Bilateral breast cancer and familial aggregations

Bilateral breast cancer and familial aggregation among Japanese female patients with breast cancer were studied and results were compared with those among American female patients. Out of 3365 female patients with breast cancer mastectomized at the Cancer Institute Hospital, Tokyo from 1946 to 1975, 92 cases were primary bilateral breast cancer. The crude incidence of bilateral cancer was 2.7%, whereas it was reported to range between 3.0% and 6.8% among American female patients. The true incidence rate of breast cancer after operation for unilateral breast cancer was calculated to be 3.4 per 1000 Japanese patients per year, while it was reported to be between 5.8 and 7.1 among American patients. These figures for American patients are roughly twice as large as those for Japanese females. In the bilateral breast cancer group, there was a high frequency of familial history of breast cancer, about three times higher than that in the unilateral breast cancer group. Further, in the bilateral breast cancer group, about half of the patients were nulliparous and 60% of the patients had breast cancers associated with fibrocystic disease in the same breast tissues. These figures were about three times greater than for those in the unilateral breast cancer group.     

Familial male breast cancer. A case report and review of the literature.

The occurrence of breast cancer in aged male and his paternal uncle is reported. A review of previously reported cases of male breast cancer (M.B.C.) occurring in families and the association with other cancers in the family members is included. Familial or hereditary factors have not been recognized as a major contributing factor in previous reports. Seven families (63.6%) out of eleven families reported had females with breast cancer. It appears that there are some families in which males as well as females have increased risk of developing breast cancer. It is believed that this report supports the genetic predisposition of breast cancer in males. Estrogen affects the growth of breast cancer through estrogen receptor. An approach to subsequent genetic studies of breast cancer may be to focus on steroid hormone receptors.     

Collective memory, candidacy, and victimisation: community epidemiologies of breast cancer risk

Collectively shared ideas of community may be equally relevant for the study of health disparities as quantifying the relationship between community structures and health. Data from focus groups (N = 18) that explored understandings of breast cancer and breast cancer risk in African American neighbourhoods revealed three conceptual domains where shared ideas of community informed responses: collective memory, community candidacy, and community victimisation by external aggressors. Reading the focus group responses in terms of these domains identified perceptions of risk and of candidacy that may be overlooked by individualised or quantitative approaches to studying breast cancer risk perceptions and related behaviours. These include novel perceived risks, such as the 'risk of knowing', as well as community-level constructions of breast cancer candidacy. 'Lay epidemiologies' of breast cancer within this population might therefore be better understood as 'community epidemiologies', where community is central to the interpretation and operationalisation of breast cancer risk. Paying attention to such community epidemiologies of breast cancer provides theoretical insights for studying breast cancer disparities and risk perceptions as well as useful guidance for designing interventions.     

乳腺癌恶性程度与HGF/c-Met、端粒酶、微血管密度相关性研究

目的:探讨乳腺癌恶性程度与肝细胞因子及其受体(HGF/c-Met)、端粒酶(hTERT)表达、微血管密度(MVD)的相关性。方法:选择确诊为乳腺癌患者102例为实验组,同期确诊为良性乳腺疾病患者40例为对照组。real～timePCR检测手术切除组织的HGF与c-Met、hTERT基因表达,免疫组织化学SP法检测切除组织MVD。结果:乳腺癌Ⅱ、Ⅲ和Ⅳ期患者的hTERT与MVD均显著高于Ⅰ期和对照组(P<0.01),Ⅱ、Ⅲ、Ⅳ期患者hTERT无显著差异(P>0.05),Ⅰ期MVD显著高于对照组(P<0.01),Ⅲ、Ⅳ期患者HGF、c-Met较Ⅰ、Ⅱ期显著升高(P<0.01),Ⅲ、Ⅳ期患者MVD、hTERT无显著差异(P>0.05)但明显高于Ⅰ、Ⅱ期(P<0.01),Ⅲ、Ⅳ期发生淋巴结转移比例明显高于Ⅰ、Ⅱ期(P<0.01)。结论:HGF及c-Met、hTERT表达与MVD和乳腺癌临床分期和肿瘤的恶性程度具有明显关系,检测这些指标可以辅助判断乳腺癌的恶性程度和预后。     

Breast cancer: incidence, nutritional concerns, and treatment approaches

Breast cancer is the leading cause of cancer death in women in the United States. Western cultural factors, such as high socioeconomic status, early age of menarche, and late age at first pregnancy, may be risk factors in the development of breast cancer. A strong positive correlation exists worldwide between fat consumption and breast cancer. Case-controlled studies also support an association of a high-fat diet and breast cancer. Animal studies using rats or mice have verified that fat is a promoter of breast cancer after exposure to a known chemical carcinogen. A high-fat diet resulted in a higher incidence of breast tumors than a low-fat diet. Recent rodent studies further suggest that a reduction in calories alone reduces breast cancer incidence. Furthermore, studies reveal that the 5-year survival is about 80% after appropriate therapy (surgery, radiation, and/or chemotherapy) for breast cancer, with early detection by self-examination as the first step to improve outcomes. Excision of the breast tumor (segmental mastectomy) and some surrounding normal tissue followed by radiation therapy can be as effective therapy for most small breast cancers as total or radical mastectomy. The authors strongly recommend obtaining medical evaluation for any lump or thickening in the breast and following good dietary practices.     

Oral contraceptive use and the risk of breast cancer in women with a "prior" history of benign breast disease

This article suggests that an improper definition of prior history of benign breast disease may be responsible for research results that show an increased risk of breast cancer among oral contraceptive (OC) users with such a history. It is maintained that women who developed fibrocystic breast disease in the 1960s-late 1970s despite longterm use of OCs were intrinsically at greater risk of breast cancer than nonusers who developed fibrocystic disease. Thus, it is improper in epidemiologic studies of OC use and the risk of breast cancer to define a prior history of fibrocystic disease as prior to the development of breast cancer or to corresponding reference ages of women without breast cancer. Rather, prior history should be defined as prior to the use of OCs. The article further analyzes the 3 major case-control studies of breast cancer that developed before 1978 that have suggested OC use increases the risk of breast cancer in women with a prior history of benign breast disease. In the 1st study, by Paffenbarger et al, the operational definition of prior history of benign breast disease appears to be prior to hospitalization for breast cancer. In the 2nd study, by Lees et al, a prior history was defined as prior to presentation at the clinic. In the 3rd study, by Brinton et al, a prior history of benign breast disease was defined as prior to the 1st screening. When stratification or adjustment for prior history of benign breast disease is restricted to disease that develops prior to any OC use, the epidemiologic studies fail to show that women with existing benign breast disease who initiate OC use alter their risk of developing breast cancer.     

Men's and women's knowledge and perceptions of breast cancer and mammography screening

BACKGROUND: Although most men are not directly affected by breast cancer, they participate in decisions influencing breast cancer screening and contribute to shaping the social norm on mammography screening. This study tested the hypothesis that men may be less knowledgeable than women about breast cancer and mammography and have less favorable perceptions of mammography screening. METHODS: A survey was mailed to 952 women and 370 men aged 40 to 80 years, randomly selected from the general population of Geneva, Switzerland. Information collected included knowledge and perceptions about breast cancer and mammography, familiarity with screening recommendations, and perceived usefulness of an organized screening program. RESULTS: Men were almost as knowledgeable as women about breast cancer (difference in z-scores: -0.12; 95% CI: -0.25, 0.02; P = 0.10) and breast cancer screening (difference: -0.12; 95% CI: -0.25, 0.02; P = 0.09). Both men and women perceived mammography screening to be useful, but men had significantly higher z-scores of positive attitude toward mammography than women (difference: 0.28; 95% CI: 0.14, 0.42; P < 0.001). Younger and more educated respondents of either sex were both more knowledgeable and more favorably inclined toward screening. CONCLUSION: Men were as knowledgeable about breast cancer and mammography screening as women but had more favorable attitudes toward breast cancer screening than women. Actions to strengthen community support for mammography screening programs should primarily target older and less educated persons of either sex.     

Knowledge and perceptions about breast cancer incidence, fatality and risk among Australian women

OBJECTIVE: Breast cancer is the most common fatal cancer among Australian women. This study aimed to provide an accurate national picture of women's understanding of breast cancer incidence, fatality and risk. METHOD: A telephone survey explored the knowledge and perceptions of a sample of 2,935 Australian women in relation to breast cancer incidence, fatality, risk factors, risk perception and level of concern. RESULTS: Australian women were well aware of breast cancer in general terms, however, there were major aspects of incidence and risk which were poorly understood. Only 5% of women nominated age as a risk factor, and only one-third were able to make an approximately correct estimate of the incidence of breast cancer in Australia. CONCLUSIONS AND IMPLICATIONS: Recommendations for future information campaigns include targeting understanding of lifetime risk of developing breast cancer, age as a risk factor, survival from breast cancer and the need to separately address the perceptions of older versus younger women.     

Incidence and prevalence estimations for breast and colorectal cancer in the Picardy region

OBJECTIVES: To provide incidence and prevalence data on breast and colorectal cancer in the Picardie area of France. METHODS: An age-period-cohort method was used to estimate regional incidence and prevalence of cancer from regional cancer mortality data and patient survival data recorded in the Somme Cancer Registry. RESULTS: European standardized breast incidence for 1998 was 110 per 100000 inhabitants. The incidence for colorectal cancer was 67 per 100000 for men and 47 per 100000 for women. Prevalence was 9656 for breast cancer and 6283 (2941 for men and 3342 for women) for colorectal cancer. Incidence of breast cancer increased considerably (80.9%) between 1979 and 1998. CONCLUSION: These results provide data on breast cancer and colorectal cancer which are useful for planning demand for healthcare or medical surveillance in the Picardie area.     

乳腺疾病高危人群乳腺癌认知度与乳腺自检现状调查及相关性研究

目的 对乳腺疾病高危人群乳腺癌认知度与乳腺自检现状进行分析,为乳腺癌防治工作提供依据。方法 以2018年6月至2019年5月在郑州市某医院进行乳腺X线检查的疑有乳腺疾病就诊者进行问卷调查,调查内容包括研究对象一般情况、乳腺癌认知度及乳腺自检情况,分析该人群乳腺癌认知度及自检现况,并对认知度及自检现状的各部分得分进行相关分析。结果 本研究共对郑州市乳腺X线检查的乳腺疾病高危人群390例进行调查,该人群年龄18~65岁,居住地为城镇209例(占53.6%),高中及以上文化程度221例(占56.7%),已婚(有配偶)349例(占89.5%),有生育史338例(占86.7%)。乳腺疾病高危人群乳腺癌认知度总分为(88.76 ± 8.40)分,乳腺自检总分为(18.26 ± 2.11),均处于中等水平。36~45岁、文化程度高中及以上、机关团体工作者、居住地为城镇、已婚的研究对象乳腺癌认知总分及乳腺自检总分更高(均P<0.01)。Pearson相关分析提示乳腺自检状况与乳腺癌认知度呈正相关(均P<0.05)。结论 郑州市乳腺疾病高危人群乳腺癌认知度与乳腺自检现状有待提高,该人群乳腺自检现状与乳腺癌认知度呈正相关,相关部门应采取针对性干预措施提高乳腺癌认知度,改善乳腺自检现状,有利于预防和及早发现乳腺癌。     

MMP-9和VEGF在乳腺癌的表达及临床意义

目的探讨基质金属蛋白酶-9(MMP-9)和血管内皮细胞生长因子(VEGF)在乳腺癌的表达及临床意义。方法应用免疫组化SP法检测96例乳腺癌组织MMP-9与VEGF的表达,并与患者临床病理指标进行分析。结果乳腺癌组织MMP-9与VEGF阳性率分别为65.6%、71.9%。MMP-9与VEGF的表达均与乳腺癌的病理分级、淋巴结转移密切相关(P<0.05)。MMP-9与VEGF在乳腺癌的表达呈正相关。结论MMP-9与VEGF参与乳腺癌的发生发展过程,可作为评估乳腺癌生物学行为的一项指标。     

Breast cancer attitudes, knowledge, and screening behavior in women with and without a family history of breast cancer

Women volunteers with or without a first-degree relative with breast cancer (FDR) were compared on several measures. Relative to the comparison group, women in the FDR group had more negative attitudes about breast cancer (including more anxiety about breast cancer), viewed their risk for getting breast cancer as greater (although they underestimated the actual risk), and were more likely to engage in appropriate screening behavior. A high percentage of women in both groups stated that they would want to have a genetic test for breast cancer if it were generally available.     

Polychlorinated Biphenyls and Breast Cancer Risk by Combined Estrogen and Progesterone Receptor Status

Studies have suggested that breast cancer risk factor profiles may vary according to joint estrogen receptor (ER) and progesterone receptor (PR) tumor status. Most of the published literature to date which has investigated the association between exposure to organochlorine compounds and breast cancer has reported null or weak associations. If, indeed, the classification by hormonal receptor status identifies different forms of breast cancer, then assessing the risk of exposure to polychlorinated biphenyls (PCBs) on breast cancer as one disease or stratifying based on ER or PR status alone may obscure the association between PCBs and breast cancer. A hospital-based case-control study of 266 cases and 347 benign breast disease controls was conducted to examine the association of blood serum and adipose tissue concentrations of PCBs with breast cancer by joint ER/PR status. Total PCBs were measured in blood serum, and the following PCB congeners were measured in breast adipose tissue: 74, 118, 138, 153, 156, 170, 180, 183, 187. We did not detect any clear relationship or change in breast cancer risk based on joint ER/PR tumor status for body burden of PCBs, whether measured in blood serum or breast adipose tissue, by total PCBs or for specific congeners. These results confirm previous findings in the literature of no positive association between environmental exposure to PCBs and risk of breast cancer.     

Sexual minority status and long-term breast cancer survivorship

Sexual minority women, such as lesbians, bisexuals, and women who have a woman partner face unique challenges, such as deciding on disclosing their sexual minority status to health providers. The purpose of this qualitative study was to explore the perceptions of sexual minority women who were long-term breast cancer survivors. Twenty-two sexual minority women, diagnosed with non-metastatic breast cancer between 2000 and 2005, participated in semi-structured, open-ended interviews. Interviews were audio-recorded, transcribed, and analyzed to identify emergent themes to summarize sexual minority women's perceptions of breast cancer survivorship. Participants' perceptions about the impact of their sexual minority identity on breast cancer survivorship consisted of: (1) breast cancer is a women's issue, not a lesbian issue; (2) I can manage my identity in the context of breast cancer; and (3) I am better off than heterosexual women. The authors' findings suggest a possible disconnect between sexual minority women with breast cancer who de-emphasized the importance of sexual minority status and the research community that emphasizes the importance of this status. Prior to counting on sexual minority women's interest in studies, researchers may need to educate sexual minority women about the need of breast cancer studies.     

肿瘤干细胞标志物ALDH1及CD133在乳腺癌中的表达及意义

目的:通过检测醛脱氢酶-1(ALDH1)及CD133的表达,探讨其作为乳腺癌干细胞标志物的敏感性和特异性。方法:应用免疫组织化学方法,检测乳腺癌干细胞标志物ALDH1及CD133在人乳腺癌组织中的表达。结果:ALDH1在乳腺癌中的表达阳性率为40.74%,ALDH1阳性染色主要分布于肿瘤细胞的胞浆,胞核不染色,阳性细胞散在分布于肿瘤组织中,部分区域可见阳性细胞密集分布现象。CD133阳性细胞表现为位于胞膜、胞浆上的棕褐色染色,胞核不染色。在27例乳腺浸润性导管癌中6例CD133呈阳性,阳性率为22.22%,并且随着乳腺癌组织学级别的增高其表达增高。结论:ALDH1及CD133联合应用可作为乳腺癌干细胞的特异性标志物。     

Lactation and reproductive histories of breast cancer patients in Tokyo, Japan

Epidemiological characteristics of breast cancer have been studied in Tokyo, an area of relatively low breast cancer rates, as part of an international collaborative study. Breast feeding of infants is customary for Japanese women, but even very prolonged lactation did not appear to be associated with a reduction in breast cancer risk. Late age at menarche and early age at first pregnancy were both associated with reduced breast cancer risk. The protective effect of early pregnancy seems much greater than has previously been recognized, and may indeed be greater in Japan than in other areas. However, the average age at first pregnancy is not lower in Tokyo than in areas than in areas where breast cancer rates are high.     

围绝经期女性乳腺癌机会性筛查情况及影响因素分析

目的调查围绝经期女性乳腺癌机会性筛查情况,分析相关影响因素。方法收集2015年3月-2019年3月在温州医科大学附属第一医院围绝经期门诊初次就诊的女性作为研究对象,采用调查问卷分析其接受乳腺癌机会性筛查的情况,并采用Logistic多元回归分析探讨影响围绝经期女性乳腺癌机会性筛查的因素。结果最终纳入1357例研究对象,422例在本次就诊前1年内行乳腺癌机会性筛查,占31.1%,其中采用乳腺超声检查者最多,占59.5%。Logistic回归分析显示:受教育程度、家庭人均月收入、人工流产史、既往乳腺疾病史、肥胖是乳腺癌机会性筛查的影响因素(P<0.05)。结论围绝经期女性的乳腺癌筛查率较低,进行乳房自检的女性较少,乳腺癌筛查率与围绝经期女性受教育程度、家庭人均月收入、人工流产史、既往乳腺疾病史、肥胖有关,应加强围绝经期女性对早期乳腺癌机会性筛查重要性的认识,以提高乳腺癌的预防与控制水平。     

An Updated Comprehensive Review on Vitamin A and Carotenoids in Breast Cancer: Mechanisms,Genetics, Assessment,Current Evidence,and Future Clinical Implications

Vitamin A and carotenoids are fat-soluble micronutrients that play important role as powerful antioxidants modulating oxidative stress and cancer development. Breast cancer is the most common malignancy in women. As the risk of breast cancer is dependent on various lifestyle factors such as dietary modifications, there is increasing interest surrounding the anti-cancerous properties of vitamin A and carotenoids. Despite the suggested protective roles of vitamin A and carotenoids in breast cancer development, their clinical application for the prevention and treatment of breast cancer is limited. In this narrative review, we discuss the roles of vitamin A and carotenoids along with the evaluation method of vitamin A status. We also exhibit the association of genetic variations involved in metabolism of vitamin A and carotenoids with cancers and other diseases. We demonstrate the epidemiological evidence for the relationship of vitamin A and carotenoids with breast cancer risk, their effects on cancer mechanism, and the recent updates in clinical practice of vitamin A or carotenoids as a potential therapeutic agent against breast cancer. This review provides insight into the preventive and therapeutic roles of vitamin A and carotenoids in breast cancer development and progression.     

Rationale and technique of clinical breast examination

Despite the advances in breast imaging, there are clear indications for the need of clinical breast examination as part of breast cancer screening for all women. The article reviews the technique for clinical breast examination and assessment of its results. The main goal of the clinical breast examination is to differentiate normal physiologic nodularity from a discrete breast mass. If a discrete mass is identified, evaluation is mandatory in all cases to exclude breast cancer. This evaluation is guided by the features of the clinical findings, the age of the woman, and her personal risk for breast cancer.