Background: Breast cancer is by far the most frequent cancer of women (23 % of all cancers), ranking second overall when both sexes are considered together. Contralateral breast cancer (CBC) is becoming an important public health issue because of the increased incidence of primary breast cancer and improved survival. The present communication concerns a study to evaluate the role of various clinico-pathological factors on the occurrence of contralateral breast cancer. Materials and Methods: A detailed analysis was carried out with respect to age, menopausal status, family history, disease stage, surgery performed, histopathology, hormone receptor status, and use of chemotherapy or hormonal therapy. The diagnosis of CBC was confirmed on histopathology report. Relative risk with 95%CI was calculated for different risk factors of contralateral breast cancer development. Results: CBC was found in 24 (4.5%) out of 532 patients. Mean age of presentation was 43.2 years. Family history of breast cancer was found in 37.5% of the patients. There was statistically significant higher rate (83.3%) of CBC in patients in age group of 20-40 years with RR=11.3 (95% CI: 1.4, 89.4, p=0.006) seen in 20-30 years and RR=10.8 (95% CI:1.5-79.6, p=0.002) in 30-40 years as compared to older age of 60-70 years. Risk of development was higher in premenopausal women (RR=8.6, 95% CI: 3.5-21.3, $p{\leq}0.001$). Women with family history of breast cancer had highest rate (20.9%) of CBC (RR=5.4, 95% CI: 2.5-11.6, $p{\leq}0.001$). Use of hormonal therapy in hormone receptor positive patients was protective factor in occurrence of CBC but not significant (RR=0.7, 95% CI: 0.3-1.5, p=0.333). Conclusions: Younger age, premenopausal status, and presence of family history were found to be significant risk factors for the development of CBC. Use of hormonal therapy in hormone receptor positive patients might be protective against occurrence of CBC but did not reach significance.
Seo, Jeong-Seok;Kee, Baik-Seok;Lee, Sang-Hoon;Lee, Jae-Kwang
Korean Journal of Biological Psychiatry
/
v.3
no.1
/
pp.96-101
/
1996
Objects : There has been the controversy that menopause may or may not influence the psychological distresses. The purpose of this study was to investigate the correlation between the hormonal status and traits of depression & anxiety in menopausal women. Method : Among the women attending menopausal clinic. menopausal women, defined as who having a amenorrhea for more than 12 months, were selected as a study group(n=83). The control group(n=73), who visited to screen the cervix cancer with regular menstruation, hod no history of hormone replacement therapy. Individual data were collected by self-reporting questionnaires. Depression state was evaluated by Beck Depression Inventory(BDI) and anxiety state by Stale Trail Anxiety Inventory(STAI), and the female hormones such as E2, FSH, and LH were obtained by blood sampling at visting clinic. Statistically the data were processed by t-test and pearson correlation analysis(p<0.05). Results : 1) The mean age of menopausal was 45.3 years. 2) In menopausal women the scores of BDI & STAI were significantly higher than in control group(p<0.05). 3) There were significant differences between menopausal and control group by E2 & FSH. 4) There was no correlation between female hormonal status and the STAI & BDI scores in both groups. Conclusion : Although menopausal women had more traits of depression & anxiety than control group, it was difficult to insist that the lack of estrogen was the only etiological factor for the traits of depression & anxiety in menopausal period. In further studies, we must consider another factors, including biological, sociocultural, psychological factor, as the cause of psychological symptoms during menopausal period.
One of the main goals of small, medium and large farms is to improve the reproductive performance of rabbit does. Stocks of lower productivity can be improved by crossing with intensive breeds. A better nutritional status of both foetuses and suckling kits has a positive effect on their later productivity. Overfeeding young females before first mating can lead to conditions of fattiness. Using restricted feeding or higher fibre content in the feed and changing it for a higher level ad libitum feeding about one week prior to first mating leads to longer lifespan and higher productive level. Intensive reproductive rhythm creates a negative energy balance in does : they are unable to consume enough feed (energy) for the nutritional requirements of foetus and lactation, and therefore lose most of their fat reserves. Furthermore, primiparous does also expend energy because they are still growing. Under intensive conditions, the 42-d reproductive rhythm (re-mating 11 days after parturition) is recommended. Under extensive conditions, the 18 or 25-d mating interval with 35 to 42-d weaning could be suitable. On small farms, natural mating is favoured; on large farms AI is commonly employed. The main advantage of AI is the all-in, all-out system. Hormonal (PMSG) treatment is used with AI to increase receptivity on d 11. Frequent and high level PMSG use can lead to higher anti-PMSG antibody rates. Lower level (max. 20 IU) and less frequent PMSG injection or non-hormonal alternative methods (short dam-litter separation, changing nursing method or lighting programs) are recommended for this reason.
Till date the phenomenon of maternal transfer of photic information was reported to regulate the fetal/neonatal growth, however its influence on neonatal immune system is still an enigma. In the present study, we observed an increase in maternal plasma melatonin level under short day length (SOL) condition with a consequent decrease in TLC and LC in their respective neonates. However, a significant decrease in maternal plasma melatonin level was noted under constant darkness (DD) with an increase in TLC and LC of their neonates. The blastogenic response (BGR) to Con A of splenocytes exhibited a significant increase in neonates of SDL females and a significant decrease in the neonates of DD females. Hence, it appears that the increase in maternal plasma melatonin under SOL condition transmitted information to decrease the immune status. Continuous exposure of females to darkness (DD) negatively regulated the maternal pineal gland activity thereby decreasing their plasma melatonin level. This information was transmitted for elevation of immune status in neonates, so that they exhibit better growth and sexual maturation. Therefore, we may suggest that the maternal photic information transmitted either prenatally through placenta or postnatally via the milk regulate the hormonal profile of Melatonin to regulate the immune status of neonates in order to influence their growth and sexual maturation.
Purpose: The purpose of this study was to investigate relationships among menopausal symptoms, functional status, and distress and to identify factors influencing distress in premenopausal breast cancer patients who had been on endocrine therapy. Methods: A descriptive correlational study was conducted. Data were collected using questionnaires from 140 patients with breast cancer undergoing endocrine therapy at a general hospital. Data were analyzed using descriptive statistics, t-test, ANOVA, Tukey HSD test, Pearson's correlation analysis and hierarchical regression analysis. Results: The mean scores for menopausal symptom, functional status, and distress were $19.65{\pm}7.86$, $2.67{\pm}0.33$ and $3.69{\pm}2.19$, respectively. The menopausal symptoms and distress were positively correlated (r=.76, p<.001). The menopausal symptoms and functional status (r=-.43, p<.001) and functional status and distress (r=-.31, p<.001) were negatively correlated. The most influential factor for distress was menopausal symptoms (${\beta}=.79$, p<.001). Conclusion: Based on the findings of this study, developing nursing intervention programs focusing on decreasing menopausal symptoms and distress are recommended.
Due to lack of sufficient data on characteristics of breast cancer patients and risk factors for developing metastasis in Iran this study was designed to understand clinical aspects impacting on survival. A cross-sectional study on breast cancer patients was conducted in an oncology clinic of the university hospital between 1995 and 2010. Data were retrieved from medical records and included age, menopausal status, tumor diameter, number of involved nodes, histopathological type, estrogen and progesterone receptor expression, c-erbB-2, primary and secondary metastasis sites, overall survival, disease free interval and type of chemotherapy protocol. The results were analyzed with SPSS 13 software. The mean age of the patients was 49.2 (27-89) years. The primary tumors were mainly ER positive (48%) and PR negative (49.3%). The status of lymph nodes dissected and examined in these patients was unknown in 19 patients (25.3%) while 18 patients (24%) had positive lymph nodes with no report on the number of involved nodes. All of the patients had received antracyclin based chemotherapy in an adjuvant or metastatic setting. Adjuvant hormonal therapy was administered to receptor positive patients. In average, overall survival after recurrence was 30 months (95%CI 24.605-35.325) for non-skeletal versus 42 months (95%CI 31.211-52.789) for skeletal metastasis (P= 0.002). The median survival was also greater for receptor positive patients; 39 months (95%CI 33.716-44.284) for PR+ versus 26 months (95%CI 19.210-32.790) for PR- (P=0.047) and 38 months (95%CI 32.908-43.092) for ER+ versus 27 months (95%CI 18.780-35.220) for ER- patients (P=0.016). No relation was found between site of first metastasis and hormone receptor, age, tumor diameter, DFI and menopausal status. Sites of metastasis were independent of age, size of the tumor, menopausal and hormone receptor status in this study. Overall survival provided significant relations with respect to receptor status and bone metastasis.
Despite the risk of high altitude disease (HAD), raising cattle at higher altitudes does have advantages such as beef quality due to minimal chance of infection and stress. The ideal situation is to determine the optimum altitude suitable for raising cattle while at the same time minimizing the risk of HAD. Therefore, in this study, we documented the health status of three groups of steers, raised at three different altitudes (200m, 400m and 800m) in Gangwon province, using routine hematological, biochemical and hormonal tests. The red blood cell counts and hemoglobin concentration were highest in the 800m group, and lowest in the 200m group, possibly due to hypoxia induced myeloid and erythroid stimulation. The mean concentration of AST, BUN and serum cortisol were lowest in the 800m. These findings suggest the stress factor will contribute the general health status of animal and indicate a difference in the Hanwoo groups raised at 800m compared to 200m, where the cattle raised at the higher altitude exhibit better health status compared to the lower altitude, possibly due to less stressful environment in the higher altitude.
Background: We aimed to evaluate the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression discordance in matched pairs of primary breast cancer and lymph node metastasis specimens and determine the effect of discordance on prognosis. Materials and Methods: Among all patients diagnosed with lymph node metastases from 2004 to 2007, primary tumors and paired lymph node metastases were resected from 209 patients. The status of ER, PR, and HER2 expression was analyzed immunohistochemically in 200, 194, and 193 patients, respectively. Discordance was correlated with prognosis. Results: Biomarker discordance between primary tumors and paired lymph node metastases was 25.0% (50/200) for ER status, 28.9% (56/194) for PR status, and 14.0% (27/193) for HER2 status. ER positivity was a significant independent predictor of improved survival when analyzed in primary tumors and lymph node metastases. Patients with PR-positive primary tumors and paired lymph node metastases displayed significantly enhanced survival compared to patients with PR-positive primary tumors and PR-negative lymph node metastases. Patients with ER- and PR-positive primary tumors and paired lymph node metastases who received endocrine therapy after surgery displayed significantly better survival than those not receiving endocrine therapy. Similalry treated patients with PR-negative primary tumors and PR-positive paired lymph node metastases also displayed better survival than those not receiving endocrine therapy. Conclusions: Biomarker discordance was observed in matched pairs of primary tumors and lymph node metastases. Such cases displayed poor survival. Thus, it is important to reassess receptor biomarkers used for lymph node metastases.
Introduction and aim: To compare reproductive factor influence on patients with pathological diagnosed malignant and benign tumor in the Breast Department, The First Peoples' Hospital of Kunming in Yunnan province, China. Methods: A hospital-based case-control study was conducted on 263 breast cancer (BC) cases and 457 non-breast cancer controls from 2009 to 2011. The cases and controls information on demographics, medical history, and reproductive characteristics variables were collected using a self-administered questionnaire and routine medical records. Histology of breast cancer tissue and benign breast lesion were documented by pathology reports. Since some variables in data analysis had zero count in at least one category, binomial-response GLM using the bias-reduction method was applied to estimate OR's and their 95% confidence intervals (95% CI). To adjust for age and menopause status, a compound variable comprising age and menopausal status was retained in the statistical models. Results: multivariate model analysis revealed significant independent positive associations of BC with short menstrual cycle, old age at first live birth, never breastfeeding, history of oral contraception experience, increased number of abortion, postmenopausal status, and nulliparity. Categorised by age and menopausal status, perimenopausal women had about 3-fold and postmenopausal women had more than 5-fold increased risk of BC compared to premenopausal women. Discussion and Conclusion: This study has confirmed the significant association of BC and estrogen related risk factors of breast cancer including longer menstrual cycle, older age of first live birth, never breastfeeding, nulliparity, and number of abortions more than one. The findings suggest that female hormonal factors, especially the trend of menopause status play a significant role in the development of BC in Yunnan women.
Background: Epidemiological findings are controversial relating to the relationship between dietary folate intake and the risk of breast cancer. We therefore conducted a meta-analysis of prospective cohort studies to clarify this association. Materials and Methods: PUBMED, EMBASE, and MEDLINE databases were searched for all relevant literature published in English from January 1, 1966 to August 2013. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using a fixed or random effects model. Results: Dietary folate intake was not significantly associated with the risk of breast cancer. The combined RR with 95%CI for the highest vs. lowest category dietary intake of folate [fifteen studies; 1,836,566 participants and 24,083 patients with breast cancer] was 0.98 (0.90-1.05). Among subgroup analysis by menstrual status, hormonal status and the consumption of alcohol, methionine and vitamin B12, no significant association was observed for the dietary intake of folate and the risk of breast cancer. Dose-response analysis showed that a 220 ${\mu}g/day$ increment in dietary folate intake was not associated with the risk of breast cancer. Conclusions: Our findings indicate that dietary folate intake has no significant effect on the risk of breast cancer.
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