Background:Breast cancer is the most commonly diagnosed malignancy among women globally, with spinal metastases significantly impacting morbidity and mortality. Surgical intervention plays a crucial role in managing symptomatic spinal lesions, yet prognostic factors and outcomes remain areas of active investigation. This study aims to evaluate survival rates and identify predictors in patients with breast cancer undergoing surgery for spinal metastases. Methods:A retrospective analysis was conducted on 97 patients who underwent surgery for spinal breast cancer metastases at a single center over a 12-year period. Data included epidemiological and preoperative profiles, biological markers, and radiological findings. Survival outcomes were assessed using Kaplan-Meier analysis, and prognostic factors were analyzed via Cox regression. Results:Postoperative overall survival rates were 72%, 64%, and 34% at 1, 2, and 5 years, respectively. Significant predictors of survival included tobacco use (HR 1.7, p = 0.025), estrogen receptor (HR 0.224, p = 0.03), triple-negative subtype (HR 4.1, p < 0.01), and lower Karnofsky scores (HR 0.488, p < 0.01). Spinal instability and preoperative neurological status did not significantly influence survival. Complications occurred in 17% of patients, with no 30-day mortality. Conclusion:This study provides one of the largest single-center experiences of surgery for spinal metastases from breast cancer in the modern treatment era. We found that overall preoperative performance and biological markers, remains a key predictor of survival, while neurological status, disease spread and spinal instability have no impact than in long-term survival. These results reflect advances in systemic therapy and surgical care, supporting surgery as an important part of multidisciplinary management for selected patients.
Background:Phosphatase and tensin homolog (PTEN) is a key tumor suppressor gene that negatively regulates the PI3K/AKT pathway. PTEN deficiency is the most frequent molecular alteration in triple-negative breast cancer (TNBC); however, the relationship between PTEN protein loss and underlying genomic alterations remains incompletely understood. Methods:Fifty TNBC cases were evaluated for PTEN protein expression by immunohistochemistry on tissue microarrays. PTEN hotspot mutations (Exons 1, 5, 7, and 9) were analyzed using Sanger sequencing, whereas copy number alterations were assessed by multiplex ligation-dependent probe amplification (MLPA) assay. PTEN alterations were correlated with clinicopathological characteristics. External validation of PTEN mRNA and protein expression and prognostic significance was performed using publicly available TCGA/CPTAC datasets and Kaplan-Meier plotter. Results:PTEN protein loss was observed in 41/50 TNBC cases (82%), indicating that PTEN deficiency is a frequent event in this subtype. PTEN mutations were detected in six cases (12%) and were confined exclusively to Exon 5, comprising one missense mutation (c.277C>A) and two truncating mutations (c.430del and c.433del). MLPA identified PTEN copy number alterations in four cases (8%), including heterozygous deletions and duplications. No significant association was observed between PTEN protein expression and genomic alterations, highlighting a substantial genotype-phenotype discordance. Analysis of independent public datasets confirmed significantly reduced PTEN mRNA and protein expression in TNBC compared with luminal and HER2-positive breast cancers. Patients with low PTEN expression showed a trend toward shorter overall survival (23.5 vs. 38.9 months), though the difference did not reach statistical significance. Conclusions:PTEN protein loss is highly prevalent in TNBC but is only partially explained by mutations and copy number alterations, suggesting that additional regulatory mechanisms, such as epigenetic or posttranscriptional events, contribute to PTEN inactivation. These findings underscore the biological importance of PTEN deficiency in TNBC and support further investigation of PTEN as a potential prognostic biomarker and therapeutic target.
Triple-negative breast cancer (TNBC) is a biologically diverse, highly aggressive class of breast cancer defined by the absence of estrogen, progesterone, and HER2 receptors. It accounts for approximately 10%-20% of all invasive breast cancers, and disproportionately affects women of younger ages and from minority groups. TNBC is distinguished by delayed diagnosis requiring special techniques, rapid metastatic progression, and limited treatment options compared with other breast cancers. Chemotherapy remains the mainstay but patients face higher relapse rates and overall survival is significantly reduced. TNBC represents a diverse array of subtypes, whose molecular differences impact their pathological behavior and response to therapy. Newer molecular markers in various stages of clinical and preclinical development show promise towards improving the management of TNBC patients. Membrane receptor proteins like trop2, nectin-4, LIV-1, gpNMB, CXCR4, DDR1, and PD-L1 have been targeted with antibody-drug complexes. Synthetic small molecules and antisense oligonucleotides have been employed for inhibition of internal cellular components like PARP enzyme and expression of genes related to cancer progression. The molecular makeup of the tumor microenvironment is also a significant factor in addressing TNBC metastasis. In conclusion, the stratification of TNBC patients on their molecular subtype needs to be more widely adopted, and a calculated combination of current and emerging strategies is needed to effectively address TNBC in the clinic.
Background:Aberrant expression of miR-326, a microRNA involved in tumor suppression, has been associated with a broad range of diseases, including cancer and autoimmune disorders. The NOB1 gene (NIN One Binding Protein 1 Homolog) is a critical component that plays a pivotal role in the biogenesis and proper functioning of the 26S proteasome. Researchers have found that miR-326 acts as a regulator of NOB1 expression by targeting its mRNA, ultimately leading to a decrease in NOB1 protein translation. Methods:This study seeks to assess the expression levels of miR-326 and NOB1 genes within breast cancer (BC) tumor tissue, along with an examination of their potential correlation, in comparison to both normal-adjacent (NATs) and healthy tissues. Forty-one BC, NATs, and eight healthy breast tissues were used. To compare the expression profiles of miR-326 and NOB1 in different tissue groups, including BC, NATs, and healthy tissues, quantitative real-time PCR (qRT-PCR) was used. Results:miR-326 expression was significantly decreased in BC tissues compared with NATs (p < 0.0001) and healthy tissues (p < 0.0001). The expression levels of NOB1 were increased significantly in BC tissue compared with NATs (p < 0.0001) and healthy tissues (p < 0.0001). A significant negative correlation was observed between miR-326 and NOB1 expression (p < 0.005). Receiver-operating characteristic (ROC) curve analysis showed that AUC = 0.8349 and AUC = 0.7 are for miR-326 and NOB1, respectively. Conclusion:Decreasing the expression of miR-326 in patients with BC may affect its target gene (NOB1) and probably lead to an increase in the expression of the NOB1 gene. This negative correlation suggests a potential regulatory role for miR-326 in controlling NOB1 expression. Our findings demonstrate that dysregulation of the miR-326 and NOB1 expression levels may contribute to BC development and progression, indicating the potential of these two genes as biomarkers for diagnostic and therapeutic approaches in BC.
Breast cancer, one of the leading cancer types, directly contributes to cancer-related mortality, but new therapies are required to improve treatment efficiency. Nanoparticle-based strategies have already introduced the most radical advances in this regard, from their first formulation through their development to the next generation as promising candidates. The present review provides an overview of nanoparticle-based strategies in breast cancer, their development, and their state of the art. The review addresses the diverse formulation of nanoparticles, including liposomes, dendrimers, and metallic nanoparticles, as well as their respective roles in drug delivery: bioavailability, focused therapeutic intervention, and lower systemic toxicity. This review covers studies on the engineering of nanoparticles for improved drug delivery, including cancer-targeted delivery to tumors and optimization within the tumor microenvironment. Additionally, new nanosized drugs may also be utilized for novel modification of nanoparticle composition for combination therapeutics, which allows pharmacological agents to enter the tumor microenvironment by combined treatment with diverse types of other agents, to provide a synergistic, effective treatment in real time, in addition to real-time monitoring. Stimuli-responsive nanoparticles, which release the drug according to the appropriate stimulus signal to provide greater accuracy and regulation in delivering the drug, are also under investigation. This review notes trends in personalized nanomedicine and nanoparticle-mediated immunotherapy that target personalized patient and immune responses, among others. Other exciting areas for nanoparticle research include AI-based optimal design and sustainable biodegradable materials aimed at maintaining nanoparticle safety. Nanoparticle-based therapies are a unique new frontier in breast cancer therapy. They have considerable clinical potential, offer promise for patient-specific treatment, and warrant further investigation in breast cancer, particularly in advanced targeting mechanisms, multifunctional approaches, and individualized interventions.
Introduction and Objective:Breast cancer is the most prevalent malignancy among Iranian women, and early detection plays a pivotal role in reducing mortality. This study was aimed at investigating factors associated with breast cancer preventive behaviors among female health ambassadors in Khoy, using the protection motivation theory as the theoretical framework. Methods:This cross-sectional analytical study was conducted among 160 female health ambassadors in Khoy in 2023. Data were collected using a standardized questionnaire based on protection motivation theory constructs, including knowledge, perceived susceptibility, perceived severity, self-efficacy, response efficacy, response costs, fear, and protection motivation. Data were analyzed using Stata Version 18, applying backward linear regression to identify factors associated with breast cancer preventive behaviors. Results:Among demographic variables, university education (B = 2.05, p = 0.008) and employment status (B = 1.58, p = 0.002) were significantly associated with breast cancer preventive behaviors. Among protection motivation theory constructs, fear (B = 0.32, p < 0.001) showed the strongest association, followed by protection motivation (B = 0.25, p = 0.007), knowledge (B = 0.10, p = 0.002), and perceived severity (B = 0.09, p < 0.001); all variables were significantly associated with preventive behaviors. The final model explained 65.6% of the variance in preventive behaviors (R 2 = 0.656, adjusted R 2 = 0.639, p < 0.001). Conclusion:The findings support the applicability of the protection motivation theory in explaining breast cancer preventive behaviors among female health ambassadors in Khoy City. Theory-based educational interventions, potentially tailored for similar demographic groups characterized by lower education levels and unemployment, may help strengthen preventive practices. However, due to the cross-sectional design of this study and its focus on a specific population in a single city, the observed relationships should be interpreted strictly as associations rather than causal effects, and these results cannot be generalized to all Iranian women. These findings highlight the potential role of community health educators in developing targeted community-based prevention programs for specific at-risk populations.
Background High breast density is commonly observed in younger breast cancer patients (<45 years), and Asian women generally have dense breasts even beyond the age of 45 years. Its relationship with breast cancer subtypes and its profile remains unclear. This study is aimed at exploring the association between mammographic density and breast cancer molecular subtypes. Methods A cross-sectional study evaluating mammographic density based on the 2013 BI-RADS classification among breast cancer patients at Dharmais Cancer Hospital between 2021 and 2023 was conducted. Clinicopathological variables-including histological subtype, tumor grade, ER, PR, HER2 status, Ki-67 index, and molecular subtypes by immunohistochemistry-were analyzed. Results High breast density (BI-RADS C and D) was observed in 69% of patients, with Category C being the most common (57.1%). Invasive ductal carcinoma of no special type was the most prevalent and 47.2% of tumors were high grade. Most tumors were ER-negative (67.1%), PR-negative (59.6%), and HER2 0 (54.0%), with high Ki-67 index in 70.2% of cases. Age was associated with breast Density C and D and TNBC molecular subtype (p < 0.05). HER2, Ki-67, and molecular subtype were negatively correlated with ER (r = -0.217, r = -0.283, and r = -0.851, respectively; p < 0.05) and with PR (r = -0.169, r = -0.287, and r = -0.840, respectively; p < 0.05). Conversely, HER2 and Ki-67 expressions were positively correlated with more aggressive molecular subtypes (r = 0.307 and r = 0.354, respectively; p < 0.05). Conclusion Younger breast cancer patients were associated with higher breast density and more aggressive tumor subtypes, which correlated with HER2 and Ki-67 expressions in breast cancer. These underscore the relevance of age-related biological factors in shaping breast cancer characteristics. However, among Indonesian women over 45 years old, the proportion of high breast density remains remarkably high (65.6%), suggesting that factors beyond age-such as genetic, hormonal, or lifestyle influences-may contribute to the persistence of dense breast tissue in this population.
Background:Examining the survival rate in breast cancer patients serves as a metric for assessing and advancing various treatment modalities. In light of the significant incidence of breast cancer in Iran, this study is aimed at examining and comparing the disease-free survival (DFS) and overall survival (OS) rates among breast cancer patients who underwent axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB). Patients and Methods:This retrospective cohort research included 1071 patients at Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, from 1991 to 2021. The recurrence and survival rates of patients undergoing ALND and SLNB in both groups were examined and evaluated. The data were analyzed using SPSS statistical software using descriptive statistical techniques (percentage, frequency, mean, and standard deviation), Kaplan-Meier analysis, and Cox regression tests. A significance threshold of 0.05 is used. Results:The average OS among all patients was 18.08 ± 0.51. The average OS in the ALND group was 18.1 ± 0.53; in the SLNB group, it was 12.8 ± 0.39, which was insignificant (p < 0.05). The average DFS among all patients was 17.13 ± 0.51. The average DFS in the ALND group was 16.95 ± 0.54; in the SLNB group, it was 11.96 ± 0.3; the difference was insignificant (p = 0.11). Conclusion:OS and DFS in the ALND group were higher than in the SLNB group, but they were not statistically significant.
PurposeLocally advanced breast cancer (LABC) remains a major therapeutic challenge, with neoadjuvant chemotherapy (NAC) serving as a cornerstone of management. However, direct evidence comparing the efficacy of sequential (AC-T) and concurrent (TAC) anthracycline-taxane regimens in real-world Middle Eastern populations remains scarce. This study is aimed at comparing the clinical outcomes of AC-T and TAC in Iranian women with LABC.MethodsA retrospective cohort study was conducted among 118 patients with Stage III breast cancer treated at Tehran, Iran. Patients received either AC-T (doxorubicin/cyclophosphamide followed by paclitaxel; n = 70) or TAC (docetaxel/doxorubicin/cyclophosphamide; n = 48). Outcomes included pathological complete response (pCR), overall survival (OS), disease-free survival (DFS), distant recurrence-free survival (DRFS), and locoregional recurrence-free survival (LRFS).ResultsBaseline demographic and clinical characteristics were comparable between groups. No significant difference in pCR rates was observed between the groups. The AC-T regimen showed higher, though nonsignificant, OS at 3, 5, and 10 years (90%, 82%, and 71%, respectively) compared with TAC (83%, 74%, and 57%). Conversely, TAC demonstrated significantly superior 10-year DRFS (62% vs. 45%, p = 0.019). DFS and LRFS were similar between regimens. Multivariable Cox regression analysis identified ER positivity as the only independent predictor of improved OS (HR = 0.42, 95% CI: 0.29-0.82, p = 0.012) and DFS (HR = 0.36, 95% CI: 0.18-0.73, p = 0.005), whereas the chemotherapy regimen was not independently associated with survival after adjustment for confounders.ConclusionBoth AC-T and TAC provided effective neoadjuvant control in LABC, with comparable survival outcomes. These findings support individualized regimen selection based on patient profile and tumor biology. Prospective studies are needed to refine region-specific treatment strategies.
Breast cancer remains one of the leading causes of cancer-related mortality amongst women worldwide, with rising incidence rates paralleling the global obesity epidemic. Obesity has been increasingly recognised as a risk factor for breast cancer, yet the molecular mechanisms underlying the association remain poorly understood. This review explores the role of angiogenesis as the central mechanism linking obesity to breast cancer progression. Angiogenesis is essential for both adipose tissue expansion and tumour growth. It is dysregulated in obesity and breast cancer, resulting in the formation of abnormal vasculature that perpetuates hypoxia and malignancy. Obesity contributes to this process through hypertrophic adipose tissue, altered adipokine profiles and elevated expression of proangiogenic factors, such as VEGF. These changes create a tumour microenvironment conducive to cancer progression, treatment resistance and poor clinical outcomes. Emerging evidence also implicates endothelial cells, pericytes and lipid metabolism in this interaction, suggesting novel therapeutic targets.
Background:The Comprehensive Oncology Rehabilitation and Exercise (CORE) pilot trial aimed to test the feasibility and acceptability of a clinical workflow algorithm that integrated exercise and rehabilitation services from breast cancer diagnosis throughout the first 24 weeks of care. Here, we investigated the preliminary effectiveness of the CORE algorithm compared with standard of care (SOC) on changes in physical function, health-related quality of life (HRQoL), and exercise engagement in women newly diagnosed with Stage I-III breast cancer with plans for surgery as first-line treatment. Methods:Seventy-two women were randomly assigned in a 2:1 ratio to CORE or SOC. All participants completed study assessments at three time points that aligned with routine breast surgical oncology clinic visits: surgical consultation (i.e., baseline), postoperative, and 24 weeks postoperative. The following outcomes and associated assessments were carried out in the clinic: physical function: PROMIS physical function survey (primary function assessment), five-time chair stand, 10-m walk, back scratch, and QuickDASH survey; HRQoL: FACT-B survey; and exercise engagement: modified Godin physical activity survey (primary engagement assessment) and accelerometer wear for 1 week following each clinic visit. Results:Fifty-nine participants had evaluable data, with the majority having Stage I disease (83%), being primarily White (75%) and non-Hispanic (90%), and having a median age and BMI of 58 years and 26.0 kg/m2, respectively. Mean difference in change in PROMIS physical function score from baseline to 24 weeks postoperative between CORE and SOC was not statistically significant (-1.86, 95% CI -6.02 to 2.3). A modest advantage in exercise engagement was observed in the CORE arm (Godin: 5.46, 95% CI -1.06 to 11.98; effect size: 0.36, 95% CI -0.07 to 0.78; accelerometry: median difference 12 min, bootstrapped 95% CI -37 to 40). Conclusion:The CORE clinical workflow algorithm demonstrates promise in improving exercise engagement. More work is needed in an adequately powered trial to confirm these findings and evaluate effectiveness on other outcomes. Trial Registration:ClinicalTrials.gov identifier: NCT04594473.
Background:Real-world safety data from Southeastern Europe are limited for ultrahypofractionated (UHF) whole-breast irradiation (WBI). We aimed to evaluate acute skin toxicity with UHF versus hypofractionated (HF) postoperative radiation therapy in early breast cancer, following implementation of this fractionation regimen. Methods:This combined prospective-retrospective study included women aged ≥50 years following breast-conserving surgery (pT1-2, pN0-1, M0). The UHF cohort (prospective) received 26 Gy in 5 fractions over one week between 2023 and 2024. The control group consisted of retrospective data obtained from institutional records of patients who received WBI using a HF schedule of 40.5-42.6 Gy in 15-16 fractions over 3 weeks between 2015 and 2020. All patients were treated with 3D-CRT WBI without regional nodal irradiation or boost. Acute skin toxicity was graded by CTCAE v5.0 at end of treatment and at 4 and 12 weeks. Results:This study included 80 patients, with 40 in each group, with a mean age of 61.1 ± 6.6 years. Baseline clinicopathological characteristics were comparable, except for a slightly larger median tumor size in the UHF group (p = 0.037). At the end of radiation therapy, acute radiodermatitis occurred in 36 of 40 (90%) patients receiving UHF and in 38 of 40 (95%) patients receiving HF (p = 0.396). The grade distribution was comparable across the two groups (p = 0.53), and no grade ≥3 events were recorded. At 4 weeks, no adverse skin reactions were observed in patients receiving UHF, and by twelve weeks, no active radiodermatitis persisted in either group. Conclusions:UHF WBI (26 Gy/5 fractions) demonstrated comparable acute skin toxicity to standard HF regimens, supporting its safety and clinical feasibility in routine practice.
Objective This study is aimed at developing and evaluating a machine learning-based model for breast cancer classification using integrated clinical, demographic, reproductive, and lifestyle data. Methods A retrospective machine learning framework was developed using data from a case-control study conducted in Tehran. The dataset included demographic, clinical, reproductive, lifestyle, and screening-related variables. Data preprocessing was performed within machine learning pipelines to ensure data quality and prevent data leakage. Duplicate records and noninformative variables were removed. Missing values were imputed using median values for numerical variables and the most frequent value for categorical variables. Categorical features were encoded appropriately, and Min-Max normalization was applied where required. Feature selection was conducted using mutual information (MI) and analysis of variance (ANOVA) within a stratified cross-validation framework. The data were split into training (80%) and test (20%) sets. Several supervised learning algorithms, including Gaussian Naive Bayes (GNB), K-nearest neighbors (KNN), decision tree (DT), random forest (RF), support vector machine (SVM), logistic regression (LR), and artificial neural network (ANN), were trained and evaluated. Model performance was assessed using accuracy, precision, recall (sensitivity), F1-score, and receiver operating characteristic-area under the curve (ROC-AUC), with stratified 5-fold cross-validation and final evaluation on an independent test set. Results Significant differences were observed between breast cancer patients and healthy controls across multiple demographic and clinical variables. Patients were generally older and more likely to be widowed, belong to higher socioeconomic classes, and be housewives, whereas higher education levels and employment were more frequent among healthy individuals (p < 0.001). Reproductive factors, including age at first marriage and breastfeeding duration, also showed significant differences. Feature selection reduced 414 initial variables to 40 key predictors. The most influential features included genetic factors (BRCA1/2 mutations and family history), reproductive and hormonal characteristics (age at menarche, menopause, and infertility), lifestyle behaviors (dietary patterns and physical activity), anthropometric measures (BMI and weight at age 30), and screening-related variables (mammography, ultrasound, and biopsy). All models demonstrated strong and stable performance with minimal differences between cross-validation and test results, indicating good generalization. RF achieved the highest performance (accuracy: 0.9897, precision: 0.9946, recall: 0.9840, F1-score: 0.9892), followed by SVM and LR, whereas ANN showed the lowest overall performance. Conclusion Machine learning models can effectively classify breast cancer using multidimensional patient data. Ensemble methods, particularly RF, demonstrated superior accuracy and robustness, highlighting their ability to capture complex nonlinear relationships. The identified predictors are consistent with established clinical and epidemiological risk factors, supporting the validity of the proposed models. These findings suggest that machine learning approaches hold strong potential for personalized risk assessment and early detection of breast cancer; however, external validation across diverse populations is necessary to confirm generalizability.
Background Iodine-125 radioactive seeds (I-125-RS) are increasingly used for preoperative localization of nonpalpable breast lesions due to their precision, safety, and logistical advantages. However, due to radiation safety regulations, their use requires a coordinated and strictly regulated workflow to ensure safe handling and retrieval of radioactive material. This study assesses the first year of a multidisciplinary protocol implemented to standardize I-125-RS management and minimize incidents. Methods A protocol involving Radiology, Surgery, Nuclear Medicine, and Pathology was established to ensure proper documentation, transport, radiographic confirmation, seed retrieval, and incident reporting. All I-125-RS recovered from formalin-fixed specimens between May 2022 and September 2023 were evaluated. Incidents were classified as protocol deviations (Category I) or technical retrieval difficulties (Category II). Clinicopathological data were collected, and analyses were performed using chi-square and ANOVA tests (p < 0.05). Results A total of 146 seeds were retrieved from 130 specimens from 123 patients. Most samples were lumpectomies (89.2%); 24.4% of patients received neoadjuvant therapy. Invasive carcinoma accounted for 82.3% of diagnoses. Double-seed placement was used in 16 cases. Positive margins occurred in 9.1%, and 7.2% required reoperation. There were 18 incidents (14.6%): Category I, 10 (55.6%), mainly documentation errors or seed displacement within containers; and Category II, 8 (44.4%), mostly seeds hidden within tissue slices. Nuclear Medicine was consulted in 11 cases. Importantly, no seeds were lost. No significant associations were found between incidents and clinicopathological variables. Conclusions The multidisciplinary protocol ensured safe and efficient handling of I-125-RS, preventing seed loss and improving traceability. Most incidents were minor, manageable, and reduced with staff training and adherence to standardized procedures. Continuous monitoring supports workflow optimization and maintains safety standards in pathology laboratories. This approach may serve as a model for institutions implementing I-125-RS localization.
BackgroundOrganoid culture has emerged as a promising model for studying normal and tumor tissues. Organoids may resemble their tissue of origin, allowing assessment of disease behavior and drug response. In breast cancer (BC), successful organoid establishment may depend on factors like time from tissue collection to culture, dissociation methods, and media composition, which may affect tumor growth and tissue similarity across culture passages. This systematic review and meta-analysis are aimed at assessing the success rate of BC organoid establishment and their similarity to parental tumors.MethodsFollowing PRISMA guidelines, we conducted an electronic search in PubMed, Embase, and Web of Science using terms related to "breast cancer" and "organoids". Heterogeneity was assessed by I2 (%), with forest plots for all studies and subgroups. A fixed-effects meta-analysis estimated the overall establishment rate with 95% confidence intervals.ResultsWe analyzed 59 full-text articles. Five culture media types and 37 added components were reported, most frequent EGF (80%), glutamine, FGF, R-spondin (66%, each), Y27632, and N-acetylcysteine (64%, each). Ten studies provided data on initial samples and established organoids, totaling 504 and 349, respectively, with an establishment rate of 71.34% (95% CI: 67.55-75.14), varying from 31.25% to 86.21%. By subtype, establishment rates were as follows: Luminal A (57.47%), Luminal B (72.51%), HER2+ (71.24%), and triple-negative (78.75). Concordance between receptor expression in tumors and organoids was observed, with kappa values of 0.692 for ER, 0.597 for PR, and 0.711 for HER2. However, positive receptor expression reverted to negative in 19%, 31%, and 28% of organoids for ER, PR, and HER2, respectively.ConclusionBreast cancer organoids were successfully established from primary tumor samples, demonstrating good overall concordance in receptor expression with the original tumors. These findings support the feasibility of patient-derived organoids as translational models; however, continuous phenotypic characterization across passages is recommended.
Background:Breast cancer screening allows early detection of treatable breast cancer malignancies. However, the use of breast cancer screening among asymptomatic women in Ghana is reported to be generally low. In addition, Ghana does not have a standardized measure to assess and quantify breast cancer knowledge and screening beliefs. Methods:This study examined the factor structure and internal consistency reliability of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ-12) in the context of Ghana. A total of 857 women from the Greater Accra Region of Ghana completed the BCSBQ-12. Exploratory structural equation modelling (ESEM) and traditional confirmatory factor analysis (CFA) were applied to the data via robust maximum likelihood estimation. Results:The results showed that, compared with the CFA solution, the ESEM solution provided a better fit to the data, with reduced interfactor correlations and adequate internal consistency reliability. The ESEM with target rotation supported the first-order three-factor structure proposed by the BCSBQ-12, indicating the importance of considering breast cancer screening uptake from, at least, three key domains (i.e., attitudes, knowledge, and barriers) in the context of Ghana. Conclusions:The results provide sound evidence of construct validity and psychometric properties for the use of the BCSBQ-12 for assessing breast cancer knowledge and screening beliefs among asymptomatic women in Ghana.
PurposeThe purpose of this study is to investigate the application of multimodal imaging technology in diagnosing diabetic mastopathy (DM).MethoodsThis study retrospectively analyzed ultrasound, mammography, and MRI findings of pathologically confirmed DM from October 2014 to October 2024.ResultsUltrasonography was performed on all 62 patients with DM, identifying a total of 67 lesions. The ultrasound findings were classified into four types: Type I presented as a focal thickening and bulging of the gland with a mix of high and low echoes (42/67, 62.7%); Type II showed focal or overall hypoechoic areas with indistinct margins (19/67, 28.3%); Type III exhibited diffuse hypoechoicity in the lesion area, poorly visualized internal structures, and markedly attenuated posterior echoes (4/67, 6.0%); and Type IV consisted of slightly hypoechoic areas (2/67, 3.0%). The overall diagnostic accuracy of ultrasound was 58.2%. Fifty-one patients with a total of 58 lesions underwent mammography. Eighteen lesions (31.0%) were negative on mammography, whereas 32 lesions (55.2%) displayed asymmetric density. The diagnostic accuracy of mammography was 69%. Five patients with five lesions underwent MRI, which revealed nonmass-like inhomogeneous progressive enhancement, isointensity and hypointensity in T2-weighted images, insignificant or slight hyperintensity in diffusion-weighted imaging, and no significant decrease in apparent diffusion coefficient value, yielding a diagnostic accuracy of 80%.ConclusionThe ultrasound characteristics of DM were marked by nonmass-type lesions with distinctive echogenic and structural features. Mammography demonstrated insignificant or nonspecific asymmetric densities without suspicious calcifications or structural distortions. Breast MRI indicated nonmassive lesions exhibiting benign features based on hemodynamic parameters and diffusion-weighted imaging. The combined application of multimodal imaging enhanced diagnostic accuracy, particularly when incorporated with patient history.
Background:This study is aimed at investigating the correlation between apparent diffusion coefficient (ADC) values obtained from diffusion-weighted imaging (DWI) and prognostic factors in breast cancer. We hypothesized that lower ADC values would be observed in more aggressive tumors, including those with higher histological grades and Ki-67 expression levels. A retrospective analysis was conducted on patients with malignant breast lesions who underwent breast magnetic resonance imaging (MRI), including DWI sequences, at our center between January 2022 and January 2023. MRI was performed on a 1.5 T scanner using a bilateral phased-array eight-channel breast coil. ADC values were calculated utilizing b values of 400 and 800 s/mm2 and evaluated in relation to prognostic factors, including age, tumor size, tumor grade, lymph node involvement, Ki-67 proliferation index, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status. Results:This study included 88 patients with 89 malignant lesions. ADC values showed no significant association with age, tumor size, histological type, lymph node involvement, or receptor status (ER, PR, and HER2). However, tumors with higher Ki-67 expression exhibited significantly lower median ADC values. For Ki-67 thresholds of ≥ 14% and ≥ 30%, p values were 0.02 and < 0.01, respectively. A negative correlation between ADC values and the Ki-67 index was noted (p = 0.01, ρ = -0.28). Additionally, Grade I tumors had higher ADC values than Grade II and III tumors (p < 0.01), while no difference was observed between Grade II and III tumors (p = 0.61). Conclusion:Lower ADC values correlate with higher tumor grades and Ki-67 expression, suggesting their potential role as imaging biomarkers for assessing breast cancer aggressiveness.
AimThe objective of this study is to evaluate the accuracy of vacuum-assisted excision as a minimally invasive method for assessing residual tumor burden in distinct breast cancer subtypes following neoadjuvant chemotherapy.Materials and MethodsIn this pilot clinical trial, 20 patients with breast cancer scheduled for neoadjuvant chemotherapy were assessed. Upon completion of chemotherapy, patients underwent ultrasound-guided vacuum-assisted excision of the tumor site, performed by a radiologist. Subsequently, surgical excision of the tumor was carried out. The pathology reports from the vacuum excision were compared with the surgical specimens to determine the concordance in detecting residual tumor tissue.ResultsAmong the 20 patients who underwent vacuum-assisted excision, 13 patients demonstrated no residual tumor in both vacuum pathology and surgical pathology. However, in four patients, including three cases of Ductal Carcinoma In Situ (DCIS) and one case of Invasive Ductal Carcinoma (IDC), a false negative vacuum excision was reported. In three patients, residual tumor was reported both in surgical and vacuum pathology. The positive predictive value, negative predictive value, and accuracy of vacuum excision for detecting residual tumor were 100%, 76.5%, and 80%, respectively. The sensitivity and specificity of vacuum excision were 42.9% and 100%, respectively.ConclusionBased on the findings of this study and considering the accuracy of vacuum excision in identifying residual tumors (80%), it is evident that vacuum excision cannot currently serve as a substitute modality for surgery in the management of patients with post-neoadjuvant breast cancer. Further research with a larger sample size is warranted to enhance our understanding in this area.Trial RegistrationIRCT20241204063942N1
Background:Breast cancer is one of the diseases in which abnormal, mutated breast cells grow out of control and form tumors. If left unchecked, the tumors can spread throughout the body and become fatal. Aim of the Study:This study is aimed at assessing the combined effect of age-specific trends over time on breast cancer. Materials and Methods:The cross-sectional study included 100 patients diagnosed with breast cancer over a period extending from January 2024 to January 2025 at Al-Amal Hospital in Baghdad. The data were collected from the records of the hospital, including the demographic ones, and another section of the data included the medical ones. Results:A total of 100 breast cancer patients were included in this study, with ages ranging from 25 to 75 years (mean ± SD : 50.47 ± 10.96 years). The highest percentage of breast cancer patients (39%) belonged to the 50-59 years age group, followed by 40-49 years (25%), while the lowest percentages were observed in the 21-29 years (5%) and 70-79 years (5%) categories. Menstrual history illustrated that 52% of patients were postmenopausal, while 44% were premenopausal, and 4% had irregular cycles. Most cancer patients were married (78%), while 11% were widowed, 8% were single, and 3% were divorced. Conclusions:This study highlights the demographic and clinical characteristics of breast cancer patients, emphasizing the predominance of cases in postmenopausal women and those residing in urban areas. It highlights the prevalence of advanced-stage and metastatic breast cancer, emphasizing the urgent need for enhanced screening and early detection.
