Association of Urinary Cesium with Breast Cancer Risk

Background: The aim of this study is to examine the association of urinary cesium with breast cancer risk.Materials and Methods: We collected survey data and urine specimens from 240 women with incident invasivebreast cancer before their treatment and 246 age-matched female controls between October 2009 and July2010. Urinary concentrations of cesium were determined by inductively coupled plasma mass spectrometry.Interviews were conducted by face-to-face to obtain information on potential breast cancer risk factors. Logisticregression analysis was used to estimate the associations. Results: Creatinine-adjusted levels [median (25th, 75th)ug/g] of cesium in cases and controls were 17.6 (13.1, 24.0) and 19.3 (15.3, 25.7), respectively. After adjustmentfor potential risk factors, women in the second and highest tertile of cesium showed a decreased risk of breastcancer in a dose-dependent manner as compared with those in the lowest tertile [ORs and 95% CIs: 0.75 (0.46-1.22) and 0.50 (0.30-0.82), respectively]. This decrease was more evident in women with ER positive or localizedclinical stage in an exploratory stratification analysis. Conclusions: These findings suggest that cesium may haveanticancer efficacy and urinary cesium has potential as a biomarker for breast cancer risk assessment.     

Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group.     

Hair dye and chemical straightener use and breast cancer risk in a large US population of black and white women

Many hair products contain endocrine-disrupting compounds and carcinogens potentially relevant to breast cancer. Products used predominately by black women may contain more hormonally-active compounds. In a national prospective cohort study, we examined the association between hair dye and chemical relaxer/straightener use and breast cancer risk by ethnicity. Sister Study participants (n = 46,709), women ages 35–74, were enrolled between 2003 and 2009, and had a sister with breast cancer but were breast cancer-free themselves. Enrollment questionnaires included past 12-month hair product use. Cox proportional hazards models estimated adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between hair products and breast cancer; effect measure modification by ethnicity was evaluated. During follow-up (mean = 8.3 years), 2,794 breast cancers were identified. Fifty-five percent of participants reported using permanent dye at enrollment. Permanent dye use was associated with 45% higher breast cancer risk in black women (HR = 1.45, 95% CI: 1.10–1.90), and 7% higher risk in white women (HR = 1.07, 95% CI: 0.99–1.16; heterogeneity p = 0.04). Among all participants, personal straightener use was associated with breast cancer risk (HR = 1.18, 95% CI 0.99–1.41); with higher risk associated with increased frequency (p for trend = 0.02). Nonprofessional application of semipermanent dye (HR = 1.28, 95% CI 1.05–1.56) and straighteners (HR = 1.27, 95% CI 0.99–1.62) to others was associated with breast cancer risk. We observed a higher breast cancer risk associated with any straightener use and personal use of permanent dye, especially among black women. These results suggest that chemicals in hair products may play a role in breast carcinogenesis.     

Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study

Background: Breast cancer remains the leading cause of death for women globally, including in Indonesia. Breast cancer screening plays a vital role in reducing deaths caused by breast cancer. However, breast cancer screening rate is still low and studies on determinants for breast cancer screening is limited in Indonesia. This study aimed to identify the determinants of breast cancer screening among women in Indonesia. Methods: This population-based study was conducted among 827 women who lived in either rural and urban areas, using a stratified sampling design where were based on province and locality combinations. Data were analysed using a binary logistic regression model to assess the associations between independent and dependent variables. Results: As many as 827 women with an average age of 29.91 (± 11.14) years old participated in this study. The overall breast cancer screening among women was 18.74%. Knowledge of breast cancer risk factors, signs, and symptoms (adj.OR = 1.75, 95%CI: 1.20 – 2.56), age of 35 to 39 years old (adj.OR. = 1.52, 95% CI: 1.02 – 2.26), and household income of ≥6,000,000 IDR (≥457 USD) (adj.OR. = 5.19, 95%CI: 1.43–18.84) were associated with breast cancer screening attendance. In contrast, Christian women had a significantly lower breast cancer screening rate that women from other religions (adj. OR. = 0.45, 95%CI: 0.24 – 0.85). Conclusion: The overall breast cancer screening attendance was poor among Indonesian women population. Age, household income, religion, and knowledge of breast cancer risk factors were identified as the determinant factors for breast cancer screening.     

Roles of Adiposity,Lifetime Physical Activity and Serum Adiponectin in Occurrence of Breast Cancer among Malaysian Women in Klang Valley

Background: Lack of physical activities throughout life is related to obesity and is a risk factor of breastcancer, however, the associations of these factors with adiponectin in the occurrence of breast cancer have notbeen well investigated. Objective: This study investigated the relationship between adiposity, lifetime physicalactivities and serum adiponectin as breast cancer risk factors among Malaysian women in Klang Valley, Malaysia.Design: A case-control study was carried out among 70 newly diagnosed breast cancer patients and 138 controlsaged 29 to 65 years old in Klang Valley. Subjects: The inclusion criteria for both groups were not havingmenstruation for premenopausal women, no evidence of pregnancy, not lactating and no chronic diseases suchas hypertension and diabetes at the time of data collection. In addition, the cases must be pathologically newlydiagnosed with breast cancer (stage I to III) and not on any therapy for cancer, with the exception of surgery.The controls were matched with cases for age ± 5 years and menopausal status. Measurements: Subjects wereinterviewed to obtain information on socio-demography, health and reproductive history using a pretestedquestionnaire. Subjects were also asked on their engagement of physical activity since secondary school.Anthropometric parameters included height, weight, waist and hips were also measured. A total of 6 ml offasting venous blood was drawn for analysis of serum adiponectin in duplicate using Linko Adiponectin ELISAKit. Fasting blood glucose (FBG) and blood pressure were also measured. Results: Mean body mass index(BMI) among cases and controls were not significantly different (p>0.05) at 26.1 ± 4.8 kg/m2 and 25.3 ± 4.5 kg/m2, respectively. FBG among cases (6.3 ± 1.8 mmol/L) was higher than controls (5.6 ± 1.1 mmol/L) (p<0.05).Waist hip ratio (WHR) of cases (0.85 ± 0.07) was also higher than controls (0.80 ± 0.06) (p<0.05). Abdominalobesity (WHR >0.85) increased risk of breast cancer by three folds [Adjusted OR 3.3 (95%CI 1.8-6.2)] (p<0.05).Adiponectin level was inversely related to waist circumference (r=-0.510, p=0.000), BMI (r=-0.448, p=0.000)and FBG (r=-0.290, p=0.026). Adiponectin level in cases (11.9 ± 4.8 μg/ml) were lower than controls (15.2 ± 7.3μg/ml) (p<0.05). A greater reduction of breast cancer risk was observed with the increasing level of serumadiponectin level according to percentiles (p<0.05). Subjects with mean serum adiponectin level at the highestquintile (>75th)(≥16.7 μg/ml) had 80% reduced risk of breast cancer [Adjusted OR 0.2 (0.0-0.6)](p<0.05). Ahigher percentage of cases (47%) had not engaged in any physical activity throughout life as compared tocontrols (19%)[Adjusted OR 3.7 (1.7-7.7)](p<0.001). Conclusions: Abdominal obesity and physical inactivitythroughout life were associated with low serum adiponectin and breast cancer risk among subjects. Thus, it isessential for Malaysian women to be physically active and achieve a healthy waistline in order to increase serumadiponectin level and reduce breast cancer risk.     

Relationship of hair dye use, benign breast disease, and breast cancer

An epidemiologic case-control study of 118 breast cancer patients and 233 controls was conducted to test the hypothesis that hair dyes are related to breast cancer. Matched controls were selected by "random digit dialing," and all epidemiologic data were collected by telephone interviews. No overall association was detected. On a prospective basis, the interaction between hair dye exposure and six variables known to be risk factors for breast cancer then were examined: previous benign breast disease (BBD), "ever" versus "never" pregnant, age at first pregnancy, menopause induced by operation, age at menarche, and education. A statistically significant increased risk of breast cancer was found for women with a history of BBD and exposure to hair dyes as compared to women with BBD but no hair dye exposure: The relative risk (RR) was 4.5, and the 95% confidence intervals (C) were 1.20 and 15.78. A total of 24 women (19 patients and 5 controls) reported a history of BBD and hair dye use. Further analysis revealed a significant association between hair dye use and breast cancer among women 40-49 years of age (RR = 3.33; 95% CI: 1.1 and 10.85) and a highly significant (P = 0.0008) dose-response relationship among women who used hair dyes for changing their natural color as opposed to covering gray hair. The numbers of patients and controls included in this study were small and several hypotheses were tested. Additional epidemiologic studies are needed before firm conclusions can be reached concerning the nature of these associations.     

Determination of Information and Support Needs of First Degree Relatives of Women with Breast Cancer

Background: Breast cancer is the most frequent type of cancer among women in the world and the mostcommon cause of deaths from cancer in females. In Turkey, breast cancer comes first in the list of the mostfrequent ten cancer types seen in women. As the incidence rate of breast cancer is high, many women havingbreast cancer in the family experience the breast cancer at secondhand. This study was carried out in an attemptto determine the information and support needs of women whose first-degree relatives have breast cancer andto what extent these needs are met. Methods: The research sample consisted of 156 women. Questionnaire Formand Information and Support Needs Questionnaires were used as the data collection tools. Results: Informationneed score averages (x̄:3.72±0.19) of women included in the research sampling were found to be higher than theirscore averages of support needs (x̄:3.24±0.41). Conclusion: Information needs which were indicated by womenas very important were related to treatment, symptoms of breast cancer and breast self examination (BSE), whilesupport needs which were indicated by women as very important were learning how to perform BSE, women’sanxiety for themselves and their relatives regarding breast cancer and having their breasts examined by a healthprofessional. It is recommended that nurses and other medical staff should give information to women whosefirst-degree relatives have breast cancer about the disease, its etiology, scanning, diagnosis, treatment optionsand protection as well as prevention.     

A place for fiber diffraction in the detection of breast cancer?

AIMS: To review the potential relevance and the place that a particular change in the fiber diffraction of hair might have in the future management of breast cancer and other pathologies. METHOD: A comprehensive overview was obtained using a complete search of the Australian National University Library (data range) and Medline (data range) using the search terms "review breast cancer screening/diagnosis/detection" and "X-ray diffraction of hair". Publications in the past 5 years were selected but older reports that were commonly referenced were not excluded. RESULTS: To date, our results have demonstrated that a specific change occurs in the diffraction pattern of hair for persons with breast cancer. Further research has shown that this change is present in the hair at an earlier stage of the cancer growth than is detectable by mammography. In addition, the change has been found to disappear when the cancer has been successfully removed. DISCUSSION/CONCLUSION: This technology uses only a few hairs, is totally user-friendly, non-invasive and does not require the patient to be exposed to any radiation. As a low-risk procedure, it could potentially provide a much needed, cost-effective early screening test for the presence of breast cancer in women of any age. As the patients are not required to be present during the test, it could also provide a testing service for women in remote areas. In this review, the origin of the diffraction pattern and the diagnostic information that can be gleaned from it are outlined.     

Psychopathological Profile of Women with Breast Cancer Based on the Symptom Checklist-90-R

Background: With effective early treatments, many breast cancer patients suffer from psychological distressdue to adverse effects and lifelong physical disfigurement. Our study aimed to evaluate the psychopathologicalprofile of breast cancer patients in comparison with healthy women and explored demographic correlates. Method:We consecutively enrolled breast cancer patients who came to the hospital for follow-up or rehabilitation careafter primary treatment, and healthy female relatives or friends of inpatients in the Cancer Institute of ChineseAcademy of Medical Sciences between August 30, 2010 and January 1, 2012. Psychopathological profile wasassessed based on the Symptom Checklist-90-R (SCL-90-R) for patients and controls. We compared demographicssuch as age, ethnicity, education, marriage, and occupation, and incorporated these data plus cancer statusfor the association with the general SCL-90-R index and scores for 9 major symptom dimensions in multipleregression analysis. Results: We surveyed a total of 291 female breast cancer patients and 531 healthy women.The average age was 55.1±6.40 years for breast cancer patients and 43.1±12.8 for healthy controls (P<0.01). Themean survival was 5.20 years for cancer patients (range, 0.60-9.90 years). There were statistically significantdifferences in education, marriage, and occupation between the two groups (P<0.01). General index (1.45±0.45versus 1.32±0.37) and 8 dimension scores (excluding anxiety) on SCL-90-R were significantly higher in patients(P<0.05). Multiple regression analysis showed that the breast cancer status was positively correlated with generalSCL-90-R index and 6 dimension scores (excluding the anxiety, phobic anxiety and paranoid ideation dimensions)(P<0.05). Regression coefficients ranged from 0.10 (depression) to 0.19 (somatization). Higher interpersonalsensitivity was noticed in single women compared to married women. Conclusions: Chinese patients withbreast cancer demonstrate greater psychopathology compared to healthy controls. The breast cancer status isan independent contributing factor to the general psychopathological profile. Breast cancer patients should begiven particular counseling and care to alleviate their psychological distress.     

A case-control study of hair dye use and breast cancer.

A case-control study of the relationship between hair dye use and breast cancer included 129 breast cancer patients and 193 control women drawn from the records of a multiphasic screening clinic. Information was obtained by telephone interview on a number of risk factors for breast cancer and on variables pertaining to hair dye use: chronologic time, duration, frequency, type, and color. From this, quantitative measures of cumulative hair dye use at various intervals prior to breast cancer (or an equivalent for controls) were obtained. A multivariate risk factor score was used to control for confounding variables. The adjusted relative risks for breast cancer versus hair dye use were greater than unity but were not generally significant. However, integral measures of hair dye use (No. of yr times frequency per yr) were significantly related to breast cancer when confounding variables were controlled. The association between hair dye use and breast cancer was greatest among women over 50 years of age and among those at lower natural risk for breast cancer. An analysis of temporal patterns showed that breast cancer was related mainly to hair dye use 10 or more years before cancer diagnosis. Because of the retrospective nature of the hair dye data and the small sample size, these results require further validation.     

CA 15-3 (Mucin-1) and Physiological Characteristics of Breast Cancer from Lahore,Pakistan

Background: High incidence of breast cancer and its fatal effect has reached an alarming stage across theglobe, including the third world countries. Many factors have been reported to be associated with the developmentof breast cancer but detailed structural and functional information is missing. CA 15-3 is one of the knownpotential tumor marker of breast cancer; however little is known about structure and functional site of thisprotein. Present study aims to investigate the functional role of CA 15-3 in breast cancer, especially in developmentand metastasis. Material and Methods: Hundred female breast cancer patients confirmed by histopathologicalreports were included in the study. Their physiological characters were recorded in a performa. Enzyme linkedimmunosorbent assay (ELISA) technique was used to estimate serum CA 15-3 level. Immunohistochemistry wasdone for estrogen (ER), progesterone (PR) and Her2/neu receptors expression. Results: The study revealed thedetails of physiological characteristics of female breast cancer. Mean age was 37.72±5.99 and 55.05±7.28 yearsand serum CA 15-3 (MUC1) level was 60.47±8.59 and 63.17±4.58 U/ml in pre and post-menopause respectively,and both groups of women had sedentary life style. Their receptor status especially of progesterone, estrogen andHER-2/neu were positive in 50% of premenopausal women and 65% of postmenopausal women. Conclusion:There are multiple physiological factors promoting breast cancer. High serum CA 15-3 level and hormonalimbalance of ER, PR and Her2/neu appears to be the main cause of breast cancer. It may be possible that thefunctional sites of these proteins may be altered which may increase the chances of metastasis in breast cancer.     

女性乳腺密度与年龄及乳腺癌的相关性研究

目的 探讨女性乳腺密度与年龄及乳腺癌的相关性。方法 对符合纳入标准并自愿接受乳腺X线检查的5006例女性,依据第四版ACR BI-RADS分类对乳腺密度进行分型,分析年龄分组、乳腺密度分型与乳腺癌间的关系。结果 5006例受检女性平均年龄(44.22±8.09)岁。乳腺密度类型为脂肪型256例(5.11%),少量型726例(14.51%),多量型3719例(74.29%),致密型305例(6.09%)。不同乳腺密度类型患者间年龄分布差异有统计学意义(P＜0.001)。各年龄组间乳腺密度类型分布差异有统计学意义(P＜0.001)。病理诊断乳腺癌184例,平均年龄(51.26±10.15)岁。乳腺密度类型中乳腺癌发生百分比由高到低依次为脂肪型10.16%(26/256)、少量腺体型9.09%(66/726)、多量腺体型2.45%(91/3719)、致密腺体型0.33%(1/305)。乳腺癌患者在各年龄组间以及不同乳腺密度类型间差异有统计学意义(P＜0.001)。结论 年龄是影响女性乳腺密度的重要因素;较低乳腺密度类型女性患乳腺癌风险较为突出。     

Role of valence state and solubility of chromium compounds on induction of cytotoxicity, mutagenesis, and anchorage independence in diploid human fibroblasts

We previously showed that carcinogenic nickel, arsenic, and chromium(VI) compounds induced anchorage independence (AI) in diploid human fibroblastic cells (HFC) derived from foreskins (K. A. Biedermann and J. R. Landolph, Cancer Res., 47: 3815-3823, 1987). To elucidate the role of the valence state of chromium and solubility of chromium compounds in inducing AI, we studied the ability of soluble and insoluble hexavalent [chromium(VI)] and trivalent [chromium(III)] chromium compounds to induce mutation and AI in HFC. Chromium(VI) compounds (PbCrO4, CaCrO4, Na2CrO4, and CrO3) were 1000-fold more cytotoxic to HFC (average 50% lethal dose 0.5 microM) than chromium(III) compounds (CrCl3, Cr2O3, Cr2S3; average 50% lethal dose 500 microM). However, equal concentrations (0.1-10.0 microM) of soluble or insoluble chromium compounds in either +6 or +3 valence states induced similar increases in frequencies of AI in HFC (100-200/10(5]. Chromium(VI)- and chromium(III)-induced AI was a stable phenotype. All soluble chromium(VI) and insoluble chromium(III) compounds studied induced mutation to 6-thioguanine resistance at cytotoxic concentrations in HFC. Insoluble PbCr(VI)O4 and a soluble form of Cr(III)Cl3 were inactive in this assay. Mutation induction by chromium(III) compounds only occurred at cytotoxic concentrations (100-1000 microM) 1000-fold greater than those concentrations of chromium(VI) compounds (0.25-1 microM) which were cytotoxic, mutagenic, and induced AI. Soluble hexavalent Na2(51)CrO4 was taken up facilely by cells at concentrations that induced cytotoxicity, mutation, and AI. At concentrations of 0.25-1.0 microM, which induced AI but were not cytotoxic or mutagenic, or concentrations of 1-1000 microM, which were cytotoxic and mutagenic, soluble trivalent 51CrCl3 was not taken up by cells. An insoluble form of CrCl3 was not taken up intracellularly but did avidly associate with cells over the concentration range 1 to 100 microM which induced AI, cytotoxicity, and mutagenicity. Therefore, both chromium(VI) and chromium(III) compounds induced genotoxic effects in human fibroblasts. Cellular uptake, cytotoxicity, mutagenicity, and AI induced by soluble chromium(VI) compounds all occurred at the low concentrations of 0.2 to 1.0 microM; hence mutagenicity and induction of AI may be coupled for soluble chromium(VI) compounds but not for insoluble PbCrO4, which induced AI but was not mutagenic. Cytotoxicity and mutagenicity of insoluble chromium(III) occurred at concentrations of 10-100 microM, but induction of AI occurred at concentrations of 0.1-10 microM, indicating that inductions of mutagenicity and AI were not coupled for chromium(III) compounds.(ABSTRACT TRUNCATED AT 400 WORDS)     

Microscopic analysis of chromium accumulation in the bronchi and lung of chromate workers

BACKGROUND: It is known that chromium is an inhaled carcinogen and an important risk factor in the development of lung carcinoma. METHODS: The authors used a microscopic X-ray fluorescence analyzer with transmitted X-ray mapping imaging (Horiba, Kyoto, Japan) to measure the accumulation of chromium in 10 resected lung tissue specimens and 90 biopsy specimens from chromate workers. RESULTS: The maximum chromium accumulation (mean +/- standard deviation) in 10 resected lung tissue specimens was 197 +/- 238 counts per second (cps)/mili ampere (mA) (range, 4-649 cps/mA). Chromium accumulation was scattered in six tissue specimens and diffuse in one specimen. Chromium accumulation in the proximal bronchi was less than in the bronchioles or subpleural regions of the lung. Chromium accumulation was detectable in 63 (70%) of 90 biopsy specimens, and the mean accumulation was 6.5 +/- 9.2 cps/mA (range, 0-46.5 cps/mA). Chromium detected in bronchial tissue specimens was deposited in the bronchial stroma but not in the epithelium. The maximum chromium accumulations in dysplasic (n = 3), squamous metaplastic (n = 10), and normal bronchial epithelia (n = 9) in chromate workers and in normal bronchial epithelia (n = 3) in non-chromate workers were 20.2 +/- 5.4, 18.3 +/- 12.2, 13.2 +/- 13.4, and 3.0 +/- 1.8 cps/mA, respectively. The amount of chromium accumulation significantly increased according to the progression of malignant change of the bronchial epithelium (P = 0.003). CONCLUSIONS: Previous studies found that lung carcinoma with chromate exposure exhibited a variety of genetic abnormalities. Considering genetic aberrations and chromium accumulation in these premalignant lesions is useful for elucidating the process of carcinogenesis in chromium-induced lung carcinoma.     

乳腺癌术后患者三氧治疗对血清TK1水平变化的影响

目的:探讨切除术后乳腺癌患者三氧治疗前后血清胸苷激酶 1(thymidine kinase-1,TK1)水平的变化及其与肿瘤分期的关系.方法:应用酶免疫点印记化学发光法检测104例切除术后乳腺癌患者三氧疗法前后血清TK1水平.比较不同临床分期乳腺癌患者接受三氧疗法前后 TK1、CA15-3及CEA水平的差异,分析TK1与雌激素受体(ER)和孕激素受体(PR)的关系.结果:三氧治疗前乳腺癌患者TK1平均值为(1.52±1.53) pmol/L,与健康体检组的(0.54±0.42) pmol/L相比,差异有统计学意义(P=0.000);三氧治疗后TK1平均值为(0.73±0.82) pmol/L,与治疗前相比,差异有统计学意义(P=0.001).根据临床分期,Ⅰ-Ⅲ期患者治疗前TK1平均值为(1.05±1.17) pmol/L,治疗后平均值为(0.38±0.44) pmol/L,差异有统计学意义(P=0.002);Ⅳ期患者治疗前TK1平均值为(2.53±1.73) pmol/L,治疗后平均值为(1.47±0.94) pmol/L,差异无统计学意义(P=0.080).CA15-3及CEA在三氧治疗前后比较,差异均无统计学意义,但Ⅰ-Ⅲ期患者CA15-3及CEA与TK1变化趋势有一致性.TK1与ER、PR有关联(r=0.455,P=0.000).结论:三氧治疗能有效降低切除术后乳腺癌患者的TK1水平,抑制肿瘤细胞增殖,控制疾病进展,且对Ⅰ-Ⅲ 期患者更有意义.     

Trends in Breast Cancer Incidence in Iraq During the Period 2000-2019

Background: Breast cancer is the most common cancer among women around the world. Objective: This study aims to explore the time trends in the incidence of breast cancer in Iraq in twenty years period (2000 to 2019) to assist health officials and decision-makers in planning and organizing programs to controlling breast cancer growth and enhance women’s health. Methods: Breast cancer data from 2000 to 2019 were obtained from the Iraqi Cancer Registry’s yearly book series (Ministry of Health). The United Nations Population Division provides annual population estimates by 5-year age groups and gender. Joinpoint regression analysis was used to calculate and assess age-specific and age-standardized incidence rates. Results: A total of 72,022 breast cancer cases were identified among women in Iraq between 2000 and 2019. The average age-standardized incidence rate (ASIRs) was 37.883/100,000. Breast cancer ASIR Iraq exhibited a significantly rising trend during the study period, with an average annual percentage change (AAPC) of +3.192%. Furthermore, a significant increase in breast cancer incidence for the age group 40–49 (AAPC = +2.162%), 50–59 (AAPC=+3.210%), 60–69 (AAPC=+5.551%), and age 70 and over (AAPC=+7.943%) were observed. When compared to other countries in the world, Iraq had a moderate rate of breast cancer ASIR. Conclusions: In summary, our finding revealed an increase in the incidence rates of breast cancer among Iraqi women from 2000 to 2019. Further research is needed to explore risk factors including levels of overweight, dietary changes, physical inactivity, obesity, smoking, high marriage age, and low birth rates to prevent and control breast cancer.     

Phase II Study of Loading-Dose Ibandronate Treatment in Patients with Breast Cancer and Bone Metastases Suffering from Moderate to Severe Pain

Background: The aim of this study was to determine the efficacy and safety of loading-dose intravenous (i.v.) ibandronate in women with breast cancer and bone metastases. Patients and Methods: In this prospective, phase II, open-label study, 13 women with breast cancer, bone metastases, and moderate/severe bone pain received ibandronate 6 mg/day (i.v. loading-dose 15 min infusion over 3 consecutive days) with follow-up until day 14. Endpoints included pain response (primary), duration until pain response, analgesic use, Karnofsky index, safety (including hematologic, biochemical, and urine examinations), and adverse events. Results: Pain intensity decreased on days 7 and 14 versus day 1 (mean visual analogue scale score: 3.2 ± 2.2 and 3.0 ± 2.1 versus 6.1 ± 0.9, respectively; p < 0.01 for both). Mean time to pain response was 8.2 ± 3.3 days. Mean rate of analgesic use decreased (69.2%, 16.7% and 15.4% on days 1, 7 and 14, respectively). Mean Karnofsky index score increased (80.8 ± 13.1 and 80.8 ± 13.2, on days 7 and 14 versus 77.7 ± 11.7 on day 1; p < 0.05 on both days). Conclusion: Bone pain and analgesic use decreased in women with breast cancer and bone metastases following loadingdose i.v. ibandronate which was well-tolerated with no renal safety concerns.