• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5219-5223
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• 2013

The number of axillary lymph nodes involved and retrieved are important prognostic factors in breast cancer. The purpose of our study was to investigate whether the lymph node ratio (LNR) is a better prognostic factor in predicting disease-free survival (DFS) for breast cancer patients as compared with pN staging. The analysis was based on 804 breast cancer patients who had underwent axillary lymph node dissection between 1999 and 2008 in Sun Yat-Sen University Cancer Center. Optimal cutoff points of LNR were calculated using X-tile software and validated by bootstrapping. Patients were then divided into three groups (low-, intermediate-, and high-risk) according to the cutoff points. Predicting risk factors for relapse were performed according to Cox proportional hazards analysis. DFS was estimated using the Kaplan-Meier method and compared by the log-rank test. The 5-year DFS rate decreased significantly with increasing LNRs and pN. Univariate analysis found that the pT, pN, LNR, molecule type, HER2, pTNM stage and radiotherapy well classified patients with significantly different prognosis. By multivariate analysis, only LNR classification was retained as an independent prognostic factor. Furthermore, there was a significant prognostic difference among different LNR categories for pN2 category, but no apparent prognostic difference was seen between different pN categories in any LNR category. Therefore, LNR rather than pN staging is preferable in predicting DFS in node positive breast cancer patients, and routine clinical decision-making should take the LNR into consideration.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9471-9473
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• 2014

Background: Since 2002, from October till December of each year, the Lebanese Ministry of Public Health conducts a mammogram based breast cancer screening campaign in the whole country for women over 40 years of age. These mammograms are performed free of charge in governmental hospitals or for reduced fees in private hospitals. The aim of this study is to analyze the direct impact of this campaign on cancer detection and subsequent treatment. Materials and Methods: Radiologic records of women screened with a mammogram during the campaign period from October till December 2012 at Saint Joseph Hospital, Baouchrieh, Beirut, were reviewed. Results of mammograms were reported using the ACR score. Women with ACR score ${\geq}4$ were tracked and investigated. Results: 900 screening mammograms were performed; median age was 55.2 years (range:31-81 years). Some 826 (91.8%) had an ACR score of ${\leq}2$; 66 (7.3%) an ACR =3 and only 8 (0.89%) an ACR=4. Thus, less than 1% (8/900) of all screened women were considered at high risk and needed a close follow-up. Among these 8 women, 4 underwent surgery for an early breast cancer, one had synchronous metastatic breast cancer and two were lost to follow-up. Conclusions: To coclude, Among 900-screened women for BC, less than 1 % (8 out of 900) were at high risk of hiding a BC (ACR=4), half of them benefited from early therapy (4 women out of 900) and one was a false positive. Larger studies on national level should be accomplished to have a complete data on breast cancer screening in Lebanon. The results of these studies can affect the Lebanese health policy regarding BC.

• BMB Reports
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• v.51 no.8
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• pp.373-377
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• 2018

Triple-negative breast cancer (TNBC) is considered to be a notorious type of cancer due to its aggressive metastatic potential and poor prognosis. Recent evidence suggests that BLT2, a low-affinity $LTB_4$ receptor is critically associated with the phenotypes of TNBC cells, including invasion, metastasis, and survival. Furthermore, in a group of 545 breast cancer patients with metastasis, we observed that the high-BLT2 subgroup had a lower disease-free-survival rate than the low-BLT2 subgroup. Thus, we theorized that anti-BLT2 strategies could facilitate the development of new therapies used for TNBC. This review focuses on recent discoveries regarding BLT2 and its roles in as a novel prognostic biomarker in TNBC.

• Journal of Marine Bioscience and Biotechnology
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• v.1 no.3
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• pp.193-197
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• 2006

The effect of protein extract from Asterina pectinifera on breast cancer chemopreventive (aromatase and cyclooxygenase-2) and metastatic (matrix metalloproteinase) enzymes was tested. Protein extract from A. pectinifera was capable of suppressing aromatase in a human placenta microsomal assay. Cyclooxygenase-2 (COX-2) activity was significantly inhibited by the protein extract from A. pectinifera at concentrations of 10, 20 and $40{\mu}g/m{\ell}$. The extract markedly reduced 12-O-tetradecanoylphorbol-13-acetate (TPA)-stimulated matrix metalloproteinase (MMP)-9 activity. These results suggest that A. pectinifera could be of therapeutic value in preventing human breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.419-422
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• 2014

Background: Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. Aim: This study aimed to analyze the clinicopathological features of metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. Materials and Methods: This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. Results: A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicular lymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cell carcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung, with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases; and stomach, 25 (6.1%) cases were the most common primary sites of malignancy. In 69 patients, excision biopsy was performed. Histopathological findings correlated well with that of cytology in all these cases. Conclusions: FNAC is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of an experienced and skilful cytopathologist can avoid the need for excision biopsy.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.268-276
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• 2018

Although patients with breast cancer receive standard treatments, they often experience recurrence or metastasis of tumors. Therefore, patients seeking treatment with traditional Korean medicine (TKM) in addition to conventional treatment have increased. We present a case of 46-year-old female with recurring breast cancer. She underwent surgeries and various hormone therapies since being diagnosed in 2007. Upon follow-up examination, she had metastatic lesions on the lung and multiple bones in 2015 and 2016. She received TKM treatments from May 2017 with Aromasin and Afinitor. However, hepatic metastasis was found after two months, so she started Capecitabine with TKM. After about two months, the liver nodules disappeared and a seeding nodule in the right paracolic gutter was decreased. After two months, the tumor response was stable disease. Back pain due to bone metastasis was improved. We suggest that combination treatment of TKM and chemotherapy is a promising method for treating breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6963-6966
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• 2015

Background: During the past few years, Hesa-A, a herbal-marine mixture, has been used to treat cancer as an alternative medicine in Iran. Based on a series of studies, it is speculated that Hesa-A possesses special cytotoxic effects on invasive tumors. To test this hypothesis, we investigated the selective anticancer effects of Hesa-A on several cancer cell lines with different metastatic potential. Materials and Methods: Hesa-A was prepared in normal saline as a stock solution of 10 mg/ml and further diluted to final concentrations of $100{\mu}/ml$, $200{\mu}g/ml$, $300{\mu}g/ml$ and $400{\mu}g/ml$. MTT-based cytotoxicity assays were performed with A549 (lung non small cancer), MCF-7 (breast adenocarcinoma), SKOV3 (ovarian cancer), and PC-3 (prostate adenocarcinoma) cells. Results: All treated cancer cells showed significant (P<0.01) or very significant (P<0.0001) differences in comparison to negative control at almost all of the tested doses ($100-400{\mu}g/ml$). At the lower dose ($100{\mu}g/ml$), Hesa-A reduced cell viability to 66%, 45.3%, 35.5%, 33.2% in SKOV3, A549, PC-3 and MCF-7 cells, respectively. Moreover, at the highest dose ($400{\mu}g/ml$), Hesa-A resulted in 88.5%, 86.6%, 84.9% and 79.3% growth inhibition in A549, MCF-7, PC-3 and SKOV3 cells, respectively. Conclusions: Hesa-A exert potent cytotoxic effects on different human cancer cells, especially those with a high metastatic potential.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5081-5086
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• 2012

Background: The liver is one of the most common metastatic sites of breast cancer, hepatic metastases developing in 6%-25% of patients with breast cancer and being associated with a poor prognosis. The aim of this study was to analyze the survival and clinical characteristics of patients with hepatic metastases from breast cancer of different molecular subtypes and to investigate the prognostic and predictive factors that effect clinical outcome. Methods: We retrospectively studied the charts of 104 patients with breast cancer hepatic metastases diagnosed at Sun Yat-sen University Cancer Center from December 1990 to June 2009. Subtypes were defined as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, triple-negative (TN). Prognostic factor correlations with clinical features and treatment approaches were assessed at the diagnosis of hepatic metastases. Results: The median survival time was 16.0 months, and the one-, two- three-, four-, five-year survival rates were 63.5%, 31.7%, 15.6%, 10.8%, and 5.4%, respectively. Median survival periods after hepatic metastases were 19.3 months (luminal A), 13.3 months (luminal B), 18.9 months (HER2-enriched), and 16.1 months (TN, P=0.11). In multivariate analysis, a 2 year-interval from initial diagnosis to hepatic metastasis, treatment with endocrine therapy, and surgery were independent prognostic factors. Endocrine therapy could improve the survival of luminal subtypes (P=0.004) and was a favorable prognostic factor (median survival 23.4 months vs. 13.8 months, respectively, P=0.011). Luminal A group of patients treated with endocrine therapy did significantly better than the Luminal A group of patients treated without endocrine therapy (median survival of 48.9 vs. 13.8 months, P=0.003). Conclusions: Breast cancer subtypes were not associated with survival after hepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtype.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.361-365
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• 2012

Aims: To investigate the relationship between the expression of ${\beta}$-tubulin III and survivin in advanced breast cancers and chemotherapeutic effects of docetaxel. Methods: Clinical pathological data of 74 patients with advanced breast cancer were retrospectively analyzed after docetaxel chemotherapy. Expression of ${\beta}$-tubulin III and survivin was assessed by immunohistochemistry and analyzed with reference to therapeutical and adverse effects of docetaxel. Results: The positive expression rate of ${\beta}$-tubulin III was 38.1% (32/84), while that of survivin was 76.2% (64/84). The effective rate (complete response + partial response) was 52.4%. That for patients with the positive expression of ${\beta}$-tubulin III or/and survivin was significantly lower than for those with negative expression (P<0.05). There were significant differences in the non-progression of median diseases, 1-year and 2-year survival rates of between the patients with positive and negative expression (P<0.05). The main side effects were myelosuppression, alimentary canal response and alopecie, no differences being observed between groups. Conclusions: The combined detection of ${\beta}$-tubulin III and survivin is a predictive index for chemotherapy effects of docetaxel in metastatic breast cancer.

• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.8-18
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• 2013

Purpose : The purpose of this study was to find and categorize the various magnetic resonance imaging (MRI) findings of spinal metastases that correlate with the type of primary cancer. Materials and Methods: We retrospectively reviewed gadolinium-enhanced magnetic resonance images of 30 patients with 169 spinal metastatic lesions from lung cancer (n = 56), breast cancer (n = 29), colorectal cancer (n = 20), hepatocellular carcinoma (HCC) (n = 17), and stomach cancer (n = 47). The size, location, extent of invasion, signal intensity, margin, enhancement pattern, and osteoblastic or osteolytic characteristics of each metastatic tumor were analyzed. Results: The metastatic lesions from HCC were larger than those from the other primary tumors (P < 0.05) except for colorectal cancer (P = 0.268). Well-defined metastatic tumor margins were more frequently seen in lung cancer and breast cancer (P < 0.01). All but HCC showed a tendency to invade the vertebral body rather than the posterior elements (P < 0.02). Colorectal cancer and HCC showed a tendency toward extraosseous invasion without statistical significance. HCC showed a characteristic enhancement pattern of 'worms-in-a-bag'. Rim enhancement with a sclerotic center was only seen in spinal metastases from stomach cancer. Conclusion: Despite many overlapping imaging features, spinal metastases of various primary tumors display some characteristic MRI findings that can help identify the primary cancer.