Aluminium in human breast tissue

Aluminium is omnipresent in everyday life and increased exposure is resulting in a burgeoning body burden of this non-essential metal. Personal care products are potential contributors to the body burden of aluminium and recent evidence has linked breast cancer with aluminium-based antiperspirants. We have used graphite furnace atomic absorption spectrometry (GFAAS) to measure the aluminium content in breast biopsies obtained following mastectomies. The aluminium content of breast tissue and breast tissue fat were in the range 4-437 nmol/g dry wt. and 3-192 nmol/g oil, respectively. The aluminium content of breast tissue in the outer regions (axilla and lateral) was significantly higher (P=0.033) than the inner regions (middle and medial) of the breast. Whether differences in the regional distribution of aluminium in the breast are related to the known higher incidence of tumours in the outer upper quadrant of the breast remains to be ascertained.     

La pratique de l’IRM mammaire au centre hospitalier de Chambéry

ObjectiveTo determine indications, technique and results of breast MRI performed at Chambery hospital (CH).Patients and methodsAnalytical retrospective study of 12 months, conducted at CH. It involved the analyzing of 100 breast MRI examinations performed in 84 patients using a brand device Siemens Magneton Area^®.ResultsThe mean age of patients was 56.2 years. The indications for breast MRI were the assessment of local and regional extension of breast cancer (28%), the results of monitoring of neoadjuvant chemotherapy (22%), the research of local recurrence after conservative treatment (14%) and cases of diagnostic discrepancies (13%). The most commonly used sequences were axial T1 ES (91%), axial T2 STIR (91%) and axial T1 with gadolinium injection (97%). The assessment of locoregional extension revealed multifocal invasion in 14 cases, pectoral in 3 cases, lymph node in 7 cases and skin in 4 cases. Concerning the monitoring of neoadjuvant chemotherapy, tumor involution was found in 10 patients and stability in 3 others. The distinction between tumor recurrence and postoperative scar showed 10 negative cases and 4 cases of tumor recurrence.ConclusionBreast MRI is an excellent non-invasive method for studying fully and satisfactorily within. It is mainly practiced in the CH to the extension of cancer and monitoring neoadjuvant chemotherapy balance.     

Ethiopian women's breast cancer self-examination practices and associated factors. A systematic review and meta-analysis

BackgroundBreast neoplasm is the most frequently diagnosed and the leading cause of cancer death in the vast majority of the countries. Breast cancer self-examination is a check-up of a woman does at home to look for changes or problems in the breast tissue. The benefit of early recognition is for early treatment that is more effective, higher long-term survival rates and better quality of life. The aim of this review was to determine the pooled prevalence of breast cancer self-examination practice and identify its associated factors among Ethiopian women.MethodsGoogle Scholar, PubMed, Science Direct, web of science, and Cochrane Library were used for search of articles. This review includes thirty four articles conducted in Ethiopia between 2011 and 2020. The review contains 14,908 women to determine the ever pooled prevalence of breast cancer self-examination practice. Health workers and students made up 28.35% of the total participants. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analyzed with Stata 14. To assess heterogeneity I² test were used. A random effect meta-analysis model was used to estimate the pooled breast cancer self-examination (BCSE) practice of Ethiopian women. Moreover associated factors were also assessed.ResultsIn Ethiopian women, the overall ever and regular pooled breast cancer self-examination practice was 36% (95% CI: 28, 43) and 16% (95% CI: 28, 43) respectively. The ever pooled prevalence for health workers or students was 53% (95% CI: 41, 65), whereas for other participants it was 25% (95% CI: 19, 30). Good knowledge about breast self-examination (AOR: 3.69: 95% CI: 2.70, 5.05), positive attitude towards BCSE (AOR: 2.72: 95% CI: 1.74, 4.24), Getting to know people with breast cancer(AOR: 2.77: 95% CI: 1.51, 5.09), family history of breast cancer (AOR: 2.49: 95% CI: 1.60, 3.88) and personal history of breast cancer (AOR: 2.26: 95% CI: 1.70, 3.01) were associated factors to BCSE practice among Ethiopian women. All of the studies included in this review were conducted in a cross-sectional design was a limitation of this review and meta-analysis.ConclusionThis review and meta-analysis showed the ever and regular pooled prevalence of BCSE among Ethiopian women. More than one third of Ethiopian women ever practiced BCSE. We recommend that awareness creation should be perform in order to tackle the risk of breast cancer.     

A piecewise mass-spring-damper model of the human breast

Previous models to predict breast movement whilst performing physical activities have, erroneously, assumed uniform elasticity within the breast. Consequently, the predicted displacements have not yet been satisfactorily validated. In this study, real time motion capture of the natural vibrations of a breast that followed, after raising and allowing it to fall freely, revealed an obvious difference in the vibration characteristics above and below the static equilibrium position. This implied that the elastic and viscous damping properties of a breast could vary under extension or compression. Therefore, a new piecewise mass-spring-damper model of a breast was developed with theoretical equations to derive values for its spring constants and damping coefficients from free-falling breast experiments. The effective breast mass was estimated from the breast volume extracted from a 3D body scanned image. The derived spring constant (k_a = 73.5 N m⁻¹) above the static equilibrium position was significantly smaller than that below it (k_b = 658 N m⁻¹), whereas the respective damping coefficients were similar (c_a = 1.83 N s m⁻¹, c_b = 2.07 N s m⁻¹). These values were used to predict the nipple displacement during bare-breasted running for validation. The predicted and experimental results had a 2.6% or less root-mean-square-error of the theoretical and experimental amplitudes, so the piecewise mass-spring-damper model and equations were considered to have been successfully validated. This provides a theoretical basis for further research into the dynamic, nonlinear viscoelastic properties of different breasts and the prediction of external forces for the necessary breast support during different sports activities.     

乳腺癌保乳术后局部复发的相关因素

随着保乳手术的开展及保乳病人的增多,相应出现了一些保乳术后局部复发的病例,而切缘阴性或阳性、术后全乳照射与否、年龄、病理类型、病例的选择、新辅助化疗后保乳术切除范围、SLNB(前哨淋巴结活检)等都与保乳术后局部复发有关。因此确保严格选择适应症病例、手术切缘阴性、术后全乳照射、病理类型为非EIC(广泛导管内癌成分)、新辅助化疗后手术范围的准确以及提高SLNB的准确率都可降低保乳手术的局部复发。本文在此就乳腺癌保乳术后局部复发的相关因素进行探讨。     

MMTV-Wnt-1转基因小鼠作为高发乳腺癌动物模型的观察

目的　观察MMTV Wnt 1转基因小鼠的乳腺癌发病情况及病理学变化规律。方法　观察MMTV Wnt 1转基因小鼠肿瘤发生情况 ,并采用原位移植将瘤组织置于裸鼠皮下 ,通过组织病理学切片来观察MMTV Wnt 1阳性转基因小鼠和移植鼠的病理学变化。结果　MMTV Wnt 1转基因小鼠最早从 7周龄开始出现乳腺瘤 ,发瘤鼠剖检可见脾、肝有不同程度的肿大 ,其他器官无明显病变 ;病理组织学检查发现发瘤鼠各脏器有不同程度的病变 ,但未出现肿瘤转移。将瘤组织移植裸鼠后 ,肿瘤可在裸鼠皮下生长 ,移植肿瘤病理学形态与原发瘤一致 ,未出现转移。结论　实验结果验证MMTV Wnt 1转基因小鼠可稳定自发乳腺肿瘤 ,可作为研究乳腺癌的良好的动物模型     

即时扩展型背阔肌肌皮瓣乳房再造在保留乳头乳晕复合体乳癌术后的运用分析

目的：探讨分析即时扩展型背阔肌肌皮瓣乳房再造在保留乳头乳晕复合体乳癌术后的运用。方法：回顾性分析我院2008年2月-2012年4月收治的乳腺癌术后患者106例,采用乳癌术即时扩展型背阔肌肌皮瓣乳房再造保留乳头乳晕复合体,观察手术效果以及满意度。结果：术后患者乳房美容优良率为88．68％明显大于对照组的47．17％,并且术后6个月治疗组生活质量评价总分明显大于对照组总分术后6个月患者生活质量评价总分明显大于术前评价总分,差异具有条件下意义（P〈0．05）,差异均具有统计学意义（P〈0．05）。结论：即时扩展型背阔肌肌皮瓣乳房再造在保留乳头乳晕复合体乳癌术后患者乳房美容效果较好,提高患者生活质量高,值得在临床上推广,但在手术后需积极处理可能存在的并发症情况。     

Immunohistochemical localization of apelin in human normal breast and breast carcinoma

The peptide apelin is a high-affinity ligand for the G-protein coupled receptor APJ. Apelin/APJ signaling plays important roles in blood pressure regulation, body fluid homeostasis, and cardiovascular development. More recently, it has been recognized that apelin/APJ signaling may also be involved in tumor angiogenesis. Studies in experimental animals have shown that apelin is abundantly secreted in the milk, and the mammary gland contains high level of pre-proapelin mRNAs and apelin protein. High level of apelin mRNA is expressed in cultured human breast carcinoma cell line (Hs 578T). However, the status of apelin expression and localization in human breast carcinoma has not been studied. In the present study immunohistochemistry was performed to investigate the expression and localization of apelin in normal human breast tissue and breast carcinoma. Cytoplasmic apelin immunoreactivity was detected in the ductal and lobular epithelial cells and vascular endothelial cells of the normal breast tissue. The myoepithelial cells were negative. The malignant tumor cells of invasive ductal or lobular carcinoma also expressed similar level of immunoreactive apelin. The fuctional significance of apelin expression in normal nonlactating breast and breast carcinoma warrants further investigation.     

Circadian concepts in normal and neoplastic breast

Normal breast exhibits rhythmic properties linked to the hormonal environment of the gland in animals and humans. Breast tumors also display rhythmic properties; however, they differ from those found normally in animals and humans. Breast cancer in humans is characterized by disruption or modification of normal circadian patterns, which may be of prognostic value. The relationships between melatonin biology and breast cancer require exploration. The present work summarizes the data concerning circadian concepts in breast cancer and explores future directions in the breast cancer treatment by chronomodulation of medications during the 24h, taking advantage of the circadian time structure of breast tissue to improve the treatment outcome.     

Assessment of biomechanical parameters of the shoulder joint at the operated side versus non-operated side in patients treated surgically for breast cancer

Aim

Isokinetic assessment of biomechanical parameters of the shoulder joint at the operated side versus non-operated side in patients treated surgically for breast cancer according to the type of surgery performed.

Circadian concepts in normal and neoplastic breast

Normal breast exhibits rhythmic properties linked to the hormonal environment of the gland in animals and humans. Breast tumors also display rhythmic properties; however, they differ from those found normally in animals and humans. Breast cancer in humans is characterized by disruption or modification of normal circadian patterns, which may be of prognostic value. The relationships between melatonin biology and breast cancer require exploration. The present work summarizes the data concerning circadian concepts in breast cancer and explores future directions in the breast cancer treatment by chronomodulation of medications during the 24h, taking advantage of the circadian time structure of breast tissue to improve the treatment outcome.     

乳腺三维断层技术结合乳腺超声对致密型乳腺病变的诊断价值

摘要 目的：探讨乳腺三维断层技术（DBT）结合乳腺超声(BUS)对致密型乳腺病变的诊断价值。方法：回顾分析2018年6月至2019年4月在我院就诊且有完整病理结果的149例致密型乳腺病变患者的影像资料,对比DBT、BUS两种检查方法的检出率;以病理结果为金标准,分析DBT、BUS、DBT联合BUS三种检查模式的诊断效能。结果：BUS对良性病变的检出率（97.87%）高于DBT（89.36%）,差异有统计学意义（x²=5.697,P＜0.05）;DBT与BUS对恶性病变的检出率分别为98.44%、95.31%,差异无统计学意义（x²=1.032,P>0.05）。DBT诊断致密型乳腺病变的敏感度为90.61%、特异度为93.55％、准确率为91.77％,BUS诊断致密型乳腺病变的敏感度为78.13%、特异度为89.36%、准确率为84.81%,DBT联合BUS诊断致密型乳腺病变的敏感度为95.31%、特异度为95.74%、准确率为95.57%。DBT联合BUS诊断致密型乳腺恶性病变的受试者工作特征曲线（ROC）的曲线下面积（AUC）为0.977,稍高于DBT的AUC（0.951）,明显高于BUS的AUC（0.885）。结论：BUS对良性病变的检出率显著高于DBT,DBT对致密型乳腺病变的诊断效能高于BUS,二者结合能提高病变的检出率与诊断效能。     

Differential expression of cholinephosphotransferase in normal and cancerous human mammary epithelial cells

Membrane phospholipids as well as fatty acid profile of cell membrane phospholipids are altered in tumorigenicity and malignancy. Synthesis of total cellular phosphatidylcholine (PC) can be used as a marker for membrane proliferation in neoplastic mammary gland tissues. Cholinephosphotransferase (CPT), the terminal enzyme in the de novo synthesis of PC, has an important role in regulating the acyl group of PC in mammalian cells. In this study, the effect of neoplasia on CPT was examined. The gene shows an elevated expression in cancerous (11-9-14) breast epithelial cell line when compared to that of normal non-tumorigenic (MCF-12A) breast epithelial cell line. Four nucleotide substitutions are observed in the cancer cell line. Of these, three are null mutations, but the third one shows an interesting serine to tyrosine substitution (at amino acid position 89 of our partial sequence which corresponds to position 323 of the CPT sequence reported as NM_020244 in GenBank) in 11-9-14 cells. The tyrosine is present in the right context of KSELYQDT, which directs tyrosine phosphorylation at the tyrosine site. Biochemical approach also reveals a 1.5-fold stimulation in CPT activity in 11-9-14 cells compared to that of the MCF-12A cells.     

Performances de la TEP au 18F-FDG dans la caractérisation initiale de la lésion primitive du cancer du sein

Objective¹⁸F-FDG PET/CT is for the moment not recommended for stage T of the TNM classification of breast cancer. The aim of our study was to evaluate the performance of ¹⁸F-FDG PET/CT in the initial staging of breast tumors. Tumor size, skin involvement and inflammation as well as the relationship between primary tumor maximum standardized uptake value (SUVmax) and histopathological grade (SBR), molecular tumor subtypes (luminal A and B, Her2 enriched, triple negative), estrogen receptors (ER), progesterone receptors (PR) and focality were evaluated.MethodsHistological reports of patients operated for breast cancer, without neoadjuvant chemotherapy, were compared to preoperative ¹⁸F-FDG PET/CT.ResultsSeventy-four patients who underwent surgery in 2016 were included. ¹⁸F-FDG PET/CT was able to visualize primary tumors in 91% and to correctly classify the T stage of the TNM classification in 81% of the cases, to detect multifocality in 73% and cutaneous and inflammatory breast cancers in 100%. The uptake intensity of ¹⁸F-FDG (SUVmax) was significantly correlated with histo-prognostic factors such as SBR grade (P = 0.02), lack of expression of estrogen receptors (ER) (P = 0.01) and progesterone (PR) (P = 0.02), positive HER2 status (P = 0.01) or triple negative subtype tumors (P = 0.02).Conclusion¹⁸F-FDG PET/CT provides relevant elements for local assessment, in particular, tumor focality and inflammatory character in addition to ensuring the regional and extension assessment.     

冰冻切片与石蜡切片对乳腺肿瘤的诊断价值研究

目的:分析和比较冰冻切片与石蜡切片对乳腺肿瘤的诊断价值。方法:选取480例新鲜乳腺标本,将其制成冰冻切片以及石蜡切片,根据诊断结果进行对比分析,评价乳腺肿瘤的冰冻切片与石蜡切片的对乳腺肿瘤的诊断价值。结果:经石蜡切片诊断乳腺良性肿瘤277例,占57.71%,良性肿瘤中以乳腺纤维瘤诊断居多;经石蜡切片诊断乳腺恶性肿瘤203例,占42.29%,以乳腺浸润性导管癌居多。冰冻切片诊断乳腺良性肿瘤279例,占58.13%;恶性肿瘤195例,占40.62%;延迟诊断6例,占1.25%。以石蜡切片诊断结果为金标准,冰冻切片诊断乳腺良性肿瘤的准确率为98.56%(273/277),诊断恶性肿瘤的准确率为95.07%(193/203),假阳性率为0.72%(2/277),假阴性率为2.96%(6/203),冰冻切片与石蜡切片诊断乳腺肿瘤的结果具有显著一致性,K值为0.965(P0.05)。结论:冰冻切片与石蜡切片诊断乳腺肿瘤的符合率较高,可作为术中快速病理检测的手段,但该种切片方式存在少量延迟诊断,多与术者操作经验有关,故术中应注重制片过程,提高冰冻切片质量。     

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.     

Breast cancer susceptibility loci in association with age at menarche,age at natural menopause and the reproductive lifespan

Background: Genome-wide association studies have identified single nucleotide polymorphisms (SNPs) associated with breast cancer risk. Some of these loci have unknown functional significance and may mediate the effects of hormonal exposures on breast cancer risk. We examined relationships between breast cancer susceptibility variants and menstrual/reproductive factors using data from two population-based studies. Methods: The first analysis was based on a sample of 1328 women age 20–74 who participated as controls in a case–control study of breast cancer conducted in three U.S. states. We evaluated the associations between age at menarche, age at natural menopause and the reproductive lifespan with 13 previously identified breast cancer variants. Associations were also examined with a genetic score created as the sum of at-risk alleles across the 13 variants. For validation, significant results were evaluated in a second dataset comprised 1353 women age 43–86 recruited as part of a cohort study in Wisconsin. Results: Neither the genetic score nor any of the 13 variants considered individually were associated with age at menarche or reproductive lifespan. Two SNPs were associated with age at natural menopause; every increase in the minor allele (A) of rs17468277 (CASP8) was associated with a 1.12 year decrease in menopause age (p = 0.02). The minor allele (G) of rs10941679 (5p12) was associated with a 1.01 year increase in age at natural menopause (p = 0.01). The results were not replicated in the validation cohort (B = −0.61, p = 0.14 and B = −0.01, p = .0.98, respectively). Conclusions: The evaluated variants and reproductive experiences may work through separate pathways to influence breast cancer risk.     

The human breast and the ancestral reproductive cycle

This paper, using modern Darwinian theory, proposes an explanation for the increasingly high incidence of breast cancer found among pre-and post-menopausal women living today in westernized countries. A number of factors have been said to be responsible: genetic inheritance (BRCA-1), diet (specifically the increased consumption of dietary fat), exposure to carcinogenic agents, lifetime menstrual activity, and reproductive factors. The primary aim of this paper is to demonstrate the value of a perspective based on Darwinian theory. In this paper, Darwinian theory is used to explore the possibility that the increased incidence of breast cancer is due primarily to the failure to complete in a timely manner the reproductive developmental cycle, beginning at menarche and continuing through a series of pregnancies and lactation. On the basis of comparative data, we assume that most women in ancestral populations began having children before age 20 or so and tended to remain either pregnant or nursing for most of their adult lives. If a woman did not have a child by age 25 or so, she probably would never have one. Therefore, selection would probably not have acted against deleterious traits, such as cancer, that appeared after that age, just as it does not act against such traits in old age. This article is based upon a paper presented at the Sixth Annual Scientific Meeting of the Human Behavior and Evolution Society, June 18th, 1994, University of Michigan, Ann Arbor. Kathryn Coe is a Ph.D. candidate in anthropology at Arizona State University and project director of an NCI grant focusing on cervical and breast cancer in Hispanic women. Field research for her doctoral dissertation focused on the health, fertility, and culture of the Chachi Indians of the coastal rain forest of Ecuador. Lyle Steadman is an assistant professor of anthropology at Arizona State University. He has conducted research for more than two years among the isolated Hewa of Papua New Guinea. His research interests include evolutionary theory and culture, particularly religion and kinship.     

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.     

乳腺X线摄影与超声在早期老年乳腺癌诊断中的对比研究

目的:比较乳腺X线摄影与超声在早期老年乳腺癌诊断中区别与应用价值。方法:选择2014年8月至2016年6月在我院就诊的老年早期乳腺癌患者为研究对象,回顾性分析比较乳腺X线摄影检查结果与乳腺超声在乳腺癌及腋窝淋巴结的辅助诊断中的诊断确诊率,分析其区别与价值。结果:(1)乳腺X线摄影比超声对钙化更敏感,而超声比乳腺X线摄影对肿物检出率更高。(2)对于直径在0.5-2.0 cm之间的小肿瘤,超声检出率比乳腺X线摄影高;而对于肉眼及查体可扪及的乳腺大肿物(直径2.0 cm),二者的检出率无明显差异。(3)乳腺X线摄影与超声对乳腺癌诊断率无明显差异,乳腺X线摄影+超声对乳腺癌的准确率高于乳腺X线摄影。结论:两种方法在老年早期乳腺癌的辅助检查中各有优缺点,二者联合应用可达到增加诊断准确率之目的。