data from the Surveillance, Epidemiology, and End Results (SEER) program. Unlike conventionally reported SEER-based cancer incidence rates in the United States, but similar to the approach taken by the International Association of Cancer Registries and the International Agency for Research on Cancer, the method uses only the first primary cancer of the given site. In addition, it also adjusts for population-based cancer prevalence in order to obtain a better population-based measure of cancer risk. For most cancers multiple cancer primaries are rare and the prevalence of the disease is low. However, female breast cancer has a comparatively high risk of subsequent breast cancers and is the most prevalent cancer in women. Hence, in white women RAIRs are 3.0% lower in ages 30-39, 4.2% lower in ages 40-49, 4.0% lower in ages 50-59, 4.1% lower in ages 60-69, 3.8% lower in ages 70-79, and 4.3% lower in ages 80 years and older compared with conventional rates. Corresponding lower percentages for black women are 3.9%, 6.9%, 5.1%, 7.8%, 6.0%, and 2.2%, respectively. Age-group specific trends in breast cancer incidence rates differed between RAIRs and conventional incidence rates, increasingly so with older age. The number of cancer cases in the United States is estimated from conventional incidence rates and population estimates. In 2007, the estimated number of malignant breast cancer cases was 181,665 for white women and 20,203 for black women. The estimated number of breast cancer cases decreased by 4.8% for whites and 6.5% for blacks when based on RAIRs. RAIRs are a better measure of breast cancer risk and trends in RAIRs are better for monitoring the effect of risk factors.     

Polymorphisms in genes encoding mt-tRNA in female breast cancer in Poland

Recently, there have been indications of participation of mitochondria in the carcinogenic process and the role of polymorphisms in increasing the risk of cancer. The aim of the study was to detect possible changes in the sequence of 22 genes encoding mitochondrial tRNA in breast cancer carcinoma, which take part in protein synthesis in the translation process. The analysis of tumour tissue and blood material sampled from 50 patients revealed that few mutations have been found. It cannot be excluded that, through their impact on the secondary and tertiary tRNA structure, polymorphisms may cause mitochondrial dysfunction and contribute to appearance of other changes in mtDNA. Mutations in tRNA genes in breast cancer may affect the cell and cause its dysfunction, as in mitochondrial diseases.     

Doses of Ukrainian female clean-up workers with diagnosed breast cancer

The Chernobyl reactor accident in 1986 has caused significant exposure to ionizing radiation of the Ukrainian population, in particular clean-up workers and evacuees from the exclusion zones. A study aiming at the discovery of radiation markers of the breast cancer was conducted from 2008 to 2015 within a collaborative project by HZM, LMU, and NRCRM. In this study, post-Chernobyl breast cancer cases both in radiation-exposed female patients diagnosed at age less than 60 from 1992 to 2014 and in non-exposed controls matched for residency, tumor type, age at diagnosis, TNM classification as well as tumor grading were investigated for molecular changes with special emphasis to copy number alterations and miRNA profiles. Cancer registry and clinical archive data were used to identify 435 breast cancer patients among female clean-up workers and 14 among evacuees from highly contaminated territories as candidates for the study. Of these, 129 breast cancer patients fit study inclusion criteria and were traced for individual reconstruction of the target organ (breast) doses. The doses were estimated for 71 exposed cases (clean-up workers and evacuees from which biomaterial was available for molecular studies and who agreed to participate in a dosimetric interview) by the use of the well-established RADRUE method, which was adjusted specifically for the assessment of breast doses. The results of 58 female clean-up workers showed a large inter-individual variability of doses in a range of about five orders of magnitude: from 0.03 to 929 mGy, with median of 5.8 mGy. The study provides the first quantitative estimate of exposures received by female clean-up workers, which represent a limited but very important group of population affected by the Chernobyl accident. The doses of 13 women evacuated after the accident who did not take part in the clean-up activities (from 4 to 45 mGy with median of 19 mGy) are in line with the previous estimates for the evacuees from Pripyat and the 30-km zone.     

The delay of breast cancer diagnosis and management during the Syrian war

BackgroundEarly detection of breast cancer (BC) is crucial for better prognosis especially in low-income countries, where advanced cancer stages are common. The Syrian war severely affected the healthcare system restraining the proper timely management of BC cases. We aimed to investigate the prevalence of patient- and system-related delays in BC diagnosis and management in Syria in addition to their predisposing characteristics and impact on the staging.MethodsThis is a cross-sectional retrospective cohort study on patients followed by the BC unit at Al-Bairouni main cancer center in Syria. The data were collected through personal interviews and retrospective revision of patients’ records.ResultsA total number of 519 patients were recruited; A quarter of them (n = 126) reported more than three months intervals between symptoms recognition and presentation to a physician. Additionally, 72 (13.9 %) patients received a confirmed diagnosis more than three months after presentation, and 12 (2.3 %) started treatment at least three months after the diagnosis. Patients who suffered from war-related inaccessibility to healthcare were 2.55 [1.58–4.11] times more likely to report significant delays. Additionally, the most common self-reported reasons for patient delay were the lack of awareness, which was more evident for less common symptoms like the change in breasts size, and shyness. Patients who reported significant delays were more likely to receive an advanced-stage diagnosis.ConclusionWar-related inaccessibility to healthcare rendered a significant group of BC patient susceptible to evident delay. This combined with significant system delays because of the overwhelmed hospitals, high costs, and insufficient personnel, equipment, medications, and training. However, personal factors, which might not be directly related to the war, like the inadequate awareness of rare symptoms and shyness still necessitate urgent interventions on the public knowledge and performed screening practices. These delays associated with receiving advanced-stage diagnoses and minimizing them can return better prognoses.     

Male and female genitalia in some Libyan species of Acrididae (Orthoptera: Acridoidea)

A comparative study of male and female genitalia was carried out in thirty‐seven Libyan species representing twenty genera of the family Acrididae. An attempt has been made to describe and illustrate the different structures, namely, epiphallus, aedeagus, subgenital plate, supra‐anal plate and cerci of the male, and spermatheca, ovipositor, subgenital plate, supra‐anal plate and cerci of the female, in Acridids, with an aim to discover their significance in order to make the identification of genera and species, together with other generic characters, more perfect and convenient. Distinct family characters are shield or bridge‐shaped condition of epiphallus; presence or absence of dorso‐lateral appendices, oval sclerites and lophi on epiphallus; divided, undivided or flexured condition of aedeagus; presence or absence of gonopore process on aedeagus; condition of apical and pre‐apical diverticula of spermatheca; presence or absence of glandular pouches of Cornstock and Kellog on female subgenital plate; and rudimentary or well developed condition of egg‐guide. Stable characters for separating the subfamilies are taken to be presence or absence of ancorae on epiphallus, long or short condition of aedeagal sclerites; elongate, slender or short and broad condition of ovipositor valves: presence or absence of Jannone's organs and setae on posterior margin of female subgenital plate; and shape of diverticula of spermatheca. Useful generic characters are shape of male subgenital plate, supra‐anal plate and cerci, broad or narrow condition of bridge, presence or absence of branch of bridge connecting lophi with bridge of epiphallus; mono‐, bi‐ or tri‐lobate condition of lophi of epiphallus, length and upcurved or downcurved condition of apical valve of aedeagus, shape of posterior margin of female subgenital plate, presence of setae on the whole posterior margin or confined to lateral margins only; and toothed, tuberculate or smooth condition of ovipositor valves, length of the lateral apodeme in relation to the dorsal valves. Specific characters are shape of egg‐guide of female subgenital plate, shape of ovipositor valves and apical tips, shape of male supra‐anal plate and cerci, size of anterior and posterior lobes of lophi of epiphallus, size and shape of ancorae, shape of apical valves of aedeagus; and size of apical and pre‐apical diverticula and presence of protuberance on pre‐apical diverticulum.     

Clinical outcomes of female breast cancer according to BRCA mutation status

BackgroundTo investigate breast cancer prognosis (disease-free (DFS) and overall survival (OS)) among carriers of germline BRCA mutations (BRCAm) in Denmark.MethodsWe identified all women in Central and Northern Denmark diagnosed with breast cancer during 2004–2011. We retrieved information on germline BRCAm testing from Clinical Genetics departments and clinical/treatment characteristics from population-based medical registries. Follow-up for recurrence, new primary cancer, and mortality extended from 180 days after diagnosis until 31/12/2012. We estimated median DFS and OS and five-year cumulative incidence and incidence rates (IR/1000 person-years), and 95% confidence intervals (95% CI), for each outcome.ResultsAmong 9874 patients, 523 (5%) underwent BRCA testing—90 were BRCAm carriers, 433 were BRCA wildtype (BRCAwt). Compared with BRCAwt women, BRCAm carriers were younger, had lower stage, and ER- and HER2- tumors. Median time from diagnosis to BRCA testing was 0.91 years and 1.3 years in BRCAm and BRCAwt women; median follow-up to first event was 3.9 and 3.4 years, respectively. Five-year DFS and OS were higher in BRCAm than BRCAwt women: 88% (95%CI = 78.3–93.5) vs. 75.3% (95%CI = 70.2–79.6) and 97.8% (95%CI = 91.4–99.4) vs 92.2% (95%CI = 88.5–94.7), respectively. Five-year IRs of recurrence were 36.7/1000 person-years (95%CI = 15.8–72.2) in the BRCAm cohort vs. 58.4 (95%CI = 42.9–77.6) in the BRCAwt cohort.ConclusionsBRCAm carriers may have a better prognosis than BRCAwt women. However, limited testing conducted mainly during follow-up, yielded low numbers for precise estimations, and may be attributable to selection bias.     

Different methylation and MicroRNA expression pattern in male and female familial breast cancer

Epigenetic regulation, has been very scarcely explored in familial breast cancer (BC). In the present study RASSF1A and RAR beta promoter methylation and miR17, miR21, miR 124, and let‐7a expression were investigated to highlight possible differences of epigenetic regulation between male and female familial BC, also in comparison with sporadic BC. These epigenetic alterations were studied in 56 familial BC patients (27 males and 29 females) and in 16 female sporadic cases. RASSF1A resulted more frequently methylated in men than women (76% vs. 28%, respectively, P = 0.0001), while miR17 and let‐7a expression frequency was higher in women than in men (miR17: 66% in women vs. 41% in men, P < 0.05; let‐7a: 45% in women vs. 15% in men, P = 0.015). RASSF1A methylation affected 27.6% of familial BC while 83% of familial cases showed high expression of the gene (P = 0.025); on the contrary, only 17% of familial BC presented RAR beta methylation and 55% of familial cases overexpressed this gene (P = 0.005). Moreover, miR17, miR21, and let‐7a resulted significantly overexpressed in familial compared to sporadic BC. RASSF1A overexpression (86% vs. 65%, P = 0.13) and RAR beta overexpression (57% vs. 32%, P = 0.11) were higher in BRCA1/2 carriers even if not statistical significance was reached. BRCA mutation carriers also demonstrated significant overexpression of: miR17 (93% vs. 35%, P = 0.0001), let‐7a (64% vs. 16%, P = 0.002), and of miR21 (100% vs. 65%, P = 0.008). In conclusion, the present data suggest the involvement of RASSF1A in familial male BC, while miR17 and let‐7a seem to be implied in familial female BC. J. Cell. Physiol. 228: 1264–1269, 2013. © 2012 Wiley Periodicals, Inc.     

Genetic markers in Libyan Jews

Summary Blood groups, serum proteins, and red-cell enzyme frequencies were determined on a random sample of 148 Libyan Jews now settled in Israel. Comparisons with data on Libyan non-Jews show significant differences in most systems, implying maintenance of a high degree of genetic isolation of the Jewish group from surrounding populations.The relative lack of the African component in their gene pool shows that they have interbred very little, if at all, with their negroid neighbours.     

Identification of novel serum peptides biomarkers for female breast cancer patients in Western China

This study aimed to identify novel serum peptides biomarkers for female breast cancer (BC) patients. We analyzed the serum proteomic profiling of 247 serum samples from 96 BC patients, 48 additional paired pre‐ and postoperative BC patients, 39 fibroadenoma patients as benign disease controls, and 64 healthy controls, using magnetic‐bead‐based separation followed by MALDI‐TOF MS. ClinProTools software identified 78 m/z peaks that differed among all analyzed groups, ten peaks were significantly different (P < 0.0001), with Peaks 1–6 upregulated and Peaks 7–10 downregulated in BC. Moreover, three peaks of ten (Peak 1, m/z: 2660.11; Peak 2, m/z: 1061.09; Peak 10, m/z: 1041.25) showed a tendency to return to healthy control values after surgery. And these three peptide biomarkers were identified as FGA605‐629, ITIH4 347–356, and APOA2 43–52. Methods used in this study could generate serum peptidome profiles of BC, and provide a new approach to identify potential biomarkers for diagnosis as well as prognosis of this malignancy.     

Provider delay in treatment initiation and its influence on survival outcomes in women with operable breast cancer

AimThe goal of this study was to determine whether a delay in starting treatment via surgery or neoadjuvant chemotherapy is related to a decrease in cancer-specific survival (CSS) in women with operable breast cancer (BrCr).BackgroundLimited medical infrastructure and a lack of cancer prevention awareness in low- and middle-income countries have caused high BrCr incidence and mortality rates.MethodsWe analyzed a retrospective cohort of 720 women treated at a single center from 2005 to 2012. CSS estimates were obtained by the Kaplan-Meier method. A Cox model of proportional risks was performed to obtain the risk of dying from BrCr. We also obtained the risk according to the category of treatment initiation.ResultsWomen with locally advanced stages and without hormone receptor expression were more likely to initiate treatment after 45 days. Patients in Stage IIIA had a 78.1% survival if treatment was initiated before 45 days (95% CI, 0.70–0.84) and 63.6% survival if treatment was started after 45 days (95% CI, 0.44–0.78; p < 0.001). Patients in Stage IIIB had a 62.9% survival if treatment was initiated before 45 days (95% CI, 0.53–0.72) and 57.4% survival if treatment started after 45 days (95% CI, 0.31-0.89; p < 0.001). Prognostic factors in which lower survival was recognized were Stage IIIA, Stage IIIB, treatment initiation after 45 days, and triple-negative tumors.ConclusionsThe initiation of treatment within the first 45 days of diagnosis of BrCr in women portends better survival compared with those who began treatment longer than 45 days from diagnosis.     

Expression of leptin and its receptor in female breast cancer in relation with selected apoptotic markers

Leptin and its receptor may be engaged in pathogenesis of breast cancer among various human tumors. In vitro investigations showed leptin-mediated escalation of estrogen synthesis and boosted activity of estrogen receptor ERalpha. Furthermore, leptin induced growth of malignant cells, counteracted apoptosis and stimulated cell migration as well as overexpression of angiogenic factors and degrading enzymes that split network of intercellular matrix. On the other side, leptin has been reported to favor apoptosis, lately. Proapoptotic effect of leptin action was revealed in interstitial cells of bone marrow and adipocytes. Our past reports provide evidences for overexpression of leptin and its receptor in breast cancer in comparison with benign mammary lesions. In current study we aimed at assessment of eventual relationships between leptin, leptin receptor and selected protein regulators of apoptosis in breast cancer. We applied immunohistochemistry for leptin, leptin receptor, anti-apoptotic Bcl-2 and Bcl-xL as well as pro-apoptotic Bak and Bax expression assessment in 106 cases of human breast cancers. The immunoreaction was graded and statistically evaluated. Expression of leptin was positively correlated with Bcl-xL, Bak and Bax (p<0.001, r=0.614; p<0.001, r=0.518; p<0.001, r=0.511, respectively). Statistical significances were noted between expression of leptin receptor and Bcl-xL or Bax (p=0.011, r=0.210; p<0.001, r=0.313, respectively). No correlation was encountered between leptin and Bcl-2, either leptin receptor and Bcl-2 or leptin receptor and Bak. On the basis of obtained results, leptin system could interfere in balance among expressions of pro- and anti-apoptotic proteins and regulate cell turnover and--by means of it--facilitate breast cancer progression.     

Multiple fluoroscopy of the chest: carcinogenicity for the female breast and implications for breast cancer screening programs.

The risk of radiation carcinogenesis has been established for breast tissue from experience with total body irradiation and multiple fluoroscopy of the chest with the patient prone. The doubling dose has been estimated to lie between 20 and 50 rads. Before undertaking radiologic screening programs for breast cancer, therefore, it is necessary to determine whether exposures below this range are safe. Of 792 women who had had tuberculosis and were followed for a minimum of 20 years, 451 had had multiple fluoroscopy while supine; 341 had not had fluoroscopy. The first group received a total radiation dose to the breast averaging 17 rads (141.5 fluoroscopies); the incidence of breast cancer in this group was not increased. Had fluoroscopy been performed with the patient prone the total radiation dose would have averaged 308 rads. The difference is thought to explain the increased incidence of breast cancer attributable to fluoroscopy given with the patient prone. Mid-breast exposure with mammography or xeroradiography varies between 3 and 6 rads. Repetitive screening would, therefore, appear safe provided total exposure did not exceed 20 rads. With this restriction there would appear to be no reason to curtail screening of women for breast cancer.