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In-person, individual counseling using the PLISSIT model is a well-known approach to help people with sexual problems. Evidence suggests that Grouped Sexuality Education (GSE) can be as effective as in-person sexuality education. The efficacy of PLISSIT versus GSE has not previously been evaluated in women with Breast Cancer (BC). In this paper, we report on the effect of PLISSIT versus GSE on self-reported sexual behaviors experienced by women after a BC diagnosis (n = 75). The women were randomly allocated into three groups, with 25 women in each arm. Data analysis of the intention-to-treat population (n = 65) revealed efficacy of both GSE and PLISSIT in improving sexual behaviors (p < 0.0001) with a positive change in sexual capacity, motivation and performance after 6- and 12-weeks post-intervention follow ups. We found the GSE model showed a greater efficacy than the PLISSIT model. Due to the substantial needs faced by women with cancer and the cost associated with implementing the PLISST model, GSE seems to be more effective. We recommend GSE for Iranian communities where management of sexual problems is at an early stage and where the sexuality of women with cancer is routinely overlooked. [ABSTRACT FROM AUTHOR]

Background: Breast cancer disease is an important public health trouble in the world. Over the past 2 decades, incidences of breast cancer among Iranian women have shown an alarmingly rapid increase. Mammography screening can lead to early detection and management of breast cancer and it also plays an important preventive role in decreasing breast cancer, especially among women over 40 years old. Objectives: This paper aims at reporting the psychometric properties of a questionnaire on mammography behavior based on health action process approach (HAPA) model. Methods: This cross-sectional study was performed between May and September 2017, and was attended by 400 women aged 40 Years and older, in comprehensive health service centers in Iran. The research subjects were selected by multi-stage cluster sampling. The instrument was designed basis on the constructs of HAPA and current literature. The scale's psychometric properties were examined by exploratory factor analysis (EFA), infraclass correlation coefficient (ICC), and Cronbach's alpha. Results: The results showed 45 items of the questionnaire, 41 items had important item-to-total correlations (P < 0.05), and they were placed in 8 factors that contributed 60.88% of the scale variance. Conclusions: The research findings contribute to the reliability and validity of the HAPA model for predictively evaluating mammography goals. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer in women. Delay in the diagnosis of breast cancer is a major challenge that can lead to disease progression. Identifying the predictors of breast cancer screening behavior is necessary to promote early detection of breast cancer. This study aims to investigate the predictors of breast cancer screening behavior in women aged 20-69 referred to public health centers. Methods: This cross-sectional study was conducted on 17255 women aged 20-69 years old in Isfahan Province referred to Public Health Centers by the multi-stage random sampling method. data were collected based on the paper forms of women's care aged 20-69 at public health centers, Isfahan, Iran, in 2012. Using STATA 14, logistic regression was employed to explore predictors of breast cancer screening behavior at a 5% significance level. Results: The mean age of women was 36.75 ± 10.46. About 6006 (34.8%) of women had a history of breast self-examination, and among women aged over 40 years, 17.7% reported ever having a mammogram. The most important factors influencing breast self-examination were age 40-49 (OR = 1.18; 95% CI: 1.06-1.33), history of hormone consumption (OR = 1.23; 95% CI: 1.15-1.33), family history of breast cancer in first-degree relatives (OR = 14.22; 95% CI: 9.83-20.57. The most important factors influencing mammography were hormone consumption (OR = 1.26; 95% CI: 1.05-1.51), and family history of breast cancer in first-degree relatives (OR = 32.55; 95% CI: 20.08-52.70). Conclusions: Our findings indicated that the performance of breast self-examination and mammography was low. The frequency of BC screening behavior was higher among women with BC risk factors The results revealed the need for health authorities to pay attention to education in BC detection methods. [ABSTRACT FROM AUTHOR]

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Background and Aims: Recognizing the ability to adapt coping mechanisms in response to the unique issues present in various Iranian societies underscores the importance of considering culture and religion when interacting with diverse groups of individuals. The objective of this study was to assess the reliability and validity of the fear of progression questionnaire‐short form (FoP‐Q‐SF) in Iranian breast cancer patients. Methods: In this methodological cross‐sectional research design, 400 Iranian breast cancer patients completed the FoP‐Q‐SF in 2023. We assessed the characteristics, content, and both exploratory and confirmatory construct validity of the measures. To evaluate the reliability and construct validity of the FoP‐Q‐SF, we calculated Cronbach's α, McDonald's omega, and the Intraclass Correlation Coefficient. Results: The average age of the patients was 49.18 (standard deviation = 16.14) years. The results of exploratory factor analysis revealed that a single‐factor structure, specifically the self‐efficacy scale, accounted for 65.045% of the total variance. The findings from the confirmatory factor analysis indicated a satisfactory model fit. The reliability analysis indicated that the internal consistency and stability of the measures were acceptable. Conclusion: The short Persian version of the FoP‐Q‐SF exhibits satisfactory validity and reliability. Thus, we recommend using this questionnaire to assess the fear of disease progression among breast cancer patients in Iran. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sexual distress in women with a history of breast surgery is a critical issue that warrants investigation. Objectives: This study aimed to predict sexual distress in women with a history of breast surgery based on their self-compassion, considering the mediating roles of body image and emotion regulation abilities. Methods: This correlational descriptive study was conducted in 2022 - 2023. The participants comprised 160 patients with a history of breast surgery from Hazrat Rasool Akram, Bazarganan, and Tarbiat Modares hospitals, and Sepid Psychotherapy Clinic in Tehran. A purposive sampling method was employed. Questionnaires were distributed and completed both in-person and online. The instruments used included the Female Sexual Distress Scale-Revised (FSDS-R), Self-Compassion Scale (SCS), Difficulties in Emotion Regulation Scale (DERS), and Body Image Scale (BIS). Data were analyzed using Pearson correlation coefficients and structural equation modeling in SPSS 25 and R software. Results: The research results demonstrated satisfactory model fit. A positive and significant relationship was found between self-compassion and sexual distress, mediated by body image, in participants with a negative history of breast surgery (P < 0.01). Additionally, difficulties in emotion regulation significantly and negatively mediated the relationship between self-compassion and sexual distress (P < 0.01). Conclusions: The findings suggest that self-compassion and difficulties in emotion regulation, with the mediating role of body image, can predict sexual distress in women post-mastectomy. Self-compassion may shield against the impacts of mastectomy by fostering an empathetic and accepting view of oneself. This perspective helps patients adapt more easily to appearance changes, experience fewer emotional difficulties, and endure less sexual distress. Thus, to mitigate sexual problems, psychotherapists are encouraged to employ approaches that emphasize self-compassion, such as acceptance and commitment therapy. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life in cancer patients has been interested to researchers in the domain of health in recent decades. Mental adjustment to cancer is a concept known as an important indicator of life quality, well-being and health of cancer patients. The aim of this paper is to examine the relation between mental adjustment to cancer and health-related quality of life (HRQoL) among some women with breast cancer. Methods: 100 patientswerenon-randomly selectedfromhospitalsandoncology clinics inKermanshahandShiraz cities, Iran. These patients completed the functional assessment of cancer treatment-breast (FACT-B) in order to measure HRQoL and mini-mental adjustment to cancer questionnaire (Mini-MAC). Data were analyzed by using correlation and regression. Results: The results show that helplessness/hopelessness (58%), fighting spirit (40%), fatalism (33%) and preoccupation anxiety (18%) explain the variance of HRQoL. Conclusions: According to the findings, there is no relation between cognitive avoidance styles and HRQoL, and it can be concluded that coping styles helplessness/hopelessness and fighting spirit are the best predictors of HRQoL in patients with breast cancer. Consequently, the evaluation of the coping styles and emergency interventions in order to enhance coping with illness in cancer patients, decrease the sense of helplessness/hopelessness and anxiety are recommended, which in turn are accompanied by increasing HRQoL. [ABSTRACT FROM AUTHOR]

Background: Breast cancer, the most prevalent cancer in women and the second leading cause of cancer-related deaths worldwide, is a complex and heterogeneous disease characterized by multiple tumor types with distinct tissue patterns, biological characteristics, and clinical behaviors. Given the critical role of histopathological and molecular characteristics in the treatment and management of breast cancer. Objectives: This study was undertaken to investigate the histopathological and molecular characteristics of malignant breast masses in the city of Sanandaj from 2019 to 2021. Methods: In this descriptive-analytical study, out of 1,631 pathology reports from breast tissue samples collected in Sanandaj, a city in northwest Iran, between 2019 and 2021, 597 (36%) malignant cases were examined for their pathological type and molecular characteristics. Data analysis was performed using SPSS 26 software, employing chi-square and Fisher's exact tests. Results: The mean age of the patients at diagnosis was 49.7 ± 11.9 years. The most prevalent molecular subtype was luminal A (56.4%), followed by triple-negative (16.7%), human epidermal growth factor receptor 2 (HER2)-positive/enriched (14.1%), and luminal B (14%). Invasive ductal carcinoma was the predominant histological type, accounting for 82.7% of cases, followed by lobular invasive carcinoma (8.2%). Papillary carcinoma accounted for 5.9% of cases, metaplastic carcinoma for 1.8%, and mucinous carcinoma for 1.3%. Higher grades at the time of diagnosis were associated with the metaplastic subtype (P < 0.001). The only biomarker that showed a significant association with pathological types of breast cancer was Ki-67. The percentage of cases positive for Ki-67 was higher in three types of breast cancer: Infiltrating ductal carcinoma, metaplastic, and papillary (intraductal) carcinoma, compared to the other types (P < 0.001). Conclusions: According to our data, infiltrating ductal carcinoma is the most prevalent pathological type, and luminal A is the most common molecular subtype among Kurdish women in Iran. It is recommended that future studies examine patient survival based on the pathological and molecular types of tumors, including the evaluation of additional biomarkers. Furthermore, comparing these results with those from other ethnic groups could provide valuable insights into the impact of ethnicity on breast cancer characteristics and outcomes. [ABSTRACT FROM AUTHOR]

Spirituality-centered cognitive therapy refers to the way in which people search for and express the meaning and purpose of their lives, as well as experience connection with themselves, others, nature, and spirituality. This study aimed to determine the effectiveness of spirituality-centered cognitive therapy on body image, sexual function, disease perception, and disturbing thoughts in women after mastectomy. This was semi-experimental research, which was conducted via a pre-test–post-test method and had a control group. The samples included 85 women with breast cancer who had undergone mastectomy, and, based on the inclusion criteria, 78 individuals were randomly selected and were then divided into two groups (39 individuals in the intervention group and 39 individuals in the control group). The intervention group received eight 120 min sessions of spirituality-centered cognitive therapy, and the control group did not receive any training. Data were collected using questionnaires on illness perception, body image, sexual function, and rumination and were then analyzed by multivariate analysis of variance with repeated measurements using SPSS-24. Before the training, there was no significant difference between the intervention and control groups in the scores obtained by the scales. After the intervention, the mean scores in all scales except sexual function were significantly different from the control group. Therefore, spirituality-centered cognitive therapy may be useful for improving negative psychological symptoms among women in Iran with breast cancer after mastectomy surgery. [ABSTRACT FROM AUTHOR]

Introduction: As a common type of malignancy, breast cancer is one of the major causes of death in women globally. The purpose of the current study was to analyze Iran research performance on Breast Cancer in the context of national and international studies, shown in the publications indexed in Scopus database during 1991-2015. Methods: Data were retrieved from the Scopus citation database in this scientometric study. The following string was employed; “breast cancer OR breast malignancy OR breast tumor OR mammary ductal carcinoma” keywords in the main title, abstract and keywords and Iran in the affiliation field were the main related keywords. The terms used were searched in Scopus using the tab specified for searching documents. Time span analyzed was 1991 to 2015 inclusive. Using the analyzing software of Scopus, we analyzed the results. Results: Iran’s increasing publication production during 1991–2015 in breast cancer research which indexed in Scopus, consists of 2,399 papers with an average of 95.96 papers per year, and achieved an h-index of 48. Iranian cancer research articles have received 15,574 citations during 1991-2015, and average citations per paper were 6.49. Iran ranked 27th among the top 30 nations with a worldwide stake of 0.67 %, the 20 top publishing journals published 744 (31%) Iranian research articles on breast cancer, among them, there were 15 Iranian journals. Conclusion: The number of Iranian research papers on breast cancer and also the number of citations to them, is increasing. Although the quantity and quality of papers are increasing, regarding the prevalence of breast cancer in Iran and also the ineffectiveness of screening programs in the early detection of the cases, more effort should be made, and Iranian policy makers should consider more investment on breast cancer research. [ABSTRACT FROM AUTHOR]

Background: Sentinel lymph node biopsy (SLNB) is primarily performed to detect axillary lymph node involvement and determine the need for surgical axillary lymph node dissection (ALND). However, the procedure is expensive and necessitates the use of radio-labelled colloids that are not readily available to a large number of patients. It also carries the risk of producing occasional false negative results. Objectives: This study aimed to define highly specific ultrasound parameters to ascertain axillary lymph node involvement as an alternative or complementary method to SLNB in selected patients who require ALND. Patients and Methods: In this prospective cross-sectional study, 256 patients with confirmed breast cancer were selected through non-probability purposive sampling. The selected patients were referred to Omid Hospital, a tertiary educational oncology center in Mashhad, Iran, from 20I8 to 2022. This study identified highly specific cut-off points for ultrasound parameters to determine lymph node involvement in comparison with the histological diagnosis post-SLNB or ALND. Measurements were taken of the tumor size, the cortical thickness of the axillary lymph node, the short axis diameter of the node, and the count of lymph nodes with a cortical thickness of ≥ 3 mm. Results: Among 256 patients with a mean age of 46.41 ± 10.77 years, 202 (87.9%) had histologically confirmed metastatic adenopathy. The ultrasound cut-off values identified to define metastasis with high certainty were as follows: A tumor size > 50.5 mm (with 97% specificity), a difference in cortical thickness of ≥ 4.5 mm (with 100% specificity), a short axis diameter of the node > 12 mm (with 95% specificity), more than three lymph nodes with a cortical thickness of ≥ 3 mm (with 943% specificity), and a cortical thickness of ≥ 6 mm (with 95% specificity). Conclusion: Highly specific ultrasound findings can diagnose lymph node metastasis with a high degree of certainty and can used as an alternative method to SLNB. A difference of ≥ 45 mm between the cortical thickness of the suspected lymph node and the contralateral lymph node and a cortical thickness of ≥ 6 mm are ultrasound findings that can detect lymph nodes involvement, with a specificity ranging from 95% to 100%. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine the effect of motivational interviewing on the change of breast cancer screening behaviors among rural Iranian women.Methods: This Randomized controlled trial (RCT) was performed on 120 Iranian rural women selected through cluster random sampling method. Out of all 20 rural health centers of Abish Ahmad District, in the northwest of Iran, about one third (six clusters) were randomly selected; out of which three were randomly assigned to the control group and three to the intervention group. A list of women aged 40-69 years in the selective health centers was prepared and 60 participants were selected for each group through the convenience sampling method based on the inclusion and exclusion criteria. Then, six group sessions (two educational and four motivational interviewing sessions) were held for the intervention group. The data were collected using demographic and obstetric questionnaire, paper-based health records, and the stages of change checklist and analyzed in SPSS 24. The groups were compared through the chi square test, homogeneity test, and the sequential logistic regression with generalized estimating equations.Results: Two months after the intervention, a significant difference was found between the two groups in terms of the stages of change for clinical breast examination and mammography by taking into account the pre-intervention stages (p = 0.001).Conclusion: MI-based counseling increased the Iranian rural women's motivation for displaying breast cancer screening behaviors.Practice Implications: The application of MI for enhancing cancer screening programs among Iranian women is suggested. [ABSTRACT FROM AUTHOR]

Objectives: Breast cancer is known as one of the deadliest forms of cancer, and it is increasing globally. There are a variety of proven and controversial risk factors for this malignancy. Herein, we aimed to undertake a systematic review and meta-analysis focus on the epidemiology of breast cancer risk factors in Iran. Methods: We performed a systematic search via PubMed, Scopus, Web of Science, and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a fixed/random-effects models. Results: Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95%CI 1.47–2.12), hormonal replacement therapy (HRT) (OR: 5.48, 95%CI 0.84–1.74), passive smokers (OR: 1.68, 95%CI 1.34–2.03), full-term pregnancy at age 30 (OR: 3.41, 95%CI 1.19–5.63), abortion (OR: 1.84, 95%CI 1.35–2.33), sweets consumption (OR: 1.71, 95%CI 1.32–2.11) and genotype Arg/Arg (crude OR: 1.59, 95%CI 1.07–2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95%CI 0.32–0.83), nulliparity (OR: 0.68, 95%CI 0.39–0.96), 13–24 months of breastfeeding (OR: 0.68, 95%CI 0.46–0.90), daily exercise (OR: 0.59, 95%CI 0.44–0.73) and vegetable consumption (crude OR: 0.28, 95%CI 0.10–0.46). Conclusions: This study suggests that factors such as family history, HRT, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13–24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development. [ABSTRACT FROM AUTHOR]

This paper aims at exploring women's meaningful perception, semantic understanding, and their experiences of breast cancer in a religion context. Accordingly, eight women who had one of their breasts completely removed by surgery (mastectomy) were studied by narrative interviews. In this narrative interview, participants told their life stories since the beginning of disease. Findings showed that religious concepts have a heightened role in the interpretation and understanding of disease, coping strategies, and gaining new concepts for life and death. Two main themes discovered in this research were fatalism on the one hand, and the hope and empowerment on the other. Despite the intrinsic conflict between these two concepts, religion, as a specific cultural and epistemological context, reconciles them; in a way, these polar concepts form a unitary structure of meaning and activity. In this structure, semantic coherence and concrete experience leads women with breast cancer to a new meaningful system, which shapes a new path for living well. [ABSTRACT FROM AUTHOR]

BACKGROUND: Estimating the burden of diseases, injuries and major risk factors is necessary for adopting appropriate health policies in every country, and this paper aims to explain the study protocol of national and sub-national burden of breast cancer in Iran from 1990 to 2013. METHODS: We will perform a systematic review of the confirmed databases and literature to gather data on breast cancer epidemiology in Iran. The definitions, data sources, organizing the team, methods of data gathering and data generating will be explained in this paper. The methodology of estimating the trend of prevalence, years of life lost due to premature death (YLLs), years of life lost due to disability (YLDs) and disability-adjusted life years lost (DALYs) of breast cancer by age groups, provinces and probable inequalities will be explained. We will tackle possible data problems due to the lack of data points on provinces and years and also geographical misalignment by using two advanced statistical methods, namely Bayesian autoregressive multilevel and Spatio-temporal models. Trend estimation will be reported using these two models together with uncertainty intervals. CONCLUSION: This study provides a comprehensive assessment of breast cancer and its specific pattern in Iran. The results will help policy makers to know the trend of prevalence, the distribution, and the inequalities of breast cancer in Iran to allocate resources in a better way. [ABSTRACT FROM AUTHOR]

Background: Breast Cancer (BC) is a formidable global health challenge, and Iran is no exception, with BC accounting for a significant proportion of women's malignancies. To gain deeper insights into the epidemiological characteristics of BC in Iran, this study employs advanced geospatial techniques and feature selection methods to identify significant risk factors and spatial patterns associated with BC incidence. Methods: Using rigorous statistical methods, geospatial data from Iran, including cancer-related, sociodemographic, healthcare infrastructure, environmental, and air quality data at the provincial level, were meticulously analyzed. Age-standardized incidence rates (ASR) are calculated, and different regression models are used to identify significant variables associated with BC incidence. Spatial analysis techniques, including global and local Moran's index, geographically weighted regression, and Emerging hotspot analysis, were utilized to examine geospatial patterns, identify clustering and hotspots, and assess spatiotemporal distribution of BC incidence. Results: The findings reveal that BC predominantly affects women (98.03%), with higher incidence rates among those aged 50 to 79. Isfahan (ASR = 26.1) and Yazd (ASR = 25.7) exhibit the highest rates. Significant predictors of BC incidence, such as marriage, tertiary education attainment rate, physician-to-population ratio, and PM2.5 air pollution, are identified through regression models. Conclusion: The study's results provide valuable information for the development of evidence-based prevention strategies to reduce the burden of BC in Iran. The findings underscore the importance of early detection, health education campaigns, and targeted interventions in high-risk clusters and adjacent regions. The geospatial insights generated by this study have implications for policy-makers, researchers, and public health practitioners, facilitating the formulation of effective BC prevention strategies tailored to the unique epidemiological patterns in Iran. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most common cancer in the world, and is associated with significant economic costs for patients and communities. Therefore, the information on the costs of the disease and the identification of its underlying factors will provide insights into designing effective interventions and reducing the costs. Thus, the present study aimed to identify the factors affecting the economic burden of breast cancer from all medical centers providing diagnostic and treatment services in southern Iran. Methods: A list of factors affecting the economic burden of breast cancer was obtained based on the effective factors searched in the databases, including PubMed, ProQuest, Scopus, ISI Web of Science, SID, and Magiran, and the opinions of BC cancer specialists. Then, the data on 460 breast cancer patients was collected from March 2020 to March 2022. The relationship between the factors affecting Breast Cancer costs was analyzed using SPSS 13.0 software by the use of multiple regression analysis. Results: The results of the multiple regression analysis showed that stages (P-value < 0.001), being an extreme user (p = 0.025), type of treatment center (P-value < 0.001), income (P-value < 0.001), chemotherapy side effects (P-value < 0.001), and distance to the nearest health center (P-value < 0.001) were important factors affecting the costs of breast cancer patients. Conclusions: According to the results, encouraging people to undergo annual screenings, increasing insurance coverage, assuring the patients about the desirability and adequacy of the provided medical services, deploying specialists in chemotherapy centers (especially nutritionists) to recommend special diets, and establishing cancer diagnostic and treatment centers in high-population cities could help reduce the costs of breast cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: The breast cancer burden is still increasing, both in developing and developed countries. The present study was conducted to determine the survival rate of breast cancer based on tumor biological subtypes in patients referring to three referral oncology centers at Mashhad University of Medical Sciences, Mashhad, Iran. Methods: The present population-based study was conducted at Imam Reza Hospital, Omid Hospital, and Reza Oncology Center, Mashhad University of Medical Sciences, Mashhad, Iran Demographic information, the status of biomarkers in immune-histochemical evaluation, clinical and pathological features of the tumor, type of therapy, recurrence, or death was recorded for each eligible patient. Results: In total, 247 patients were included in the study. The mean age of patients was 48.8 ± 1.3 years. The mean time of survival was 2.64±0.13 years. In detail, the survival rate from the first year to the fifth year was reported as 100%, 96%, 91%, 90%, and 89%, respectively. The survival rate of the luminal B subtype was higher than other subtypes but the difference was not significant (P=0.7). Only in terms of metastasis, there was a significant difference between the alive and dead patients (P=0.0001). Conclusion: Despite no significant relationship between biological markers, the breast cancer subtype, and its survival rate, the overall survival rate of the patients decreased lightly through five years. However, further studies are required to indicate more accurate data about the breast cancer survival rate in our region. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is a leading cause of cancer-related deaths among women worldwide, and its incidence has increased in Iran over recent years. Objectives: In this study, we aimed at assessing the completeness of BC pathology reports in the population-based cancer registration system and perform a spatial analysis of the incidence of this cancer in Iran in 2016 to help policymakers develop targeted interventions. Methods: We conducted a retrospective descriptive analysis, using secondary data from the Integrated Cancer Information Management System, and obtained 13789 BC pathology reports from all provinces in Iran in 2016. Pathology data, including tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade were examined for completeness by age group. Results: Pathology reports from 4000 women with BC in 2016 from across all provinces of Iran were selected for this study. The completeness of tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade increased with aging. In addition, the completeness of pathology reports varied across different variables. Accordingly, the tumor grade and pathologic T stage had the highest and lowest completeness rates (100 % versus 27.4%), respectively. Spatial analysis revealed significant high-risk areas for BC incidence, including Isfahan, Markazi, Chaharmahal and Bakhtiari, and Kohgiluyeh and Boyer-Ahmad provinces in central Iran. In contrast, North Khorasan was identified as a low-risk area. Conclusions: Considering the incompleteness of the pathology report in most of the tumor variables in the BC registry, we recognize the gaps to improve pathology data. To ensure effective interventions for BC control, tailored preventive measures are needed, particularly for high-risk areas. Continuous evaluation and data completion, including standard cellular pathology reports, are necessary for accurate BC control in Iran. [ABSTRACT FROM AUTHOR]

Background: Cancer recurrence is an important care challenge for breast cancer survivors. It is necessary to understand and identify the barriers and facilitators that affect the decision to start retreatment by those facing breast cancer recurrence compared to factors affecting their decision to start the initial treatment, which is different. Objectives: This study is part of a qualitative study with a grounded theory approach, which was conducted to explain the facilitating and inhibiting factors affecting the decision to start retreatment in survivors of breast cancer recurrence, using a qualitative content analysis method. Methods: This study was conducted based on the experiences of 16 patients with breast cancer recurrence and 2 oncologists to confirm the findings of the effective inhibiting and facilitating factors in patients' decisions to start retreatment for breast cancer recurrence in one of the hospitals in Tehran, Iran. The samples were selected, using the purposeful sampling method trying to have maximum diversity. Data were collected through in-depth semi-structured telephone interviews from November 2020 to November 2021 and analyzed, using the conventional content analysis method following the Elo and Kyngas method, which includes 3 phases, including the preparation phase, the organizing phase, and the reporting phase. Credibility, transferability, dependability, confirmability, and authenticity were used for determining the trustworthiness of data. Results: Both groups of inhibiting and facilitating factors were divided into 5 categories, including individual factors, social factors, family factors, illness characteristics, and treatment-related factors. Also, each category included sub-categories in two groups of inhibiting and facilitating factors affecting the decision to start treatment again. Conclusions: Based on the results of the present study, it is necessary to increase the awareness of patients with breast cancer by the treatment staff about the possibility of recurrence and to know the factors influencing their decision-making process to start retreatment. Nurses should play the role of advisors, educators, and supporters of the patients in this field. [ABSTRACT FROM AUTHOR]

Context: As breast cancer treatment going forward, need for supportive strategies grows. That creates an important call to summarize what has been done regionally. Objectives: In this study, we systematically reviewed articles that proceeded rehabilitation and supportive care in breast cancer patients in Iran to present a research map of rehabilitation research in the past 10 years in Iran. Data Sources: All articles published from January 2006 to October 2015 were included. All of the breast cancer studies in Iran were searched in 3 English (Web of Science, PubMed, and Scopus) and 2 Persian databases (SID and IranMedex). Study Selection: All papers related to rehabilitation in breast cancer were included and categorized into 5 subgroups including qualitative, instrument, lymphedema, interventional, and observational studies. Three reviewers (two surgeons and an epidemiologist) screened the primary search and divided it into subgroups. Data Extraction: Tworeviewers used a checklist to critically appraise the full text of the selected articles. The necessary information of retrieved articles was extracted and recorded in the designed data extraction spreadsheet in Excel software. Results: A total of 194 articles (102 in English and 92 in Persian) were assessed for eligibility of inclusion in the review, of which, 121 were excluded, and 73 studies were kept. The included studies consisted of 14 on qualitative design, 5 studies in the translation and validation of research instruments, 7 articles in the field of lymphedema, 20 articles about different intervention modalities on breast cancer patients (including education, social status, psychological, exercise, etc.), and 27 observational studies about anxiety, depression, quality of life, sexual function, emotional distress, complementary medicine, lifestyle, etc. Conclusions: Most of the reviewed studies insisted on a prevalence of physical, psychological, functional, and spiritual problems of breast cancer survivors and their caregivers. Designing a mega project to offer a palliative and rehabilitation service package according to the needs of Iranian patients may become a priority in their health care system. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study exploring how Iranian women coped with newly diagnosed breast cancer and provides a foundation for cultural-based care. Background. Although research has indicated that coping strategies are associated with adaptation to breast cancer, and despite the number of women with newly diagnosed breast cancer increasing each year, there is no information on how Iranian women cope with breast cancer when compared with women of other cultures. Method. In this qualitative study, 19 women with newly diagnosed breast cancer were interviewed during the period May–September 2004 about coping with their disease. Interviews were analysed using a content analysis method. Findings. The main themes emerging from this qualitative study included coping using a religious approach (acceptance of disease as God's will; spiritual fighting), thinking about the disease (positive thinking: positive suggestion, hope, intentional forgetfulness; negative thinking: hopelessness, fear, impaired body image), accepting the fact of the disease (active acceptance; passive acceptance), social and cultural factors and finally finding support from significant others. Conclusion. Understanding how Iranian women cope with diagnosis of breast cancer is important to nurses involved in the process of healing. The majority of strategies used by Iranian women were positive, and religious faith played a major role in this. The findings of the study can be used to design a nursing approach to improve successful coping in Iranian women suffering from breast cancer, and can provide nurses and other healthcare professionals with deeper understanding of these women as they face this diagnosis. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most wellknown and prominent genes susceptible to breast cancer were BRCA1 and BRCA2. They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Breast cancer, as the most prevalent malignancy among women globally and in Iran, affects important aspects of the lives of the survivors of this condition, especially the quality of sexual life. Solution-focused brief therapy is one of the therapeutic counseling approaches used in various fields, including sexual function problems. In recent years, online and internet-mediated counseling methods have received more attention. Objective: This study investigated the effect of online counseling based on a solution-focused approach in improving the sexual quality of life (SQL) of women with breast cancer. Materials & methods: In this clinical trial, the research population consisted of women with a history of breast cancer with a recorded file in Shahid Ramazanzadeh Radiation Oncology Center in Yazd and at least 6 months had elapsed since the end of their treatment. After selecting 80 samples based on the random numbers table, they were assigned into two groups of 40, i.e., active control and intervention, using random allocation software. Participants in the intervention group were given online counseling through the Skyroom space with a solution-focused approach. Eight weekly sessions were held each lasting 60–90 min. The active control group received an educational file to improve the SQL. All participants in two groups completed the SQL questionnaire at the beginning of the study, at the end of the study, and 1 month after the study. Data were analyzed with SPSS18 using descriptive and inferential statistics. Results: Finally, the data of 33 participants in the intervention group and 32 participants in the active control group were analyzed. The mean score of the SQL in the intervention group increased from 68.57 ± 18.63 before the intervention to 78.84 ± 12.7 immediately after the intervention (P = 0.015), and to 79.60 ± 19.88 1 month after the intervention (P = 0.012). The mean score of the SQL in the active control group increased from 64.45 ± 22.76 before the intervention to 67.20 ± 20.29 immediately after the intervention (P = 0.33), and to 68.70 ± 20.76 1 month after the intervention (P = 0.62). The difference in the mean score of the SQL before and after the intervention between the two groups was statistically significant (P = 0.007). Conclusion: It seems that the use of counseling with a solution-focused approach in women with a history of breast cancer improves the SQL. Thus, considering the effectiveness of this type of training, it is recommended that this method be used as a sexual health counseling method in medical centers. Trial registration: This clinical trial is registered in Iranian registry center of clinical trials (IRCT) by registration code of IRCT20201221049784N1 in 06/03/2021. [ABSTRACT FROM AUTHOR]

Introduction: Doxorubicin (DOX), an anthracycline antibiotic, is one of the most effective anticancer agents used to treat breast cancer. Multidrug resistance is a major problem in the treatment of breast cancer, and researchers have tried to find an efficient strategy to overcome it. In this study, the synergistic anticancer effects of resveratrol (RSV) and DOX on human breast cancer cell lines (MCF-7) were investigated. Material & Methods: This research was conducted in 2021-2022 in Afra Laboratory (Tehran, Iran). MCF-7 breast epithelial cells were treated with concentrations of 12.5, 25, 50, 100, and 200 μg/ml RSV for 24, 48, and 72 h, and then the wells containing the cells of this group were treated with different doses of DOX (0.25, 0.5, 2.5, 1, and 5 μg/ml for 24, 48, and 72 h). Afterward, the survival rate of the cell was evaluated using MTT assay and flow cytometry methods. Findings: The results showed that the effect of resveratrol was less than 50% after 24 hours, indicating the effective role of time. In general, the antioxidant property of resveratrol decreased with an increase in concentration, so that the highest percentage of radical inhibition was recorded at a concentration of 25 μg/ml. The percentage of inhibition by DOX was also higher than the inhibition by RSV. However, for both samples, the percentage of radical inhibition decreased with increasing concentration. Discussion & Conclusion: Resveratrol treatment increased the cytotoxic activity of DOX against breast cancer cell growth when administered concurrently or 24 h before DOX. These results suggested that treatment with a combination of RSV and DOX might be a useful strategy to enhance the efficacy of DOX by promoting the intracellular accumulation of DOX and reducing multidrug resistance in human breast cancer cells. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is one of the most burdensome cancers worldwide. Despite advancements in diagnostic and treatment modalities, developing countries are still dealing with increasing burdens and existing disparities. This study provides estimates of BC burden and associated risk factors in Iran at the national and subnational levels over 30 years (1990–2019). Methods: Data on BC burden for Iran were retrieved from the Global Burden of Disease (GBD) study from 1990 to 2019. GBD estimation methods were applied to explore BC incidence, prevalence, deaths, disability-adjusted life years (DALYs), and attributable burden to risk factors based on the GBD risk factors hierarchy. Moreover, decomposition analysis was performed to find the contribution of population growth, aging, and cause-specific incidence in the total incidence change. Age-standardized rates (per 100,000 population) and 95% uncertainty intervals (UI) were reported based on sex, age, and socio-demographic index (SDI). Results: Age-standardized incidence rate (ASIR) increased from 18.8 (95% UI 15.3–24.1)/100,000 in 2019 to 34.0 (30.7–37.9)/100,000 in 2019 among females and from 0.2/100,000 (0.2–0.3) to 0.3/100,000 (0.3–0.4) among males. Age-standardized deaths rate (ASDR) increased slightly among females from 10.3 (8.2–13.6)/100,000 in 1990 to 11.9 (10.8–13.1)/100,000 in 2019 and remained almost the same among males—0.2/100,000 (0.1–0.2). Age-standardized DALYs rate also increased from 320.2 (265.4–405.4) to 368.7 (336.7–404.3) among females but decreased slightly in males from 4.5 (3.5–5.8) to 4.0 (3.5–4.5). Of the 417.6% increase in total incident cases from 1990–2019, 240.7% was related to cause-specific incidence. In both genders, the BC burden increased by age, including age groups under 50 before routine screening programs, and by SDI levels; the high and high-middle SDI regions had the highest BC burden in Iran. Based on the GBD risk factors hierarchy, high fasting plasma glucose (FPG) and alcohol were estimated to have the most and the least attributed DALYs for BC among females, respectively. Conclusions: BC burden increased from 1990 to 2019 in both genders, and considerable discrepancies were found among different provinces and SDI quintiles in Iran. These increasing trends appeared to be associated with social and economic developments and changes in demographic factors. Improvements in registry systems and diagnostic capacities were also probably responsible for these growing trends. Raising general awareness and improving screening programs, early detection measures, and equitable access to healthcare systems might be the initial steps to tackle the increasing trends. [ABSTRACT FROM AUTHOR]

Breast cancer may be associated with religious/spiritual problems for women. This multimethod qualitative study aims to show the components of religious/spiritual intervention strategies in breast cancer cases in Iran. The religious/spiritual intervention strategies were arranged according to the patient's religious/spiritual problems based on the proposed tree diagram. This working model includes answering questions regarding the religious/spiritual cause(s) of the disease; distinguishing between divine justice and getting sick; describing the patient's attitude toward God and its effect on viewing the disease; explaining the patient's feelings and emotional relationship with God; identifying weakened religious/spiritual beliefs and replacing them with accepted beliefs; and using daily practices to communicate with God. Implications of the findings and usefulness of this model are discussed. Spiritual care providers can use this model to provide religious/spiritual care services to Iranian Muslim women with breast cancer. [ABSTRACT FROM AUTHOR]

The halophilic microorganisms living in extreme environments contain high concentrations of carotenoids with notable medical abilities. The purpose of this study was to evaluate the anticancer effect of carotenoids extracted from native Iranian halophilic microorganisms with the ability to inhibit breast cancer cell line. To begin the study, 40 halophilic strains were cultured, and 8 strains capable of producing pigmented colonies were chosen from those cultured strains. In the next step, from among 8 strains using MTT assay, 1 capable of reducing cell viability of the breast cancer MCF‐7 cell line was chosen as a selective strain. The principal carotenoid was characterized using UV‐visible, FT‐IR spectroscopic, and LC‐MASS analyses. Using real time PCR technique, the expression of genes specific for apoptosis, in the presence or absence of carotenoid, was examined. Among all strains, carotenoid extracted from strain A15 had the most potent cytotoxic effect on breast cancer cell line (IC50 = 0.0645 mg/mL). 16S rRNA gene analysis showed that strain A15 had similarity with Haloarcula hispanica for about 99.5%. According to the analysis results, it could be estimated that the principal carotenoid extracted form Haloarcula sp. A15 was similar to bacterioruberin. Both early and late apoptosis were increased significantly about 10% and 39%, respectively, due to upregulation of CASP3, CASP8, BAX genes expression in MCF‐7 cell line. In contrast, the expression of genes MKI67, SOX2 were significantly downregulated in treated MCF‐7 cell line. The results of this study showed that Halophilic archaeon strain could be a good candidate for the production of high added‐value bacterioruberin due to its possible anticancer properties. Significance statement: The results of the present study showed that the pigment obtained from A Haloarcula sp. A15 present in native saline environments of Iran increases the expression of apoptotic genes in the MCF‐7 cell model of breast cancer. The results of this research may provide a target for elucidating the possible activity of the cytotoxic, antiproliferative, and apoptosis‐inducing pigment extracted from archaea halophile in MCF‐7 cell line in breast cancer treatment. Therefore, it is assumed that it is possible to introduce this compound (pigment), after further research, as a new anticancer raw material with natural origin in medicine. The proposed study design divulges the importance of investigating of apoptotic genes expressions to find better therapeutic options to combat breast cancer. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is one of the diseases which is mostly affected by negative emotions. However, the context factors that leads to lack of positive valence in these patients is not clear. The current study aimed to identify the context factors in the lack of positive valence system in women suffering from breast cancer. Method: Research method was qualitative grounded theory and data was obtained from in-depth interviews with patients at the Motamed Jihad University Cancer Research Institute during 2022. Participants were voluntarily and purposefully selected and sampling continued until data saturation. At the end, 10 individuals participated. Data were coded in three levels according to the Strauss and Corbin method. Results: In relation to the positive valence system, we extracted three theoretical, nine axial and 24 open codes. The theoretical codes contained reward response (with axial codes of reward prediction, initial response to reward and reward saturation), reward learning (with axial codes of prediction error and reward habit) and reward valuation (with the axial codes of uncertainty of risk, delay in reward valuation, frustrated non-reward and attempt to value rewards). Theoretical, axial and open codes were evaluated by experts to obtain internal and structural validity as well as conceptual framework model and therapy protocol that were designed by extracted codes. Conclusion: The possibility of decreasing or increasing the incidence of cancer depends on the presence or absence of the positive valence system. The suggested therapy protocol represented that the positive valence factors enhancement might limit the possibility of breast cancer. [ABSTRACT FROM AUTHOR]

The Body Image after Breast Cancer Questionnaire (BIBCQ) is a breast cancer specific tool for body image assessment which measures the long-term effects of breast cancer on different aspects of body image in breast cancer survivors. Culturally-appropriate instruments are needed for body image after breast cancer assessment. This study was conducted to assess the psychometric properties of the Persian version of BIBCQ. In this methodological study, BIBCQ was translated into Persian through forward-backward translation. In totally, 400 breast cancer survivors in north of Iran completed the BIBCQ. The content validity was assessed by twelve experts. The construct validity of the questionnaire was evaluated through exploratory and confirmatory factor analyses and its convergent and discriminant validity were evaluated using Fornell and Larcker's approach. The reliability of the questionnaire was also evaluated through Cronbach's alpha and McDonald's omega. In exploratory factor analysis, five factors were identified. Second-order factor analysis showed an overarching concept that labeled "Body image stigma". The questionnaire had acceptable content and convergent validity and composite reliability. This scale can be used in future studies to assess body image in Iranian breast cancer survivors. Healthcare policy makers can use the findings of the present study to develop care plans for improving body image and mental health among breast cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Breast self-examination (BSE) is an important part of health care for all women in every stage of life. This study aimed to investigate the effect of theory of planned behavior (TPB) on doing BSE in a sample of Iranian women. Methods: A cross-sectional study was carried out to examine the factors affecting the BSE in 400 women. Then, a quasi-experimental study was conducted on 200 subjects (100 in experimental group and 100 in control group). The educational intervention for the experimental group consisted of 8 training sessions. A questionnaire including demographic characteristics, knowledge, and constructs of TPB was used to measure BSE performance before and 6 months after the intervention. Constructs of attitude, subjective norms, and perceived behavioral control predicted the intention to do the BSE. Results: The mean age of the subjects was 31.65 ± 7.59 years. The studied variables predicted 38.7% of behavioral intention (P <.001, odds ratio = 0.387). Six months after the intervention, the experimental group showed a significant increase in the knowledge, attitude, perceived behavioral control, subjective norms, intention, and BSE performance compared with the control group (P <.001). Conclusions: This study showed that educational intervention based on the TPB was effective in promoting breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators and health care planners use educational texts based on these constructs of TPB to increase their influence on individuals via screening behavior for breast cancer. [ABSTRACT FROM AUTHOR]

Introduction: The internet has become a powerful worldwide information source that revolutionized access to knowledge, especially in the fields of health and medicine (health knowledge). Therefore, providing high-quality, accurate, reliable, and relevant information on dependable websites is a possible way of providing the patient with needed information and, thus, achieving the benefits of informed patients regarding outcomes. This study aimed to evaluate the quality and accuracy of breast cancer knowledge among Persian language websites. Methods: Two search engines were searched in the Persian language about breast cancer. The first 30 websites were selected for further evaluation based on the completeness, correctness, transparency, and accessibility of health knowledge. The DISCERN instrument was used to assess the quality of the Persian language websites on this issue. Results: Among the 30 websites, about 23% of websites provide completely correct information and about 30% provide mostly correct information. Sixty percent of the websites provided author information, and 46% of them had a healthcare professional or expert as the author. Sixty percent of the websites stated the creation date on the pages, while 40% of them did not provide any health knowledge. Scores on accessibility were always easy for most of the websites. Based on the quality rating system of DISCERN, about 60% of the websites were presented as very poor. Conclusion: Website rankings enable healthcare professionals to identify and signpost patients to reliable up-to-date websites to ensure that patients receive high-quality knowledge. This review has provided evidence of inadequate and inaccurate health knowledge about breast cancer on the Persian language websites. This issue requires further investigation to understand the barriers and solutions available to provide reliable information about breast cancer and how this information affects the patient's outcomes. Trial registration: The project was found to be in accordance with the ethical principles and the national norms and standards for conducting research in Iran with the approval ID and date of IR.TUMS.IKHC.REC.1399.379 and 2021–01-01 respectively, and is registered with research project number 49890 in the Vice Chancellor for Research and Technology Development of Tehran University of Medical Sciences, Tehran, Iran. URL: https://ethics.research.ac.ir/EthicsProposalViewEn.php?id=170978. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most common malignancy in women worldwide. It is also the second leading cause of cancer death among women after lung cancer. Considering the relationship among plasma folate levels, the level of uracil, and DNA damage in cell division, methyl tetrahydrofolate reductase (MTHFR) is a suitable candidate for studies on the susceptibility to cancer, including breast cancer. This study aimed to investigate the relationship between two polymorphisms in the MTHFR gene and the risk of breast cancer among women in Markazi Province, Iran. Material & Methods: This case-control study investigated the rs1801131 and rs1801133 polymorphisms of the MTHFR gene and breast cancer risk in a large population including 80 patients and 80 healthy women in Markazi Province, Iran, using the PCR-RFLP technique. The specimens were genotyped by agarose gel electrophoresis. Finally, the data were analyzed in SPSS software (version 26). (Ethic code: IR.ARAKMU.REC.1396.25) Findings: There was a statistically significant difference between the two groups of patients and controls regarding three genotypes of the rs1801133 locus (P=0.006). Moreover, the CT genotype (P=0.001, OR=2.471, 95% CI=1.229- 4.965) and total TT and CC genotypes (P=0.000, OR=3.375, 95% CI=1.716- 6.637) were significantly associated with the risk of breast cancer. However, the TT genotype (P=0.538) showed a protective role against breast cancer. In contrast, there was no statistically significant difference between the two groups of patients and controls in terms of three genotypes of the rs1801131 locus (P=0.149), which is consistent with the results of some studies. Discussion & Conclusion: The rs1801133 polymorphism of the MTHFR gene can be used as a marker in clinical prognostic studies related to the risk of breast cancer. [ABSTRACT FROM AUTHOR]

Objectives: Radiotherapy is one of the treatments used for different types of cancer. Acute radiodermatitis is one of its most common complications. Despite the high prevalence of radiodermatitis, few studies investigated how to prevent or treat this complication. Hence, a standard treatment has not been introduced so far. We sought to evaluate the efficacy of Dermolina-Henna cream, a new polyherbal formulation, compared to Mometasone cream for alleviating acute radiodermatitis among breast cancer patients. Design: Randomized active-control double-blind clinical trial. Setting/Location: The oncology clinic of Shohaday-e Tajrish Hospital (Tehran, Iran). Subjects: Women older than 18 years with breast cancer undergoing radiotherapy. Interventions: Patients were instructed to apply a thin layer of Dermolina-Henna or Mometasone cream once daily on their lesions at least 3 h after radiotherapy for 4 weeks, and if grade I or II radiodermatitis developed, also afterward. Patients were visited weekly until end of study at after 4 weeks. Radiation Therapy Oncology Group standard questionnaires were evaluated and recorded every week as the primary outcome. Outcome measures: Primary outcome was defined as evaluating the efficacy of Dermolina-Henna cream to change the radiodermatitis grade, while the level of patients' satisfaction and the rate of adverse events recorded by patients were secondary outcomes. Results: The trends on decrease in number of lesions, erythema, radiodermatitis grade, burning sensation, pain, and itchiness were statistically significant for each treatment, separately (p < 0.001), except for radiodermatitis grade in Mometasone group (p = 0.4). Dermolina-Henna was significantly better than Mometasone in alleviating burning sensation (p < 0.001) and itchiness (p = 0.041). Approximately 3.7% of patients showed adverse events and 3.7% declared dissatisfaction in both groups. Conclusions: In summary, we showed that Dermolina-Henna cream and Mometasone cream were significantly effective in decreasing severity of radiodermatitis symptoms among patients with breast cancer. Dermolina-Henna cream was significantly superior to Mometasone cream in alleviating burning and itchiness. Clinical Trial Registration Number: IRCT20200115046144N1. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the most prevalent types of cancer in Iranian women and the second cause of death in women worldwide. Gene mutations are the key determinants of the disease; therefore, the genetic study of this disease is of paramount importance. One of the genetic evaluation methods of this disease is microarray technology, which allows the examination of the simultaneous expression of thousands of genes. Clustering is the method for analyzing high-dimension data, which we used in the present research for collecting similar genes in separated clusters. Method: A descriptive and inferential statistical analysis was carried out to evaluate unsupervised learning models of gene expression analysis and five bi-clustering methods (including PLAID (PL), Fabia, Bimax, Cheng & Church (CC), and Xmotif) were compared. For this purpose, we obtained the microarray gene expression data for lapatinib-resistant breast cancer cell lines from previously published research. The enrichment efficacy of the clusters was evaluated with gene ontology, and the results of these five models were compared with the Jaccard index, variance stability, least-square error, and goodness of fit indices. Furthermore, the results of the best model were assessed for building a genes sets network with Bayesian networks. Results: After preprocessing, clustering was performed on the data with the dimension (4710 x 18) of the genes. Four models, except for CC, successfully found bi-clusters in the data set. The data evaluation revealed that the results of the models were almost the same, but the PL model performed better than the others, finding 11 bi-clusters; this model was used to build the network of gene sets. Conclusion: According to the results, the PL method was suitable for clustering the data. Accordingly, it could be recommended for data analysis. In addition, the gene sets network formed on gene expression data was incompetent. [ABSTRACT FROM AUTHOR]

We report a 52‐year‐old patient with a history of breast cancer (BC) referred to the clinic of Afzalipour Hospital, in Kerman, eastern Iran, with a 1‐week complaint of restless dyspnea. A chest computed tomography scan revealed consolidations in the upper lobes of both lungs. The patient had no history of smoking or underlying diseases that would predispose her to consolidation, including pneumonia. Then, bronchoscopy was performed for the patient, and bronchoalveolar lavage fluid was sent to the Iranian National Registry Center, where the Lophomonas parasite was detected in the sample and confirmed using a polymerase chain reaction test. Finally, her symptoms improved by receiving oral metronidazole three times a day for 3 weeks. [ABSTRACT FROM AUTHOR]

The article comments on the paper "Coping With Breast Cancer in Newly Diagnosed Iranian Women." The paper focuses on a Muslim society and provides insight into women's explanatory models of perceiving and coping with their illness. The knowledge gained from the study has implications for global healthcare situations. From a nursing perspective, being aware of the social and cultural aspects of care can be challenging since it requires confrontation with one's assumptions and reinterpretations of concepts regarding health, illness, care and well-being.

Background: Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran. Methods: This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/ df were evaluated. The significance level in all tests was considered 0.05. Results: The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ2 = 18.45, df = 10, n = 800, χ2/ df = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model. Conclusions: The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior. [ABSTRACT FROM AUTHOR]

Background: Developing asymmetries are uncommon mammographic findings with a chance of being associated with malignancy. Objectives: The current study aimed at correlating ultrasound, magnetic resonance imaging (MRI) findings, and histopathology of patients with developing focal asymmetry in opportunist screening mammograms setting, and presents a diagnostic approach to developing asymmetry. Methods: This was a cross-sectional studyona database of opportunist screening mammographyat the Breast Clinic, Cancer Center, at Tehran University of Medical Sciences from January 2017 to December 2018. Mammogram screenings (n = 12,169) were evaluated for developing asymmetry. Findings of mammography, ultrasound, MRI findings, and histopathology of patients with developing asymmetry were collected and analyzed. Results: Fifty-four cases (0.44%) had developed asymmetry in screening mammograms. After excluding 18 patients with considering exclusion criteria, the data of 36 patients were analyzed. The summation artifact was the etiology of developing asymmetry in 11 (30.5%) patients. Ultrasound was performed in 28 patients, and 14 (38.8%) patients had no correlated findings. All 3 malignant cases had ultrasound correlates, and a significant association existed between sonography and the risk of malignancy in patients having developing asymmetry (P = 0.003). Three malignant cases of the study underwent MRI, 1 with segmental clumped non-mass enhancement, and 2 showed a mass with rim enhancement. A significant association was revealed between a family history of breast cancer (P = 0.04) and developing asymmetry. The positive predictive value of developing asymmetry for malignancy was 8.3%. Conclusions: Patients having developing asymmetry should be evaluated for malignancy, using supplementary techniques, such as additional mammographic views, ultrasound primarily, or MRI. A biopsy is required for indeterminate findings. [ABSTRACT FROM AUTHOR]

Background: Ductal carcinoma in situ (DCIS) is widely recognized as the precursor of invasive ductal carcinoma (IDC). We aimed to compare clinicopathological characteristics and prognosis between IDC with and without coexisting DCIS stratified by biological subtypes to evaluate the clinical outcome of these two groups. Method: Data from 5814 patients with IDC (32.4) and IDC/DCIS (67.6%), who underwent surgery from December 1993 through December 2019, were retrospectively assessed. We evaluated the prognosis of IDC with coexisting DCIS in different molecular subtypes. Results: IDC/DCIS patients were younger (P < 0.001). They also presented with a low tumor grade and had less lymph node involvement compared with the pure IDC patients. Compared with the patients with IDC, luminal B subtype was more frequent in those with IDC/DCIS, with 19.4% versus 13.2 %; human epidermal growth factor receptor-2 enriched subtype was also more frequently observed, with 12.2 vs. 8.7%. The 5-year disease-free survival (DFS) was higher in the IDC/DCIS patients (P = 0.036). The survival outcomes significantly improved in the cases with a higher amount of DCIS. The presence of coexisting DCIS (P =0.038), tumor size (P < 0.001), lymph node status (P = 0.005), lymph vascular invasion (P = 0.02), and molecular subtypes (P < 0.001) were found to be DFS-associated independent prognostic factors. Conclusion: DCIS along with IDC were associated with improved prognosis. The presence of DCIS may be a marker of lower aggressiveness, and could be noticed as a prognostic factor in future treatment algorithms. [ABSTRACT FROM AUTHOR]

Background: The breast is a sensitive organ for women. In addition to pain, breast cancer can cause many psychological problems for the patient. The aim of this study was to compare the effectiveness of gestalt therapy (GT) alone and combined with cognitive-behavioral therapy (CBT) [GT-CBT] on the hope and pain intensity of women with breast cancer. Methods: This quasi-experimental study had a pre-test and post-test design with a control group. Out of 96 available patients with breast cancer who were referred to Imam Khomeini Hospital Cancer Clinic in Tehran, Iran, 60 cases were selected based on the inclusion criteria and randomly assigned to the control (n=20), GT (n=20), and GT-CBT (n=20) groups. Patients in the intervention groups received weekly online sessions (90 minutes) of GT or GTCBT during eight weeks of training using the Zoom app. The data were collected through the miller hope scale (MHS) and hayes & peterson visual analog scale (VAS) and analyzed using descriptive (Mean±SD) and inferential (analysis of covariance) statistics by SPSS software version 20. The significance level was set at 0.05. Results: The results indicated that both GT and GT-CBT significantly increased hope and decreased pain intensity scores (eta=0.73, F(51, 2)=70.06, P<0.001). GT-CBT showed significantly higher effectiveness than GT (P<0.05). Conclusion: According to the results, it is suggested to use integrated methods, such as GTCBT to enhance hope and manage the pain intensity of patients with breast cancer. [ABSTRACT FROM AUTHOR]

Metastatic breast cancer is a disease of early breast cancer that usually occurs several years after the early breast cancer. Breast cancer is the most common cancer among Iranian women. According to the new statistics in Iran 6160 breast cancers are diagnosed in the country each year and 1063 cases lead to death. In this paper, epidemiology, diagnosis and treatment have been investigated. In this study, case–control clinical trials and open studies with adequate data were collected. Due to the higher risk of age group 40–49 years and the advent of advanced breast cancer in Iranian women, the early diagnosis and determination of the exact size of the tumor before surgery is important in choosing a therapy plan. The decision on the therapy of invasive breast cancer depends on several factors such as cancer stage, tumor size and type, pathological and cytological status of the tumor, the patient's opinion, the presence or absence of estrogen and progesterone receptors in the cytoplasm of tumor cells and so on. [ABSTRACT FROM AUTHOR]

Objective: Previous studies on the association between glycaemic index (GI) and glycaemic load (GL) in relation to breast cancer risk are contradictory. The aim of this study was to examine the association between dietary GI and GL and risk of breast cancer in Iranian women.Design: Population-based case-control study. Dietary GI and GL were assessed using a validated Willett-format 106-item semi-quantitative FFQ.Setting: Isfahan, Iran.Participants: Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom the status of breast cancer was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population.Results: After controlling for potential confounders, individuals in the highest tertile of dietary GI had 47 % higher odds of breast cancer than women in the lowest tertile (OR: 1·47; (95 % CI 1·02, 2·12)). Stratified analysis by menopausal status showed such association among postmenopausal women (OR: 1·51; (95 % CI 1·02, 2·23)). We found no significant association between dietary GL and odds of breast cancer either before (OR: 1·35; (95 % CI 0·99, 1·84)) or after adjustment for potential confounders (OR: 1·24; (95 % CI 0·86, 1·79)). In addition, stratified analysis by menopausal status revealed no significant association between dietary GL and odds of breast cancer.Conclusions: Our findings showed a significant positive association between dietary GI and odds of breast cancer. However, we observed no significant association between dietary GL and odds of breast cancer. [ABSTRACT FROM AUTHOR]

Background and Objectives: Breast cancer is the most commonly diagnosed cancer in women which can cause spiritual distress in them. This study aims to assess the effects of mindfulnessbased schema therapy (MBST) and transdiagnostic intervention on spiritual distress of women with breast cancer. Methods: This is a quasi-experimental study (Clinical trial) with a pre-test/post-test/followup design using a control group. Participants were 41 women with breast cancer referred to Omid and Imam Reza hospitals in Mashhad, Iran during 2017-2020, who were selected using a convenience sampling method and randomly assigned into two experimental groups and one control group. For both experimental groups, the intervention was performed at ten weekly sessions. The used instrument was the Spiritual Distress Scale of Ku et al. Data were analyzed using repeated measures analysis of variance and Bonferroni post hoc test in SPSS software, version 25 software. Results: There was a significant difference in the mean scores of spiritual distress in the experimental groups compared to the control group in the post-test and follow-up phases (P<0.001). There was no significant difference between the effectiveness of transdiagnostic intervention and MBST in the post-test and follow-up phases (P>0.05). Conclusion: Both transdiagnostic intervention and MBST can reduce the spiritual distress of women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: Virtual education today is about to become one of the most important educational methods in nursing. However, there have been few studies that examine the effectiveness of virtual education to increase knowledge towards breast cancer among nurses in Iran. Purpose: The aim of this study was to compare the knowledge towards breast cancer among nurses who were provided with two different methods of virtual training. Methods: This quasi-experimental study was conducted among 182 nurses in two hospitals in Tehran, Iran, who were randomly selected and divided into two groups of 91 nurses. Participants of the first group got virtual training about breast cancer in two sessions within two weeks by Skyroom. In the second group, the content was sent as educational messages by WhatsApp within two weeks. Participants' knowledge in both groups was measured using valid and reliable questionnaires developed by the researchers as a pretest and three posttests, and the satisfaction of the participants was also measured. To analyze the data, analysis of variance, standard deviation, t-test and Tukey test were performed. Results: According to the average score observed in the post-test period, the score of the WhatsApp group was 7.62, significantly higher than the Skyroom group of 6.25. The scores of the three post-test were higher than the pre-test in the two groups (with no significant difference between the two groups, p-value = 0.825 in the first post-test), but the scores declined from the first to third tests, showing a decline in the learning effect with time. However, the slope was gentler in the WhatsApp group, indicating a more persistent learning effect. Conclusion: This study showed that teaching with educational messages through WhatsApp had a greater impact on the sustainability of learning than teaching via lecturing through Skyroom. [ABSTRACT FROM AUTHOR]

Background: Women's perception and knowledge of breast cancer signs, symptoms, and risk factors could be conducive to breast cancer risk management and interventions. The present study aimed to explore Iranian laywomen perceptions and expert opinions regarding breast cancer risk factors.Methods: This qualitative study was conducted from March to November 2019 in Mashhad, northeast of Iran. Through purposive sampling, 24 laywomen (women with and without BC) and 10 experts of different fields including oncology, surgery, gynecology and reproductive health were selected. Data collection was carried out using semi-structured interviews, which was mainly focused on the participants' understanding and perception of BC risk factors. The data was analyzed utilizing conventional content analysis developed by Graneheim & Lundman. Components of trustworthiness, including credibility, dependability, confirmability, and transferability were considered.Results: The main category of risk factors, which emerged from the lay participants' data analysis, were "unhealthy lifestyle and habits" , "hormonal influences", "environmental exposures", "Individual susceptibility "and "belief in supernatural powers". The experts had similar perspectives for certain risk factors, yet not for all. The category of "Individual history of disease" was emerged only from experts' interviews.Conclusion: In the present study, the lay participants' perception concerning BC risk factors was found to be a mixture of cultural beliefs and the scientific knowledge dispersed by the media, internet, and health services. Primary prevention approaches, including awareness of breast cancer risk factors, are required for women to make improved health-related choices. [ABSTRACT FROM AUTHOR]

INTRODUCTION. Depression is a debilitating disease that is highly prevalent among cancer patients. Various studies in Iran have reported different prevalence. This systematic review and meta-analysis was conducted to estimate the overall prevalence of depression in Iranian women with breast cancer. MATERIAL AND METHODS. In this study, published articles in Persian and English were collected without time limit. Keyword searches for depression, depressive disorder, dysthymic disorder, major depressive disorder, breast cancer, breast neoplasm, and Iran and all of their potential combinations were performed in Scientific Information Database (SID), MagIran, PubMed, Scopus, Web of Science databases. The heterogeneity between studies was assessed using the Q-Cochrane test and, given the significant heterogeneity, a random-effects model was used to estimate the overall prevalence of depression. Data were analyzed using STATA version 11 software. RESULTS. The analysis of 22 selected articles with a total sample size of 3,082 showed that the overall prevalence of depression in women with breast cancer was 49.98% (95% confidence interval: 48.43-52.52). The prevalence of depression in Region 1 in the country was (28%; 95% confidence interval: 25.53-52.55) and in other regions, it was (63.79% with 95% confidence interval of 61.82-76.76). The highest and the lowest prevalence of depression were related to BDI (69.33%; 95% confidence interval: 67.19-71.48) and HADS (26.43%; 95% confidence interval: 23.14-29.72), respectively. CONCLUSIONS. Half of the Iranian women with breast cancer had depression. Given the overlap of physical symptoms of cancer with depression, identifying at-risk patients for controlling and providing therapeutic interventions seems necessary. [ABSTRACT FROM AUTHOR]

Purpose: Taking care of cancer patients and treating them are among major challenges in the field of health. Several studies have shown that promotion of hope is an efficient strategy for effectively treating this group of patients, reducing their symptoms, and improving the quality of their life. It seems that spiritual care can boost hope in these patients. This study aims to determine the effects of nursing care based on the Support-Based Spiritual Care Model on boosting hope among women with breast cancer. Methods: In this controlled clinical trial, 72 patients with breast cancer were selected through consecutive sampling and randomly assigned to two control and intervention groups (n = 36 in each group) based on four randomized blocks. The intervention was carried out based on the Support-Based Spiritual Care Model for the patients and their main caregivers in six sessions. Besides, the Snyder's hope scale was completed before and 1 month after the intervention by the participants in the intervention and control groups. Results: The results of the independent samples t-test showed no significant difference in the mean scores of hope between the intervention and control groups before the intervention (P > 0.05). However, after the intervention, the mean scores of hope for the intervention and control groups were 46.71 ± 4.61 and 40.40 ± 5.42, respectively, showing a significant intergroup difference as verified by the independent samples t-test (P < 0.05). Conclusion: According to the results of this study, providing nursing care based on the Support-Based Spiritual Care Model can raise hope in patients with breast cancer. Clinical implications: Healthcare professionals can boost hope in cancer patients through proper planning and adequate support in providing nursing care based on the proposed model. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the most prevalent female cancers in developing countries. It seems that breast cancer affects Iranian women a decade earlier than women from developed countries, however, there is not enough evidence for this hypothesis. Methods: This repeated cross-sectional study was carried out on 6057 Iranian women, living in Isfahan province, using historical data from 2001 to 2013 and 506,095 British women in the same period. The UK breast cancer data came from the ONS website (www.ons.gov.uk) on request for the period of 2001 to 2013. The weighted mean age of women with breast cancer was compared between Iran and the UK by the independent t-test using STATA 14 at a 5% significance level. Results: The age-standardized incidence rate (ASR) in Iran (Isfahan) increased from 22.0 to 68.0 per 100,000 populations from 2001 to 2013. The corresponding ASR in the UK increased from 152.4 to 169.8 per 100,000 population. The standardized mean age of breast cancer was 50.5 years (SD=12.6) and 63.6 years (SD=14.0) in Iranian and British women, respectively. Conclusion: These findings imply that Iranian women were, on average, diagnosed with breast cancer a decade earlier than English women. Therefore, screening for breast cancer should begin at lower ages for Iranian women. [ABSTRACT FROM AUTHOR]