• Journal of Cancer Prevention
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• v.21 no.2
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• pp.88-94
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• 2016

Background: Breast cancer is the most common malignant disease in women. The patients with advanced breast cancer develop metastasis to bone. Bone metastasis and skeletal-related events by breast cancer are frequently associated with the invasiveness of breast cancer cells and osteoclasts-mediated bone resorption. Forsythia koreana is used in oriental traditional medicine to treat asthma, atopy, and allergic diseases. The aim of this study was to evaluate the inhibitory effects of F. koreana extracts on the invasion of breast cancer cells and bone resorption by osteoclasts. Methods: Cell viability was measured by an MTT assay and the migration and invasion of MDA-MB-231 cells were detected by a Boyden chamber assay. The formation of osteoclasts and pit was detected using tartrate-resistant acid phosphatase staining and calcium phosphate-coated plates, respectively. The activities of matrix metalloproteinases (MMPs) and cathepsin K were evaluated by gelatin zymography and a cathepsin K detection kit. Results: The fruit and leaf extracts of F. koreana significantly inhibited the invasion of MDA-MB-231 cells at noncytotoxic concentrations. The fruit extract of F. koreana reduced the transforming growth factor ${\beta}1-induced$ migration, invasion and MMPs activities of MDA-MB-231 cells. In addition, the fruit, branch, and leaf extracts of F. koreana also inhibited the receptor activator of nuclear factor kappa-B ligand-induced osteoclast formation and osteoclast-mediated bone-resorbing activity by reducing the activities of MMPs and cathepsin K. Conclusions: The extracts of F. koreana may possess the potential to inhibit the breast cancer-induced bone destruction through blocking invasion of breast cancer cells, osteoclastogenesis, and the activity of mature osteoclasts.

• Kosin Medical Journal
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• v.33 no.3
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• pp.297-306
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• 2018

Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.569-575
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• 2014

Although mammography is the primary imaging modality for the breast, it has its limitations especially with dense breast parenchyma. Breast magnetic resonance imaging (MRI) has evolved into an important adjunctive tool as it is currently the most sensitive technique for breast cancer detection. Despite this high sensitivity, overlap in the appearances of some benign and malignant breast lesions results in additional unnecessary intervention with negative results. These false positives, in addition to high cost and limited availability, necessitate establishing proper indications for breast MRI. The literature was here reviewed for recent clinical trials, meta-analyses and review papers which have studied this important subject. PubMed; the US national library of medicine, was utilized to review the literature in the last twenty years. Using the obtained information, current uses of breast MRI are discussed in this paper to determine the indications which are relevant to clinical practice.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.342-346
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• 1999

Background: Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. Materials and Methods: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefulness in detecting breast cancer in patients under 35 years and over 60 years of age. Results: The mammographic results are as follows : 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows : 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breast cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. Conclusion: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors in young women and may correlate with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.147-155
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• 2012

Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. Results: After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing; were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment; had an elevated ductal carcinoma in situ but not invasive cancer detection rate; had larger breast cancers; and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Conclusions: Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.346-352
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• 2006

Objectives: The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. Methods: The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. Results: For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. Conclusions: The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9327-9333
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• 2014

Breast cancer is the second most common cancer and second leading cause of cancer deaths in women. Phosphatidylinositol-3-kinase (PI3K)/AKT pathway mutations are associated with cancer and phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene mutations have been observed in 25-45% of breast cancer samples. Insulin growth factor binding protein-5 (IGFBP-5) can show different effects on apoptosis, cell motility and survival in breast cancer. We here aimed to determine the association between PIK3CA gene mutations and IGFBP-5 expressions for the first time in breast cancer patients. Frozen tumor samples from 101 Turkish breast cancer patients were analyzed with high resolution melting (HRM) for PIK3CA mutations (exon 9 and exon 20) and 37 HRM positive tumor samples were analyzed by DNA sequencing, mutations being found in 31. PIK3CA exon 9 mutations (Q546R, E542Q, E545K, E542K and E545D) were found in 10 tumor samples, exon 20 mutations (H1047L, H1047R, T1025T and G1049R) in 21, where only 1 tumor sample had two exon 20 mutations (T1025T and H1047R). Moreover, we detected one sample with both exon 9 (E542Q) and exon 20 (H1047R) mutations. 35% of the tumor samples with high IGFBP-5 mRNA expression and 29.4% of the tumor samples with low IGFBP-5 mRNA expression had PIK3CA mutations (p=0.9924). This is the first study of PIK3CA mutation screening results in Turkish breast cancer population using HRM analysis. This approach appears to be a very effective and reliable screening method for the PIK3CA exon 9 and 20 mutation detection. Further analysis with a greater number of samples is needed to clarify association between PIK3CA gene mutations and IGFBP-5 mRNA expression, and also clinical outcome in breast cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2861-2866
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• 2016

It is thought that population characteristics of breast cancer may be due to a variation in the frequency of different alleles of genes such as CYP1B1. We aimed to determine the association of CYP1B1 polymorphisms in 200 breast cancer cases and 40 controls by PCR-RFLP. Frequencies were assessed with clinical and risk factors in Egyptian patients. The genotype LV and the Leu allele frequencies for patients and controls were 42.9% and 50%, and 52.9% and 53.3%, respectively), with no significant differences observed (P values = 0.8 and 0.6, respectively). There was also no significant association between genotypes and any risk factors for cases (P>0.05) except laterality and metastasis of the tumor (P values=0.006 and 0.06, respectively). The CYP1B1 polymorphism Val432Leu was not associated with breast cancer in Egypt, but may provide clues for future studies into early detection of the disease.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10157-10164
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• 2015

Background: Breast cancer is the most common cancer among women in the State of Qatar. Due to low participation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancer at advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantly related to women's low level of awareness of breast cancer screening. The objectives of this study were to: (1) determine the factors that influence Qatari women's awareness of breast cancer and its screening activities: and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking women in Qatar. Materials and Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the most recent national recommended guidelines of BCS, participation rates in BCS activities, and factors related to awareness of BCS activities. Results: While most participants (90.7%) were aware of breast cancer, less than half had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breast exams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% had knowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately (13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam (CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once every year or two years). Awareness of BCS was significantly related to BCS practice, education level, and receipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and the media. Conclusions: The low levels of participation rates in BCS among Arab women in this study indicate a strong need to increase awareness of the importance of breast cancer screening in Qatari women. Without this awareness, compliance with the most recent breast cancer screening recommendations in Qatar will remain low. An increased effort to implement mass media and public health campaigns regarding the impact of breast cancer on women's health and the benefits of early detection of breast cancer must be coupled with an enhanced participation of health care providers in delivering this message to Qatar population.

• Journal of Korean Academy of Nursing
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• v.7 no.1
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• pp.30-38
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• 1977

Breast cancer is one of the most feared health problems in women ; Recent studies revealed that it had come up to be the second most in this country and high prevalent disease in the western countries among breast disease in women. However, early detection of the cancer mass is known to be easier than in many other malignancies. This study was performed to investigate the various characteristics of patients of breast cancer ; by the structural variables, menstrual, marital, and child bearing, and also their understandings and attitude towards the disease. A hundred any in- and out- patients of 51. Mary's Hospital and National Atomic Institute, Seoul were sampled. Data were gathered through direct interview by the researcher from February 1976 to January 1977 and the clinical records were used as references. Results are as follows ; 1. Breast cancer revealed to be most prevalent in the forties ; average age of 45.2 years. 2. The average age of menarche revealed to be 15.4 years ; the largest group were the 16-20 years (N=75, 68.2%). In 55 cases (50%) menstruation were normal, 38 (34.5%) postmenopausal and only in 17 (15.5%), menstruation revealed irregularity. 3. The average marital age revealed to be 22.3 years ; the largest group were 21-25 group (N=43, 39.1%). The average duration of marital life revealed to be 24.7 years ; 11-20 years group were the largest (M=34, 30.9%). 4. Most of the patients revealed to have pregnancy experiences(N=100, 90.9%) ; the average rate of experience were 5, 3 times the largest group were 3.4 times group(N= 32, 29.1%). 54 patients (49.1%) revealed to have had abortion experience ; the average were 3.4 times. 5. The largest group(N=77, 70%) had been breast feeding : followed by mixed feeding (N=12, 10.9%) and artificial feeding(N=10, 9.1%). 6. Personal health history revealed that in 20 patients (18.2%) revealed to have the past history of Purulent mastitis, 5 patients(4.5%) of breast cancer and 3 patients(2.7%) of uttering cancer family history. 7. In the one half (N=56, 50.9%, they had some information about breast cancer :27 (24.5%) by mass media, 12 (10.9%) through personal contacts and 17 (15.5%) were not able to classify the source of information. 8. In 55 cases (50%) the canoe, mass were discovered incidentally, in 39 cases (35.5%) by manual detection by self, in 10 cases (9%) by others and in 6 cases(5.5%) by observing subjective symptoms. 9. The average duration lapsed between the discovery of cancer mass and the visit to the hospital revealed to be 9.4 month. Chief reason for the delay revealed to be the non-chaplaincy due to the absence of pain(N=50, 45.5 %) followed by the administration of herb and commercial medication (N=19, 17.3%). 10. The left side breast was more affected than the right side breast, represent by 60 cases in the left and 39 cases in the right. The most frequent site of the breast cancer was the upper- outer quadrant in 53 cases (47.7%), and followed by the center in 20 cases(18 %), and the upper inner quadrant, in 19 cases (17.1%). There was / cases of bilateral carcinoma. The most prominent symptom was painless mass.