Latest News on Breast Cancer Research: Jan – 2020

Randomised controlled trial of conservation therapy for breast cancer: 6-year analysis of the Scottish trial

Background: to work out whether, when primary carcinoma is treated by local excision supported by systemic therapy appropriate to the oestrogen receptor status (ER) of the tumour, local radiotherapy are often avoided.

Methods: We administered a randomised controlled trial in 585 patients aged but 70 years with primary breast cancers of 4 cm or less in size in four specialist units and 7 other hospitals in Scotland. After local excision of the tumour (1 cm margin) and an axillary lymph-node clearance or sample, all patients received systemic therapy with oral tamoxifen 20 mg daily or six 3-weekly intravenous bolus injections of cyclophosphamide 600 mg, methotrexate 50 mg, and fluorouracil 600 mg per m2, depending upon the ER concentration within the primary tumour. Patients were then randomly allocated to postoperative radical radiotherapy (50 Gy to breast with boost to the tumour bed) or to no further local treatment. The median follow-up of living patients was 5•7 years. the first analysis was by intention to treat but since some patients didn’t receive systemic therapy appropriate to their ER status, a subsidiary analysis was restricted to 464 patients in whom all details of the protocol had been observed. [1]

Reproductive factors and breast cancer.

Early age at menarche, late age at menopause, and late age initially full-term pregnancy are linked to a modest increase within the risk of developing carcinoma . Some evidence suggests that the sooner the full-term pregnancy, the sooner the amount of decreased susceptibility of breast tissue changes begins. Nulliparity is said to an increased risk for carcinoma diagnosed after 40 years old. Multiple full-term pregnancies decrease the danger of breast cancers diagnosed after 40 years no matter the age initially birth. On the opposite hand, they’ll increase the danger for breast cancers diagnosed before 40 years old. Surgical removal of the ovaries protects against carcinoma . nursing apparently protects against carcinoma in China, but a protective effect has not been established within the US. aside from shorter intervals between menstrual periods, which tend to extend the danger , research has not yet made clear the etiologic roles of cycle characteristics. Other unclear etiologic roles include increased intervals between births, spontaneous and abortion , infertility, multiple births eventually pregnancy, and hypertension during pregnancy. [2]

Endogenous hormones and breast cancer risk.

There is substantial evidence that prime estrogen levels in postmenopausal women are related to a rise in carcinoma risk, but such a relation has not yet been established in premenopausal women, despite biologic evidence that breast somatic cell division rates are high during the secretory phase of the cycle when estradiol and progesterone levels are high. the shortage of total consistency among studies that have assessed estrogen differences, whether in carcinoma patients versus controls or in subgroups of the population characterized by different risk profiles for carcinoma , isn’t unexpected given the extraordinarily complex methodological issues that has got to be addressed in these studies. There has been a transparent evolution over time within the level of sophistication of those sorts of studies, further decreasing the likelihood of finding consistent patterns within the literature. Other hormones may play a crucial role in carcinoma development also. [3]

Incidence of breast cancer attributable to breast density, modifiable and non-modifiable breast cancer risk factors in Singapore

Incidence of carcinoma is rising rapidly in Asia. Some carcinoma risk factors are modifiable. We examined the impact of known carcinoma risk factors, including body mass index (BMI), reproductive and hormonal risk factors, and breast density on the incidence of carcinoma , in Singapore. The study population was a population-based prospective trial of screening mammography – Singapore carcinoma Screening Project. Population attributable risk and absolute risks of carcinoma thanks to various risk factors were calculated. Among 28,130 women, 474 women (1.7%) developed carcinoma . The population attributable risk was highest for ethnicity (49.4%) and lowest for case history of carcinoma (3.8%). The proportion of breast cancers that’s due to modifiable risk factor BMI was 16.2%. [4]

Immunohistochemical Pattern of Breast Cancer in Maiduguri, Borno State

Background: carcinoma is one among the foremost common cancer affecting women in Nigeria, with a really high morbidity and deathrate if the diagnosis is delayed. it’s common among women in both developed and developing countries of the planet .

Objectives: this is often administered to work out the immunohistochemical and histopathological patterns of carcinoma in Maiduguri.

Methodology: 100 and fifty two cases of female carcinoma were retrieved from the archive of Department of Histopathology, University of Maiduguri Teaching Hospital. ER, PR and HER2 expression was assessed using immunohistochemical staining. [5]

Reference

[1] Forrest, A.P., Stewart, H.J., Everington, D., Prescott, R.J., McArdle, C.S., Harnett, A.N., Smith, D.C., George, W.D. and Group, S.C.T.B., 1996. Randomised controlled trial of conservation therapy for breast cancer: 6-year analysis of the Scottish trial. The Lancet, 348(9029), (Web Link)

[2] Kelsey, J.L., Gammon, M.D. and John, E.M., 1993. Reproductive factors and breast cancer. Epidemiologic reviews, 15(1), (Web Link)

[3] Kelsey, J.L., Gammon, M.D. and John, E.M., 1993. Reproductive factors and breast cancer. Epidemiologic reviews, 15(1), (Web Link)

[4] Incidence of breast cancer attributable to breast density, modifiable and non-modifiable breast cancer risk factors in Singapore
Peh Joo Ho, Hannah Si Hui Lau, Weang Kee Ho, Fuh Yong Wong, Qian Yang, Ken Wei Tan, Min-Han Tan, Wen Yee Chay, Kee Seng Chia, Mikael Hartman & Jingmei Li
Scientific Reports volume 10, (Web Link)

[5] A. Imam, B., O. Okechi, O., Abdullahi, K., Abubakar, U., B. Musa, A., Okorie, N., Umar, S., O. Muhammed, A., M. Mohammed, O., Zakariya, A., K. Ibrahim, K. and Umar, A. (2017) “Immunohistochemical Pattern of Breast Cancer in Maiduguri, Borno State”, Journal of Cancer and Tumor International, 5(1), (Web Link)

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