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Thyroid cancer is one of the most common female cancers, and the incidence is increasing. Although surgery remains a conventional treatment for thyroid cancer, active surveillance has emerged as a reasonable option for low-risk groups. Recently, thermal ablation techniques, such as radiofrequency ablation (RFA), have attracted attention as minimally invasive alternatives for managing thyroid cancer. RFA is an outpatient ultrasound-guided thermal ablative procedure that is a potential alternative to surgery for thyroid cancer. Its applications extend to patients with local recurrence of cancer in the neck who are either unsuitable for surgery or prefer non-surgical interventions. RFA has also shown promise in cases where surgery is not feasible, particularly in low-risk papillary thyroid microcarcinoma (PTMC), showing excellent local control. Recent studies have reported favorable outcomes of RFA in various types of primary thyroid cancer beyond PTMC, as well as in cases of distant metastases such as those affecting bone. This study reviews the historical evolution, technical aspects, and clinical applications of RFA for thyroid cancer and predicts the future direction of RFA in thyroid cancer.

Thyroid nodules are a common medical concern with an increasing prevalence due largely to the widespread use of ultrasonography (US). US is the primary diagnostic tool for identifying thyroid nodules, determining their size and characteristics, guiding fine-needle aspiration (FNA), and diagnosing lymph node metastasis. The most consistent US features indicating a malignancy in thyroid nodules include spiculated margins, microcalcifications, a taller-than-wide shape, and pronounced hypoechogenicity. Based on these imaging findings, clinicians must determine which nodules require further evaluation and which can be monitored over time. Despite the central role of thyroid US in managing these nodules, there is no clear consensus regarding which nodules should undergo US-guided FNA, nor is there a standardized terminology for describing the US features. Consequently, medical societies recommend using US risk stratification systems to standardize reporting and simplify clinical decision-making. This review aims to provide a comprehensive overview of the various US risk stratification systems employed for thyroid nodules, allowing readers to gain a better understanding of how nodules are assessed using these different systems. Furthermore, this study examines the efficacy, weaknesses, and potential pitfalls of these US risk stratification systems and discusses future perspectives for their optimal clinical application in managing thyroid nodules.

Breast cancer is the most commonly diagnosed cancer in women and its incidence and the mortality associated with it have increased over the years. Early detection of breast cancer via various imaging modalities can significantly improve the prognosis of patients. Ultrasound is a useful imaging tool for breast lesion characterization due to its acceptable diagnostic performance and non-invasive and real-time capabilities. However, one of the major drawbacks of ultrasound imaging is operator dependence. Artificial intelligence (AI), particularly deep learning, is gaining extensive attention for its excellent performance in image recognition. AI can make a quantitative assessment by recognizing imaging information, thereby improving ultrasound performance in the diagnosis of breast cancer lesions. The use of AI for breast ultrasound in clinical practice is extremely important, as it saves time, reduces radiologist fatigue, and compensates for a lack of experience and skill in some cases. This review article discusses the basic technical knowledge required, the algorithms of AI for breast ultrasound, and the application of AI in image identification, segmentation, extraction, and classification. In addition, we also discuss the future perspectives for the application of AI in breast ultrasound.

Abstract Background Women from Asian and western countries have vastly different ages of onset of breast cancer, with the disease tending to occur at an older age in the West. Through an investigation of the patterns of old-onset breast cancer (OBC) in Korean women, we aimed to identify the characteristics of Korean OBC and evaluate whether these patterns are changing in relation to increasing westernization. Methods This study retrospectively evaluated 102,379 patients who underwent surgical treatment of primary breast cancer between January 1, 2000 and December 31, 2013 in Korea. We used hospital -based breast cancer registry and analyzed data from these patients using multiple linear regression analysis to compare the characteristics and chronologically changing patterns between OBC (70 years of age or older) and non-OBC (40–69 years of age) patients in Korea. Results A total of 6% of the 102,379 patients had OBC. Overall, OBC had more favorable biological features, such as a higher incidence of luminal A subtype, than did non-OBC, except for a higher incidence rate of triple-negative breast cancer (TNBC). However, OBC also presented with a higher overall disease stage, including higher T and M stages. Although the incidence rates of both OBC and non-OBC have increased overtime, the relative proportion of OBC patients has slightly increased, whereas that of non-OBC has slightly decreased. The increase in the incidence of both OBC and non-OBC was primarily due to the luminal A subtype. Conclusions Based on a hospital-based registry, overall, Korean OBC had favorable biological features but showed a higher rate of TNBC and advanced cancer stages. The incidence trend of breast cancer in Korea is slowly shifting toward an older age at onset, largely due to the luminal A subtype. Our results may provide novel insights into OBC in Asia, and aid in the development of optimal management of the disease in Asia. Trial registration Retrospectively registered.

Abstract Background The role of lipid metabolism in obesity and cancer manifestations cannot be underestimated, but whether alterations in lipid metabolism can manipulate the vasculature to promote obesity among breast cancer (BC) survivors is yet to be clearly understood. This study quantified plasma lipid and particle sizes using high-throughput proton (1H) nuclear magnetic resonance (NMR) and tested their associations with obesity among breast cancer (BC) survivors. Methods A total of 348 (225 premenopausal and 123 postmenopausal) BC survivors enrolled from five hospitals in Korea were included. We assessed thirty-four plasma lipid biomarkers using 1H NMR, and obesity status was defined as a body mass index (BMI) of 25 kg/m2 or greater. Generalized linear and logistic regression models were applied to estimate the least-square means of BMI (kg/m2) and odds ratio (OR)s of obesity, respectively, and the corresponding 95% confidence interval (CI)s across plasma lipid levels. Results Mean (SD) values of BMI was 23.3 (3.2) kg/m2 and 90 (25.9%) had BMI of ≥ 25 kg/m2. BMI levels increased with increasing total triglycerides (TG), TG in lipoproteins and very-low-density lipoprotein (VLDL) subfractions. However, BMI levels decreased with increasing tertiles of high-density lipoprotein (HDL)-cholesterol (C) and HDL particle size (HDL-p). Similar associations were observed in the logistic regression models. The increasing and decreasing BMI trends with TG and HDL profiles respectively were predominantly limited to premenopausal BC survivors. Conclusions Increasing levels of plasma total TG and TG in lipoproteins were associated with increasing levels of BMI among premenopausal BC survivors. High HDL-C levels and large HDL-p were inversely associated with obesity among premenopausal BC survivors. Due to the cross-sectional design of this study, longitudinal studies are necessary to examine the association between obesity and lipid profile among BC survivors.

Abstract Sirtuin 6 (SIRT6) regulation is involved in carcinogenesis. However, its role in breast cancer (BC) metastasis remains unclear. We investigated the effects of SIRT6 on protein kinase C activator- and cytokine-mediated cancer cell invasion and migration in MCF-7 and MDA-MB-231 cells and the association between SIRT6 and matrix metalloproteinase-9 (MMP-9) expression. To assess MMP-9 and SIRT6 expression in patients, protein levels in BC tissues were analyzed. MCF-7 and MDA-MB-231 cell viability was analyzed using MTT assays. SIRT6 was silenced in both cell lines and protein secretion, expression, and mRNA levels were analyzed. Transcription factor DNA activity was investigated using luciferase assays. Matrigel invasion assays were used to assess the effects of SIRT6 in both cell lines. SIRT6 and MMP-9 expression in cancer tissues was significantly higher than in paired normal breast tissues. 12-O-tetradecanoylphorbol-13-acetate (TPA) or tumor necrosis factor-α (TNF-α) increased MMP-9 expression and cell invasion and migration, but SIRT6 knockdown abolished these effects. SIRT6 overexpression additively increased TPA- and TNF-α-induced MMP-9 expression. SIRT6 knockdown suppressed the mitogen-activated protein kinase (MAPK) signaling pathway and thus TPA- and TNF-α-induced MMP-9 expression. SIRT6 silencing suppressed TPA- and TNF-α-induced nuclear factor-κB (NF-κB) and activator protein-1 (AP-1) expressions in both cell lines, and treatment with MAPK, NF-κB, and AP-1 inhibitors reduced MMP-9 expression. The anti-invasive effects of SIRT6 in BC cells might be mediated by suppression of MAPK phosphorylation and reduction in NF-κB and AP-1 DNA activities, leading to MMP-9 downregulation, suggesting that SIRT6 modulation has the potential to target BC metastasis.

The term ‘pregnancy-associated breast cancer’ is no longer used as it has been consistently reported that breast cancer during pregnancy and breast cancer after delivery (postpartum breast cancer) have different characteristics and prognosis. The purpose of this study is to define postpartum breast cancer by analyzing the incidence rate, related factors, and prognosis according to the timing of breast cancer. Data from the Korean National Health Insurance Service were used to analyze 1,292,727 women aged 20-49 years who birthed their first child between 2007 and 2012. The annual incidence rate of breast cancer after delivery increased every year (7.7 per 10,000 person-years after 5 years, 19.36 per 10,000 person-years after 10 years). The risk of breast cancer was significantly higher (hazard ratio 1.15, 95% CI 1.05-1.27, P=0.0037) in women diagnosed with gestational diabetes, but that was not associated with overall survival (OS). Patients diagnosed with breast cancer within 5 years of delivery had a poorer prognosis than those diagnosed later (5-year OS,

Ultrasonography is mandatory for the evaluation of thyroid nodules. Although B-mode and Doppler ultrasonography are both sensitive for the diagnosis of thyroid lesions, they lack specificity in differentiating benign from malignant nodules. Elastography has been described as an accurate predictor of malignancy by determining tissue elasticity. There are several methods utilized to evaluate the stiffness of normal tissue and the thyroid nodule, such as strain elastography, acoustic radiation force impulse, and shear wave elastography. Many studies show that elastography has both high sensitivity and specificity that approaches 100% for the determination of thyroid carcinoma. In addition, elastography also has a very high negative predictive value and thus, may also be helpful in the identification of thyroid nodules that do not need further diagnostic evaluation, including fine needle aspiration cytology. However, in the light of current evidence, there is a need for standardization and consensus on the most optimum elastography acquisition process. The purpose of this review is to provide a comprehensive summary of the use of elastography in the evaluation of thyroid nodules.

Abstract Background Fine-needle aspiration (FNA) is a frequently utilized method for the diagnosis of thyroid nodules. Although the technique has clear advantages, the injury caused by the aspiration needle can induce various histological alterations. Herein, we report a case of follicular adenoma showing histological alterations possibly caused by FNA biopsy. Furthermore, the histological appearance of the lesion mimicked those of medullary thyroid carcinoma, particularly in the frozen section. Case presentation Ultrasonography of a thyroid nodule in a 39-year-old man revealed a mass (2.2 cm in diameter) in the right thyroid lobe. FNA was performed three times on the mass, and the results of the cytology were atypia of undetermined significance. Thereafter, the patient underwent right hemithyroidectomy. The histological findings of the operative frozen section analysis indicated medullary thyroid carcinoma. However, after evaluation and immunohistochemical staining of the permanent section, the mass was diagnosed as follicular adenoma with extensive fibrosis. Conclusion The histological alterations observed in the follicular adenoma are believed to have been caused by injury during the repeated FNA procedures.

Purpose The extent of surgery necessary in patients with unilateral papillary thyroid carcinoma (PTC) on preoperative radiologic imaging is still in doubt. In this study, we aimed to define risk factors that could be indicators for malignant nodules in the contralateral thyroid lobe. Methods We included 438 patients who underwent total thyroidectomy between January 2011 and December 2014 at our institution. In this study, patients were divided into two groups according to the presence of contralateral occult carcinoma identified by postoperative pathological examination. We analyzed the clinicopathologic factors including characteristics of coexistent nodules in the contralateral lobe based on preoperative radiological imaging. Results A total of 96 patients (21.9%) had PTC in the contralateral lobe. There were no significant differences between patients with or without contralateral occult carcinoma with respect to gender, age, primary tumor size, central lymph node metastasis, extrathyroidal extension and stage. The presence of Hashimoto’s thyroiditis was an independent predictive factor for contralateral occult carcinoma (P=0.01). Conclusion A risk factor for contralateral occult carcinoma in unilateral PTC patients is Hashimoto’s thyroiditis. Therefore, more caution is needed when determining optimal surgical methods for PTC patients with Hashimoto’s thyroiditis.

Purpose: Breast cancer in young women deserves special consideration, such as dense breast, more aggressive progression, and oncoplastic surgery. Magnetic resonance imaging (MRI) is a more recent modality than ultrasonography (US), but the role of MRI in patients with a dense breast is still controversial. This comparative study analyzed the relationship between the preoperative radiological and the postoperative pathological tumor size for young breast cancer patients.Methods : : All breast cancers diagnosed in patients 45 years or younger from January 2016 to December 2018 were reviewed. Tumor size measurements obtained on breast US and MRI were compared for accuracy with those obtained in the final pathology results. Patients with only microcalcification on imaging modalities and those who had undergone neoadjuvant chemotherapy were excluded.Results : : A total of 103 breast cancer patients were included in this study. Of the 103 breast cancers with both imaging modalities performed, 86 (83.5%) were infiltrating ductal carcinomas and 17 (16.5%) were ductal carcinoma in situ. The mean tumor size measured on MRI was significantly greater than that measured on pathology (18.5 ± 11.0 mm vs. 16.6 ± 8.5 mm), whereas the sizes measured on US was not significantly different from that measured on pathology (16.5 ± 9.5 mm vs. 16.6 ± 8.5 mm). The tumor size measured on MRI was greater than that measured on US.Conclusion : : Measurements taken by US were more accurate in measuring the tumor size in patients 45 years of age or younger than MRI.

The identification of axillary lymph node metastases in breast cancer patients is a critical factor in determining the stage, deciding the treatment modality, and predicting the prognosis. Over the years, axillary staging has evolved from a radical axillary lymph node dissection to a more conservative sentinel lymph node biopsy. The main goal of axillary imaging techniques is to identify metastatic lymph nodes with optimal accuracy, high enough to initially select patients for an upfront lymph node dissection. Features suggestive of an axillary lymph node metastasis may be seen with a range of imaging modalities. On the other hand, ultrasonography is the method of choice for evaluating the node morphology and allowing image-guided interventions of abnormal nodes. Gray-scale ultrasonography is not perfect on its own. Newer techniques, such as elastography or contrast-enhanced ultrasonography, have shown promise in identifying axillary lymph node metastases. This review provides a comprehensive overview of ultrasonography for an axillary lymph node assessment in breast cancer patients.

BackgroundWe compared the clinicopathological characteristics and survival outcomes of invasive lobular carcinoma (ILC) cases with those of invasive ductal carcinoma (IDC) cases in various hormone receptor expression subgroups.MethodsWe compared clinicopathological characteristics, overall survival (OS), and breast cancer-specific survival (BCSS) between patients with IDC (n = 95,486) and ILC (n = 3,023). In addition, we analyzed the effects of different hormone receptor expression subgroups on survival.ResultsThe ILC group had more instances of advanced stage and hormonal receptor positivity than did the IDC group (p < 0.001), but the IDC group had higher histological grade and nuclear grade, as well as higher frequency of human epidermal growth factor receptor 2 and Ki67 expression than did the ILC group (p < 0.001). The OS and BCSS were not significantly different between the IDC and ILC groups. The 5-year OS of the IDC group was 88.8%, while that of the ILC group was 90.6% (p = 0.113). The 5-year BCSS of the IDC group was 94.8%, while that of the ILC group was 95.0% (p = 0.552). When analyzing each hormone receptor expression subgroup, there were no significant differences in survival between the IDC and ILC groups. However, the estrogen receptor (ER) negative/progesterone receptor (PR) negative subgroup showed differences in survival between the IDC and ILC groups. Moreover, the hazard ratio of ILC in the ER negative/PR negative subgroup was 1.345 (95% confidence interval: 1.012-1.788; p = 0.041).ConclusionsHormone receptor expression should be considered when determining prognosis and treatment regimen for IDC and ILC. Researchers should further study the ER negative/PR negative population to identify treatment and prognostic models that will facilitate the development of individualized therapy for these patients, which is needed for good outcomes.

Abstract Background Identification of specific needs in patients with cancer is very important for the provision of patient-centered medical service. The aim of this study was to investigate the unmet needs and related factors of Korean breast cancer survivors. Methods A multicenter, cross-sectional, interview survey was performed among 332 Korean breast cancer survivors. The Comprehensive Needs Assessment Tool for cancer patients was administered to survivors who gave written informed consent to participate. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results The level of unmet needs was highest in the domain ‘Information and education’ (mean ± SD; 1.70 ± 1.14) and the item with the highest level of unmet needs was ‘Needed help in coping with fear of recurrence’ (2.04 ± 1.09). Unmet needs were correlated with age, stage, multiplicity, HER2, treatment state, marital status, employment, psychosocial status, and problems in EQ-5D dimensions. In multiple regression analysis, the 50–59 age group showed a higher level of recognition for physical symptom needs and the unemployed group expressed greater needs for information and education. Survivors with multiplicity had greater needs in the domains of healthcare staff and physical symptom. The stress group showed high levels of needs in all domains except religious support. The group with thoughts of suicide showed higher levels of unmet needs for physical symptom. Conclusion Most prevalent unmet needs in Korean breast cancer survivors were found in the ‘information and education’ domain. The 50–59 age group, unemployment, multiplicity, stress and suicidal thoughts were associated with higher levels of unmet needs among Korean breast cancer survivors. Our findings revealed more vulnerable breast cancer survivors with unmet needs and physicians should take a precision approach to satisfy unmet needs of these survivors.

Summary: Background: A survey of breast surgeons was conducted to evaluate changes in clinical practice regarding sentinel node biopsy (SNB) among clinically node-negative patients after neoadjuvant chemotherapy for breast cancer with axillary node metastasis. Methods: We conducted two surveys among 252 members of the Korean Breast Cancer Society. The questionnaire comprised a case presentation and two associated questions. The case outlined a woman diagnosed with right breast cancer; core needle biopsy had confirmed invasive ductal carcinoma and tumor size was 4 cm on imaging examination. Fine needle aspiration examination for axillary lymph node enlargement showed metastatic carcinoma. The patient underwent neoadjuvant chemotherapy and tumor size was decreased by 2 cm; axillary lymph node enlargement was not observed on palpitation or imaging examination. Finally, the patient underwent breast conserving surgery. Survey recipients were asked: 1. Would you perform SNB in this patient? 2. If you perform SNB and no axillary node metastasis is seen, would you perform additional axillary lymph node dissection (ALND)? Results: The response rate was 28.2% (71/252) and 15.1% (38/252) in 2013 and 2017, respectively. For the first question, the SNB to ALND ratio increased significantly from 54% versus 46% in 2013 to 92% versus 8% in 2017 (p

Sulforaphane [1-isothiocyanato-4-(methylsulfinyl)-butane] is anisothiocyanate found in some cruciferous vegetables, especiallybroccoli. Sulforaphane has been shown to displayanti-cancer properties against various cancer cell lines. Matrixmetalloproteinase-9 (MMP-9), which degrades the extracellularmatrix (ECM), plays an important role in cancer cell invasion.In this study, we investigated the effect of sulforaphane on12-O-tetradecanoyl phorbol-13-acetate (TPA)-induced MMP-9expression and cell invasion in MCF-7 cells. TPA-inducedMMP-9 expression and cell invasion were decreased bysulforaphane treatment. TPA substantially increased NF-κB andAP-1 DNA binding activity. Pre-treatment with sulforaphaneinhibited TPA-stimulated NF-κB binding activity, but not AP-1binding activity. In addition, we found that sulforaphanesuppressed NF-κB activation, by inhibiting phosphorylation ofIκB in TPA-treated MCF-7 cells. In this study, we demonstratedthat the inhibition of TPA-induced MMP-9 expression and cellinvasion by sulforaphane was mediated by the suppression ofthe NF-κB pathway in MCF-7 cells. [BMB Reports 2013; 46(4):201-206]

We identified demographic, lifestyle, and clinical factors associated with vitamin D status among breast cancer survivors. The vitamin D prediction model may be a useful surrogate of circulating 25-hydroxvitamin D (25(OH)D) concentrations when this measure was not available. We included a total of 216 Korean breast cancer survivors aged 21–79 years who had been diagnosed with stage I to III primary breast cancer and had breast cancer surgery at least 6 months before enrolment. We used linear and logistic regressions to identify determinants for the plasma 25(OH)D concentrations and vitamin D insufficiency (plasma 25(OH)D concentration < 50 nmol/L). We observed that 48.85% of breast cancer survivors had a plasma 25(OH)D concentration less than 50 nmol/L. We identified the following determinants for plasma 25(OH)D concentrations: time since diagnosis (β = −0.005 for 1 month increment), supplementary vitamin D intake (β = 0.06 for 10 μg/day increment), season of the blood draw (β = 0.35 for summer; β = 0.32 for fall; β = 0.26 for winter vs. spring), smoking status (β = 0.28 for former vs. never), use of any supplement (β = −0.35 for non-use vs. use), and the parity number (β = −0.30 for three or more vs. one) were associated with the plasma 25(OH)D concentrations. In addition to the aforementioned variables, body mass index (BMI) was associated with the prevalence of vitamin D insufficiency. We identified the determinants for the plasma 25(OH)D concentrations among Korean breast cancer survivors. Future studies are needed to investigate the role of vitamin D in the progression of breast cancer among Korean breast cancer survivors.

Background: Breast cancer-related lymphedema (BCRL) is a secondary lymphedema that occurs after breast cancer related treatments. BCRL develops from damage or dysfunction of the normally functioning lymphatic system due to surgery, radiation therapy, and rarely due to cancer recurrence. This nationwide, retrospective study was aimed at investigating the incidence and risk factors of BCRL using the database of the Korean National Health Insurance Service (NHIS). Methods: Patients with newly diagnosed breast cancer who underwent breast surgery from 1 January 2017 to 31 December 2020, were recruited. The incidence was compared by four groups according to the operation type of breast cancer [breast conserving surgery (BCS) with sentinel lymph node biopsy (S), BCS with axillary lymph node dissection (A), total mastectomy (TM) with S, modified radical mastectomy (MRM)]. The incidence rates of lymphedema were calculated by the number of incident events by the total follow-up period. Cox proportional hazard regression was used to calculate the risk of incidence of lymphedema based on a patients' characteristics, breast cancer treatment, and comorbidities. Results: The final cohort of operation subjects that satisfied the inclusion criteria was 34 676. BCRL occurred in 4242 patients (12.2%), and the median follow-up period was 695.4 days. The BCRL was diagnosed in the BCS with S (8.0%), BCS with A (23.5%), TM with S (10.7%), and MRM (28.5%) with an incidence of 40.8, 132.2, 55.8, and 171.8 per 1000 person-years, respectively. Young age, obesity, chemotherapy, radiotherapy, residence in metropolitan areas, and hyperlipidemia were identified as risk factors. Conclusion: In Korea, the incidence of BCRL was found to be 12.2%, with the highest risk observed among patients who underwent MRM. Therefore, surgical oncologists should meticulously assess the appropriate surgical approach and consider providing education to patients with risk factors for BCRL, aiming to ensure effective prevention strategies. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer. Materials and Methods Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis. Results The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02). Conclusion Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient's age at IBC diagnosis, income level, and a receipt of systemic treatments. [ABSTRACT FROM AUTHOR]

Epigallocatechin gallate (EGCG), a major constituent of green tea, has potential as a treatment for a variety of diseases, including cancer. EGCG induces apoptosis and inhibits tumorigenesis through multiple signaling pathways in breast cancer cells. β‑catenin signaling modulators could be useful in the prevention and therapy of breast cancer. However, the precise anticancer effect of EGCG through the β‑catenin signaling pathway in breast cancer is unclear. The present study investigated the association between β‑catenin expression and clinicopathological factors of breast cancer patients, and the effect of EGCG on β‑catenin expression in breast cancer cells. β‑catenin expression was analyzed according to the clinicopathological factors of 74 patients with breast cancer. All patients were females diagnosed with invasive ductal carcinoma. Western blot analysis revealed that β‑catenin was expressed at higher levels in breast cancer tissue than in normal tissue. β‑catenin expression was associated with lymph node metastasis (P=0.04), tumor‑node‑metastasis stage (P=0.03) and estrogen receptor status (P<0.01). EGCG decreased MDA‑MB‑231 cell viability and significantly downregulated the expression of β‑catenin, phosphorylated Akt and cyclin D1. Remarkably, additive effects of LY294002 and wortmannin, two phosphatidylinositol‑3 kinase inhibitors, were observed. The present results suggest that EGCG inhibits the growth of MDA‑MB‑231 cells through the inactivation of the β‑catenin signaling pathway. Based on these promising results, EGCG may be a potential treatment for triple negative breast cancer patients. [ABSTRACT FROM AUTHOR]

Docosahexaenoic acid (DHA) is an omega-3 fatty acid that is considered to have applications in cancer prevention and treatment. The beneficial effects of DHA against cancer metastasis are well established; however, the mechanisms underlying these effects in breast cancer are not clear. Cell invasion is critical for neoplastic metastasis, and involves the degradation of the extracellular matrix by matrix metalloproteinase (MMP)-9. The present study investigated the inhibitory effect of DHA on MMP-9 expression and cell invasion induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) in the MCF-7 breast cancer cell line. DHA inhibited the TPA-induced activation of mitogen-activated protein kinase (MAPK) and the transcription of nuclear factor (NF)-κB, but did not inhibit the transcription of activator protein-1. DHA increased the activity of peroxisome proliferator-activated receptor (PPAR)-γ, an effect that was reversed by the application of the PPAR-γ antagonist GW9662. In addition, combined treatment with GW9662 and DHA increased NF-κB-related protein expression. These results indicate that DHA regulates MMP-9 expression and cell invasion via modulation of the MAPK signaling pathway and PPAR-γ/NF-κB activity. This suggests that DHA could be a potential therapeutic agent for the prevention of breast cancer metastasis. [ABSTRACT FROM AUTHOR]

Background: Nerve growth factor (NGF) is a neurotrophin and has been suggested to induce heme oxygenase-1 (HO1) expression. Although the role of HO1 in tumorigenesis remains controversial, recent evidence suggests NGF and HO1 as tumor-progressing factors. However, the correlative role of NGF and HO1 and their prognostic impact in breast carcinoma is unknown.Methods: We investigated the expression and prognostic significance of the expression of NGF and HO1 in 145 cases of breast carcinoma.Results: Immunohistochemical expression of NGF and HO1 was observed in 31% and 49% of breast carcinoma, respectively. The expression of NGF and HO1 significantly associated with each other, and both have a significant association with histologic grade, HER2 expression, and latent distant metastasis. The expression of NGF and HO1 predicted shorter overall survival of breast carcinoma by univariate and multivariate analysis. NGF expression was an independent prognostic indicator for relapse-free survival by multivariate analysis. The combined expression pattern of NGF and HO1 was also an independent prognostic indicator of overall survival and relapse-free survival. The patients with tumors expressing NGF had the shortest survival and the patients with tumor, which did not express NGF or HO1 showed the longest survival time.Conclusions: This study has demonstrated that individual expression of NGF or HO1, and the combined NGF/HO1 expression pattern could be prognostic indicators for breast carcinoma patients. [ABSTRACT FROM AUTHOR]

Fisetin is a flavonoid found in plants and has been reported to be effective in various human diseases. However, the effective mechanisms of ultraviolet-A (UVA)-mediated skin damage are not yet clear. In this study, we investigated the protective mechanisms of fisetin regarding UVA-induced human dermal fibroblasts (HDFs) and human epidermal keratinocytes (HEKs) damages. Fisetin showed a cytoprotective effect against UVA irradiation and suppressed matrix metalloproteinases (MMPs), MMP-1, and MMP-3 expression. In addition, fisetin was rescued, which decreased mRNA levels of pro-inflammatory cytokines, reactive oxygen species production, and the downregulation of MAPK/AP-1 related protein and NADPH oxidase (NOX) mRNA levels. Furthermore, UVA-induced MMP-1 and MMP-3 were effectively inhibited by siRNAs to NOX 1 to 5 in HDFs and HEKs. These results indicate that fisetin suppresses UVA-induced damage through the NOX/ROS/MAPK pathway in HDFs and HEKs.