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Open nanoshells such as nanobowls or nanocups collectively described as 'semi shells' have unique plasmonic properties due to their lack of symmetry. So far, their fabrication was based on multistep and laborious methods such as solid state sputter coating or selective deposition/etching using sacrificial templates. In this work, we report a rapid one step colloidal synthetic protocol for PEGylated semi-shell (SS) fabrication by simultaneous facet specific anisotropic chemical etching of rhombic dodecahedral ZIF-8 and heterogenous nucleation & growth of gold. The SS possesses a strong localized surface plasmon resonance in the near-infrared region, which is retained after surface passivation with polyethylene glycol and subsequent cryopreservation for extended shelf-life. Freshly reconstituted PEGylated SS was found to be safe & non-toxic in healthy C57BL/6 mice post intravenous administration. The PEGylated SS displayed significant photothermal efficiency of ~37% with 808 nm laser irradiation. Preclinical assessment of intra-tumoral photothermal efficacy indicated complete remission of primary breast tumor mass with insignificant metastasis to vital organs in 4T1 FL2 tumor bearing CD1 nude mice. Further, PEGylated SS mediated photothermal therapy also yielded morbidity free survivael of 75% for up to 90 days, indicating their potential to significantly improve outcomes in advanced breast tumors. Anisotropic gold-based colloidal nanoparticles such as semi shells have unique optical properties and widespread applications such as in bioimaging, biosensing and therapy, however, the fabrication process of semi shells remains a challenge due to laborious multistep solid state and colloidal procedures. In this study, the authors develop a rapid one-pot colloidal synthetic route for the fabrication of semi shells using ZIF-8 as a sacrificial template, and demonstrate their promise for photothermal therapy. [ABSTRACT FROM AUTHOR]

Background: Results from studies investigating the association between ultra-processed foods (UPFs) and breast cancer are scarce and, in some cases, contradictory. Therefore, we aimed to evaluate the association between the intake of processed foods (PFs) and UPFs with the risk of breast cancer in Iranian women. Methods: The present case (n = 133) - control (n = 266) study was carried out at two general hospitals in Tehran, Iran. A 168-item semi-quantitative food frequency questionnaire was used to assess the participants' dietary intake. Also, the NOVA classification was used to identify PFs and UPFs. The association between PFs and UPFs with the odds of breast cancer was analyzed using logistic regression models. Results: According to Model 1 of conditional logistic regression, the odds of breast cancer were higher in the last tertile of UPFs than in the first tertile (odds ratio (OR) = 1.930; 95% confidence interval (CI): 1.080–3.449). In Model 2, no significant association was observed between the second and last tertiles of PFs and UPFs with the odds of breast cancer compared to the reference tertile. Also based on menopause status, the odds of breast cancer increased in the last tertile only among premenopausal women in Model 2 (OR = 3.656; 95% CI: 1.326–10.079). Conclusions: This study demonstrated that higher consumption of UPFs is associated with higher odds of breast cancer in premenopausal women. [ABSTRACT FROM AUTHOR]

Triple‐negative breast cancer (TNBC) is a breast malignancy with a poor prognosis and limited therapeutic options. Many studies show that TNBC exhibits heterogeneity across clinical, histopathological, and molecular levels. In this review, we discuss the immunogenic features of TNBC with a focus on immunotherapy and the current standard of care in the neoadjuvant, adjuvant, and metastatic setting. In addition, we address the ongoing research on immunotherapy, antibody‐drug conjugates (ADCs), poly ADP‐ribose polymerase (PARP) inhibitors, and future challenges in the treatment of this entity. [ABSTRACT FROM AUTHOR]

Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by poor prognosis due to the absence of effective targeted therapies. Emerging evidence indicates that the gut microbiota and its metabolites play a key role in the occurrence and development of TNBC. This study aimed to explore the metabolic changes and potential mechanisms associated with TNBC. Objectives: This study aimed to explore the potential relationship between targeted metabolites and the gut microbiota in TNBC. Design: We recruited 8 participants, including 4 with TNBC and 4 with benign fibroadenomas as controls. Methods: The gut microbiota was analyzed using metagenomics on fecal samples. Liquid chromatography–mass spectrometry (LC-MS) was employed to identify differential metabolites in serum and fecal samples. The correlation between the gut microbiota and metabolites was analyzed using Spearman's correlation analysis. Results: Analysis of altered serum metabolites in the TNBC group revealed changes, particularly in carboxylic acids and derivatives, benzene, and substituted derivatives. Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathway analysis revealed significant enrichment in 18 pathways. Regarding fecal metabolites, differences between the 2 groups also included carboxylic acids and derivatives, benzene, and substituted derivatives, with 28 metabolic pathways enriched based on KEGG pathway analysis. Metagenomics analysis showed differences in the relative abundance of Anaerococcus, Fischerella, and Schizosaccharomyces at the genus level, which have been previously associated with breast cancer. Furthermore, 4 serum metabolites—L-glutamine, citrate, creatinine, and creatine—along with 9 fecal metabolites, were associated with the aforementioned microbiota. Conclusion: Our findings highlight distinct metabolite profiles in the serum and feces of patients with TNBC. The identification of gut microbiota and their associated metabolites provides new insights into the pathophysiological mechanisms underlying TNBC. [ABSTRACT FROM AUTHOR]

Background: Bone metastases are common in patients with progressive cancer and often present in long bones, leading to adverse events such as pathologic fractures. In the acute care setting, physical therapists (PTs) may be the initial providers who identify symptoms associated with fracture risk and communicate concerns to help prevent such adverse events. Case description: A 39-year-old female patient with metastatic breast cancer was admitted to the hospital due to uncontrolled pain. She had a history of bone metastases to the left femur; however, no restrictions or precautions were noted during the initial PT examination. During this initial PT examination, she reported worsening hip pain with weight-bearing activities. Outcomes: With the PT's recognition of red flag symptoms, an MRI was completed, which revealed extensive metastatic disease in her left femur with concern for an imminent fracture; as a result, prophylactic fixation was performed. Her functional abilities improved after surgery and consistent therapeutic intervention, allowing her to achieve a level of independence sufficient to return home safely. Discussion and conclusion: This case demonstrates the successful identification of imminent fracture risk by a PT in a patient with metastatic breast cancer, as well as the therapeutic management that accompanied this process in the acute care setting. [ABSTRACT FROM AUTHOR]

Granulomatous mastitis (GM), a benign inflammatory disease of the breast, often mimics breast cancer on presentation. We present a case of GM during pregnancy manifesting as a breast mass, sudden onset of plantar pain, and erythema nodosum (EN). A 31‐year‐old pregnant Japanese woman, gravida 2, para 1, was referred to our hospital with severe plantar pain on both soles, causing difficulty walking. This pain worsened and EN appeared on both lower legs, followed by a left breast mass. Ultrasound findings suggested malignancy; however, aspiration biopsy confirmed GM. Her arthritis and EN resolved 2 days after commencing oral prednisolone and her walking improved. EN with/without arthritis is commonly associated with GM, especially during pregnancy. The described manifestations with a breast mass are suggestive of this diagnosis. [ABSTRACT FROM AUTHOR]

Garcinia kola is a medicinal food commonly consumed in Sub-Sahara Africa, for which Kolaviron (KV) is the active portion. As a follow-up to our earlier chemopreventive studies, we investigated the chemotherapeutic effects of KV on experimentally induced mammary carcinogenesis in female Wistar rats. Mammary carcinogenesis was induced using 80 mg/kg of 7,12-dimethylbenzanthracene (DMBA) administered by oral gavage. One hundred-fifty days post-DMBA induction, estrogen receptor-α (ER-α) levels were determined in the experimental rats before treatment with KV commenced. Treatment was done using 50, 100, and 200 mg/kg KV thrice a week for 4 weeks, after which the experiment was terminated. Significantly higher levels of estrogen receptor-α, CYP 1A1, malondialdehyde, formation of lobular neoplastic cells, epithelial hyperplasia, lymphocyte infiltration, and increased cytokine (interleukin-6 and tumor necrosis factor-α) activity were observed in DMBA-induced rats, which were attenuated in KV-treated rats. Tyrosine metabolism was exclusively enriched in DMBA-induced rats in contrast to KV-treated rats. Collectively, the results point to the chemotherapeutic potential of KV. [ABSTRACT FROM AUTHOR]

Objective: In highly aggressive malignant cancers including breast cancer, vasculogenic mimicry (VM) is the potential of tumor cells to generate a vascular channel network for delivering blood to tumor cells. Detection of genes involved in this process is critical to designing targeted therapy against breast cancer metastasis. In this study, we evaluated the roles of FAK and ILK in the progression of VM in metastatic breast tumor cells. Results: Primary (4T1T), and highly metastatic (4T1B and 4T1L) breast tumor cells were isolated from cancerous mice. The potential of cancer cells to organize themselves into vascular-like structures (VM) has been evaluated with in vitro assessment. The expression of ILK and FAK were examined using real-time polymerase chain reaction. We confirmed the high ability of metastatic tumor cells in vascular-like structure formation. In molecular analysis, our data showed that ILK and FAK expression was significantly elevated in metastatic breast tumor cells. These results indicated that the higher potential of metastatic tumor cells in vascular-like structure formation may be related to higher expression of ILK and FAK. Analysis of molecular features of metastatic tumor cells could be utilized to create a targeted therapeutic strategy against metastasis in breast cancer. [ABSTRACT FROM AUTHOR]

High-Intensity Focused Ultrasound (HIFU) as a promising and impactful modality for breast tumor ablation, entails the precise focalization of high-intensity ultrasonic waves onto the tumor site, culminating in the generation of extreme heat, thus ablation of malignant tissues. In this paper, a comprehensive three-dimensional (3D) Finite Element Method (FEM)-based numerical procedure is introduced, which provides exceptional capacity for simulating the intricate multiphysics phenomena associated with HIFU. Furthermore, the application of numerical procedures to an anatomically realistic breast phantom (ARBP) has not been explored before. The integrity of the present numerical procedure has been established through rigorous validation, incorporating comparative assessments with previous two-dimensional (2D) simulations and empirical data. For ARBP ablation, the administration of a 0.1 MPa pressure input pulse at a frequency of 1.5 MHz, sustained at the focal point for 10 seconds, manifests an ensuing temperature elevation to 80°C. It is noteworthy that, in contrast, the prior 2D simulation using a 2D phantom geometry reached just 72°C temperature under the identical treatment regimen, underscoring the insufficiency of 2D models, ascribed to their inherent limitations in spatially representing acoustic energy, which compromises their overall effectiveness. To underscore the versatility of this numerical platform, a simulation of a more clinically relevant HIFU therapy procedure has been conducted. This scenario involves the repositioning of the ultrasound focal point to three separate lesions, each spaced at 3 mm intervals, with ultrasound exposure durations of 6 seconds each and a 5-second interval for movement between focal points. This approach resulted in a more uniform high-temperature distribution at different areas of the tumour, leading to the ablation of almost all parts of the tumour, including its verges. In the end, the effects of different abnormal tissue shapes are investigated briefly as well. For solid mass tumors, 67.67% was successfully ablated with one lesion, while rim-enhancing tumors showed only 34.48% ablation and non-mass enhancement tumors exhibited 20.32% ablation, underscoring the need for multiple lesions and tailored treatment plans for more complex cases. [ABSTRACT FROM AUTHOR]

We present a unique case of metastatic metaplastic breast carcinoma responding dramatically to immunochemotherapy. A 46‐year‐old Japanese woman with primary metaplastic carcinoma of the breast, which was immunohistochemically confirmed to be triple‐negative breast cancer, underwent radical surgery, followed by adjuvant chemotherapy with an anthracycline and a taxane. Since multiple lung metastases were detected two months post‐chemotherapy and the primary site was shown to be PD‐L1‐positive, the immune checkpoint inhibitor (ICI) pembrolizumab plus gemcitabine/carboplatin was initiated. While the treatment was discontinued after 15 days due to suspected drug‐induced pneumonitis, the lung metastases significantly shrank with no development of new lesions for three months. The patient remained alive as of approximately 15 months after the recurrence date. This case highlights the potential of immunochemotherapy in treating metaplastic breast carcinomas. [ABSTRACT FROM AUTHOR]

Background: While longitudinal designs can provide significant advantages compared to single measurement/cross sectional designs, they require careful attention to study infrastructure and the risk of attrition among the sample over multiple time points. Objective: The strategies used to design and manage an appropriate infrastructure for a longitudinal study and approaches to retain samples are explored using examples from 2 studies, a 25-year study of persons living with multiple sclerosis and a 10-year longitudinal follow-up of breast cancer survivors. Results: Key strategies (developing appropriate infrastructure, minimizing costs to participants, and maximizing rewards of study participation) have helped address the serious threat of attrition in these longitudinal samples. Conclusion: Implementation of these strategies can help mitigate some of the disadvantages and leverage the strengths of longitudinal research to produce reliable, insightful, and impactful outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To verify the ability of pretreatment [18F]FDG PET/CT and T1-weighed dynamic contrast-enhanced MRI to predict pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients. Methods: This retrospective study includes patients with BC of no special type submitted to baseline [18F]FDG PET/CT, NAC and surgery. [18F]FDG PET-based features reflecting intensity and heterogeneity of tracer uptake were extracted from the primary BC and suspicious axillary lymph nodes (ALN), for comparative analysis related to NAC response (pCR vs. non-pCR). Multivariate logistic regression was performed for response prediction combining the breast tumor-extracted PET-based features and clinicopathological features. A subanalysis was performed in a patients' subsample by adding breast tumor-extracted first-order MRI-based features to the multivariate logistic regression. Results: A total of 170 tumors from 168 patients were included. pCR was observed in 60/170 tumors (20/107 luminal B-like, 25/45 triple-negative and 15/18 HER2-enriched surrogate molecular subtypes). Higher intensity and higher heterogeneity of [18F]FDG uptake in the primary BC were associated with NAC response in HER2-negative tumors (immunohistochemistry score 0, 1 + or 2 + non-amplified by in situ hybridization). Also, higher intensity of tracer uptake was observed in ALN in the pCR group among HER2-negative tumors. No [18F]FDG PET-based features were associated with pCR in the other subgroup analyses. A subsample of 103 tumors was also submitted to extraction of MRI-based features. When combined with clinicopathological features, neither [18F]FDG PET nor MRI-based features had additional value for pCR prediction. The only significant predictors were estrogen receptor status, HER2 expression and grade. Conclusion: Pretreatment [18F]FDG PET-based features from primary BC and ALN are not associated with response to NAC, except in HER2-negative tumors. As compared with pathological features, no breast tumor-extracted PET or MRI-based feature improved response prediction. [ABSTRACT FROM AUTHOR]

Radiotherapy (RT) is an integral component in the treatment of breast cancer. The aims of this study were to estimate the cost per 5-year Local Control (LC) and Overall Survival (OS) benefits of the first course of RT, based on breast cancer stage, and the potential cost savings with adoption of the FAST-Forward protocol. All RT activities for breast cancer RT July 2017-June 2020 and their associated costs were consolidated together. The average cost of treatment course was calculated (average cost per fraction X average no. of fractions). Cost per outcome was estimated based on published gains in 5-year LC and OS with optimal use of radiotherapy. 481 patients with breast cancer were analysed. The average cost per fraction was $285 AUD (£148 GBP) for all stages. The average costs for 5-year LC and OS gain were $31,483 AUD (£16 392 GBP) and $235,435 AUD (£122 566 GBP) respectively for all stages. The estimated costs for 5-year LC outcomes were $29,675 AUD (£15 450 GBP), $34,675 AUD (£18 053 GBP) and $32,478 AUD (£16 910 GBP) for Stage I-III respectively. The estimated costs for 5-year OS were $455,909 AUD (£237 378 GBP), $532,727 AUD (£ 277 375 GBP) and $60,717 AUD (£31 614 GBP) for Stage I-III respectively. 266 patients had characteristics that made them eligible for the FAST-Forward protocol. A cost saving of $2592–3864 AUD (£1350–2012 GBP) per patient was estimated had these patients been treated with the protocol. The cost of RT for LC outcome is similar across stages. The greatest value for OS outcome was seen in patients with Stage III breast cancer, due to the greater survival benefit with RT in these patients compared with Stage I-II breast cancer. Significant cost savings can be made by implementing the FAST-Forward protocol. • Cost per 5-year local control outcome was similar for Stage I-III breast cancer ranging from $29,675 AUD to $32,478 AUD. • Cost per 5-year overall survival outcome was cheaper for stage III breast cancer compared with Stage I-II breast cancer. • Use of the FAST-Forward ultrahypofractionation protocol significantly reduces RT costs. [ABSTRACT FROM AUTHOR]

To present the final results of a phase I trial on stereotactic radiosurgery (SRS) delivered using volumetric modulated arc therapy (VMAT) in patients with primary or metastatic tumors in different extracranial sites. The DESTROY-2 trial, planned as a prospective dose escalation study in oligometastatic (one to five lesions) cancer patients relied on the delivery of a single high dose of radiation utilizing high-precision technology. The primary study endpoint was the definition of the maximum tolerated dose (MTD) of SRS-VMAT. The secondary objectives of the study were the evaluation of safety, efficacy, and long-term outcomes. All patients consecutively observed at our radiotherapy unit matching the inclusion criteria were enrolled. Each enrolled subject was included in a different phase I study arm, depending on the tumor site and the disease stage (lung, liver, bone, other), and sequentially assigned to a particular dose level. Two hundred twenty seven lesions in 164 consecutive patients (male/female: 97/67, median age: 68 years; range: 29–92) were treated. The main primary tumors were: prostate cancer (60 patients), colorectal cancer (47 patients), and breast cancer (39 patients). The maximum planned dose level was achieved in all study arms, and the MTD was not exceeded. 34 Gy, 32 Gy, 24 Gy, and 24 Gy were established as the single-fraction doses for treating lung, liver, bone, and other extracranial lesions, respectively. The prescribed BED 2Gy α/β:10 to the planning target volume ranged from 26.4 Gy to 149.6 Gy. Twenty-seven patients (16.5%) experienced grade 1–2 and only one grade 3 acute toxicity, which was a pulmonary one. In terms of late toxicity, we registered only 5 toxicity>G2: a G3 gastro-intestinal one, three G3 bone toxicity, and a G3 laryngeal toxicity. The overall response was available for 199 lesions: 107 complete response (53.8%), 50 partial response (25.1%), and 31 stable disease (15.6%), leading to an overall response rate of 94.5%. Progression was registered only in 11 cases (5.5%). The overall response rate in each arm ranged from 88.6% to 96.4%. The overall two-year local control, distant metastasis free survival, disease free survival, and overall survival were 81.7%, 33.0%, 25.4%, and 78.7% respectively. In conclusion, the planned doses of 34 Gy, 32 Gy, 24 Gy, and 24 Gy were successfully administered as single-fractions for the treatment of lung, liver, bone, and other extracranial lesions, respectively, in a prospective SRS dose-escalation trial. No dose-limiting toxicities were registered, and minimal acute and late toxicity were reported. New indications for SRS are currently being studied in oligoprogressive patients receiving targeted drugs or in combination with immunotherapy. The DESTROY-2 trial represents, in our opinion, a credible starting point for future modern radiosurgery trials. • One of the few prospective SRS studies exploring MTD across different clinical settings. • 34 Gy, 32 Gy, and 24 Gy single fraction were safely delivered to lung, liver, bone. • The highest dose level was reached in all the settings, not exceeding the MTD. • The toxicity profile was low with one acute and five late toxicities >G2. • High LC rates and encouraging long-term outcomes were observed. [ABSTRACT FROM AUTHOR]

Background The coronavirus disease 2019 (COVID-19) pandemic impacted cancer services worldwide. We examined the effect of the first three pandemic waves on the number of electronic (e)-referrals to rapid access clinics (RACs) for breast, lung and prostate cancer in Ireland. Methods This study used a retrospective, repeated cross-sectional design. The predicted weekly number of e-referrals by suspected cancer types from March 2020 to May 2021 was calculated using the Holt-Winters seasonal smoothing method, based on the observed numbers from a representative pre-pandemic period (01 January 2019 to 01 March 2020) and compared this with the observed number across the first three pandemic waves (02 March 2020 to 09 May 2021). Percentage differences were calculated between observed and predicted numbers of e-referrals for the three RACs and patterns were examined in each wave. Results Observed e-referrals were lower than predicted for all three RACs in the first wave of the pandemic (15.7% lower for breast, 39.5% lower for lung and 28.1% lower for prostate) with varying levels of recovery in the second and third waves for the three e-referral types. Conclusions The COVID-19 pandemic impacted patterns of e-referrals to RACs in the first three pandemic waves in Ireland. Early identification of changes in engagement with health services, such as a decrease in primary care presentations with a resultant decrease in e-referrals to RACs can allow for a rapid response from cancer control programmes. Continued surveillance of the impact of service disruption on cancer services allows policy makers and strategic leaders in cancer control programmes to respond rapidly to mitigate the impact on cancer outcomes. [ABSTRACT FROM AUTHOR]

Objective: Schizophrenia seems to have a complex association with various types of cancer, exerting a protective effect against some cancers while being a risk factor against some others. Therefore, we intended to conduct an updated systematic review and meta-analysis in order to examine the relationship between schizophrenia and the risk of breast cancer incidence. Method: We did a systematic search of databases, namely Web of Science, Scopus, Embase, PubMed, and PsycINFO up to August 15, 2024. Screening and data extraction were performed independently. Data was analyzed using Stata16 software. We used the random effect model to pool the results, while the heterogeneity between studies was calculated using Cochran's Q test and (I2) index. Results: We found 15 studies, among which 12 were included in this meta-analysis. The results indicated that the risk of breast cancer development is significantly increased in women with schizophrenia (SIR: 1.43, 95% CI: 1.08-1.85, P < 0.01; IRR: 1.19, 95% CI: 1.13-1.26, P < 0.01). Subgroup analysis revealed significant differences in the incidence of breast cancer rates among women with schizophrenia based on geographic location and duration of follow-up. Conclusion: The results indicate that schizophrenia increases the risk of developing breast cancer. Therefore, taking preventive measures concerning breast cancer among women with schizophrenia is crucial. Additionally, regular screening programs should be implemented to ensure early diagnosis and treatment in case breast cancer is detected. [ABSTRACT FROM AUTHOR]

This article, published in the International Journal of Surgical Pathology, presents a case study of a 53-year-old woman with a rapidly enlarging breast mass. The mass was initially diagnosed as a fibroadenoma but was later found to be a malignant phyllodes tumor (MPT) with heterologous telangiectatic osteosarcoma. MPTs are rare and aggressive tumors with a high risk of recurrence and metastasis. The presence of heterologous elements, such as osteosarcoma, classifies the tumor as MPT. This case is unusual because telangiectatic osteosarcoma arising in MPT is rare, with few reported cases in the literature. The article provides detailed histologic descriptions and diagnostic criteria for this type of tumor. The patient underwent resection and adjuvant radiation therapy and has remained disease-free for 19 months. [Extracted from the article]

Context.--Metastatic pleomorphic lobular carcinoma (MPLC) to the bladder is rare and has considerable histologic and immunohistochemical overlap with plasmacytoid urothelial carcinoma (PUC). Objective.--To distinguish MPLC from PUC morphologically and immunohistochemically, including a newer marker, TRPS1. Design.--Ten MPLCs to the bladder were reassessed and stained with estrogen, progesterone, and androgen receptors; GATA3; keratin 5/6; HMWK; GCDFP-15; and TRPS1. Sixteen PUCs constituted controls. Results.--We studied 4 transurethral resections of bladder tumors and 6 biopsies from 10 women (median age, 69 years) who had breast cancer on average 15 years prior. Microscopic patterns included single cells and cords of cells (n = 4), nests/sheets of dyscohesive cells (n = 2), or both (n = 4). All tumors had cells with voluminous eosinophilic cytoplasm and eccentric nuclei mimicking PUC, and 7 of 10 tumors had signet ring cells. MPLCs were positive for estrogen (8 of 10), progesterone (3 of 7), and androgen (4 of 10) receptors; GCDFP-15 (7 of 10); GATA3 (9 of 10); HMWK (7 of 8); and TRPS1 (7 of 10). No MPLCs stained for keratin 5/6 (n = 9). Of 16 PUCs, 2 showed faint and 2 demonstrated strong TRSP1 staining; 7 of 16 were negative for p63. Conclusions.--MPLC to bladder often presents in patients with a remote history of breast cancer, exhibiting significant histologic and immunohistochemical overlap with PUC. Based on prior works and the current study, estrogen receptor (particularly SP-1), mammaglobin, and p63 help differentiate MPLC from PUC. Keratin 5/6 may aid in distinguishing a less frequent basal-type PUC because it is typically negative in MPLC. Some PUCs express TRPS1. Caution should be exercised because immunophenotypes of these tumors greatly overlap, and ramifications of misclassification are major. [ABSTRACT FROM AUTHOR]

Vascularity plays a pivotal role in the progression of breast lesions and may be associated with their aggressiveness and likelihood of being malignant. Contrast-enhanced imaging techniques are necessary to evaluate vascularity due to the limited sensitivity of conventional color Doppler techniques, in which motion artifacts are eliminated using wall filters. However, in this process, low-flow signals from small vessels also get removed unintentionally. Advancements in technology have revolutionized the way ultrasound images are generated, resulting in tremendous improvements in Doppler imaging techniques. The new, ultrasound-based noncontrast microvascular imaging techniques overcome the limitations of conventional Doppler, and are highly sensitive for detecting microvessels and low flow. The resultant high Doppler sensitivity leads to detection of vascularity in more breast lesions. It is important for radiologists to understand the imaging principles and the clinical implications of the new techniques, to optimally utilize them and aid correct diagnosis. Angio-PLUS is one such recent advancement, which uses unfocused or plane waves and three-dimensional wall filtering to analyze tissue motion in time, space, and amplitude domains that effectively distinguish between blood flow and tissue. The information is beneficial for assessing the lesion vascularity without using contrast. This article aims to explain the Doppler imaging techniques, their clinical applications, scanning methods, and review the common Doppler-based diagnostic criteria used in the evaluation of breast lesions. [ABSTRACT FROM AUTHOR]

Nonmass lesions in breast ultrasound (US) are areas of altered echogenicity without definite margins or mass effect. However, these lesions may show calcifications, associated architectural distortion, or shadowing just like masses. They vary in their echogenicity, distribution, ductal or nonductal appearance and the associated features that can be seen in variety of benign and malignant pathologies. With no uniform definition or classification system, there is no standardized approach in further risk categorization and management strategies of these lesions. Malignant nonmass lesions are not uncommon and few sonographic features can help in differentiating benign and malignant pathologies. US-guided tissue sampling or lesion localization can be preferred in the nonmass lesions identified on second look US after magnetic resonance imaging or mammography. This article aims to describe various imaging patterns and attempts to provide an algorithmic approach to nonmass findings on breast US. [ABSTRACT FROM AUTHOR]

Granular cell tumors of breast are rare neoplasms, majority of which are benign. Their imaging appearances are often indistinguishable from breast cancer. They may demonstrate a few differentiating features and unlike breast cancer, typically follow a benign course. Histopathology and immunochemistry form the cornerstone of diagnosis of granular cell tumor. In this article, we presented a series of three cases of granular cell tumors with variable presentations. Our goal is to increase familiarity for these neoplasms and for the readers to be able to distinguish them from the more common entity of breast cancer, as their prognosis and management differ. [ABSTRACT FROM AUTHOR]

The apoptotic potential of Ficus religiosa bark methanol extract (FRme) was examined using MDA-MB-231 breast cancer cells. MDA-MB-231 cell cytotoxicity by FRme was dose-dependent with EC50 of 91.32 ± 4.21 μg mL−1 however, it was non-toxic to normal cell line (HEK 293 T). Apoptosis identified by flow cytometer showed 32.5% cells in apoptosis and 61.6% in late apoptosis. FRme blocked cell cycle growth and proliferation at the G1/S phase. An increased expression of BAX with the proteolytic cleavage of PARP-1 and a downregulation of Bcl-2 levels by Western blot was recorded. Confocal microscopy studies identified chromatin condensation and loss of nuclear structures in apoptotic cells. UPLC-MS analysis of FRme for novel bioactives identified rutin, 3-caffeoylquinic acid, luteolin 7-O-rutinoside, 6-C-glucosyl-8-C-arabinosylapigenin, and kaempferol-3-O-rutinoside. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate microcalcification detectability in digital breast tomosynthesis (DBT) and synthetic 2D mammography (SM) for different acquisition setups using a virtual imaging trial (VIT) approach. Materials and methods: Medio-lateral oblique (MLO) DBT acquisitions on eight patients were performed at twice the automatic exposure controlled (AEC) dose. The noise was added to the projections to simulate a given dose trajectory. Virtual microcalcification models were added to a given projection set using an in-house VIT framework. Three setups were evaluated: (1) standard acquisition with 25 projections at AEC dose, (2) 25 projections with a convex dose distribution, and (3) sparse setup with 13 projections, every second one over the angular range. The total scan dose and angular range remained constant. DBT volume reconstruction and synthetic mammography image generation were performed using a Siemens prototype algorithm. Lesion detectability was assessed through a Jackknife-alternative free-response receiver operating characteristic (JAFROC) study with six observers. Results: For DBT, the area under the curve (AUC) was 0.97 ± 0.01 for the standard, 0.95 ± 0.02 for the convex, and 0.89 ± 0.03 for the sparse setup. There was no significant difference between standard and convex dose distributions (p = 0.309). Sparse projections significantly reduced detectability (p = 0.001). Synthetic images had a higher AUC with the convex setup, though not significantly (p = 0.435). DBT required four times more reading time than synthetic mammography. Discussion: A convex setup did not significantly improve detectability in DBT compared to the standard setup. Synthetic images exhibited a non-significant increase in detectability with the convex setup. Sparse setup significantly reduced detectability in both DBT and synthetic mammography. Clinical relevance statement: This virtual imaging trial study allowed the design and efficient testing of different dose distribution trajectories with real mammography images, using a dose-neutral protocol. Key Points: • In DBT, a convex dose distribution did not increase the detectability of microcalcifications compared to the current standard setup but increased detectability for the SM images. • A sparse setup decreased microcalcification detectability in both DBT and SM images compared to the convex and current clinical setups. • Optimal microcalcification cluster detection in the system studied was achieved using either the standard or convex dose setting, with the default number of projections. [ABSTRACT FROM AUTHOR]

Objective: This study aims to determine whether persistent T1-weighted lesions signify a complete pathological response (pCR) in breast cancer patients treated with neoadjuvant chemotherapy and surgery, and to evaluate their correlation with imaging responses on MRI. Materials and methods: A retrospective review was conducted on data from breast cancer patients treated between January 2011 and December 2018. Patients who underwent breast MRI and pre- and post-neoadjuvant chemotherapy followed by surgery were included. Those with distant metastasis, no planned surgery, pre-surgery radiation, ineligibility for neoadjuvant chemotherapy, or unavailable surgical pathology were excluded. Groups with and without persistent T1-weighted lesions were compared using the chi-square test for categorical variables and the Student t test or Wilcox rank sum test for continuous variables. Univariate logistic regression was used to evaluate the association of the final pathological response with the presence of T1-persistent lesion and other characteristics. Results: Out of 319 patients, 294 met the inclusion criteria (breast cancer patients treated with neoadjuvant chemotherapy and subsequent surgery); 157 had persistent T1 lesions on post-chemotherapy MRI and 137 did not. A persistent T1 lesion indicated reduced likelihood of complete pathological response (14% vs. 39%, p < 0.001) and imaging response (69% vs. 93%, p < 0.001). Multivariable analysis confirmed these findings: OR 0.37 (95% CI 0.18–0.76), p = 0.007. No other characteristics correlated with T1 residual lesions. Conclusion: Persistent T1-weighted lesions without associated abnormal enhancement on post-treatment breast MRI correlate with lower complete pathological and imaging response rates. Clinical relevance statement: The study underscores the importance of persistent T1-weighted lesions on breast MRI as vital clinical markers, being inversely related to a complete pathological response following neoadjuvant chemotherapy; they should be a key factor in guiding post-neoadjuvant chemotherapy treatment decisions. Key Points: • Persistent T1 lesions on post-chemotherapy breast MRI indicate a reduced likelihood of achieving a complete pathological response (14% vs. 39%, p < 0.001) and imaging response (69% vs. 93%, p < 0.001). • Through multivariable analysis, it was confirmed that the presence of a persistent T1 lesion on breast MRI post-chemotherapy is linked to a decreased likelihood of complete pathological response, with an odds ratio (OR) of 0.37 (95% CI 0.18–0.76; p = 0.007). • In addition to the convention of equating the absence of residual enhancement to complete imaging response, our results suggest that the presence or absence of residual T1 lesions should also be considered. [ABSTRACT FROM AUTHOR]

Objectives: Supplemental MRI screening improves early breast cancer detection and reduces interval cancers in women with extremely dense breasts in a cost-effective way. Recently, the European Society of Breast Imaging recommended offering MRI screening to women with extremely dense breasts, but the debate on whether to implement it in breast cancer screening programs is ongoing. Insight into the participant experience and willingness to re-attend is important for this discussion. Methods: We calculated the re-attendance rates of the second and third MRI screening rounds of the DENSE trial. Moreover, we calculated age-adjusted odds ratios (ORs) to study the association between characteristics and re-attendance. Women who discontinued MRI screening were asked to provide one or more reasons for this. Results: The re-attendance rates were 81.3% (3458/4252) and 85.2% (2693/3160) in the second and third MRI screening round, respectively. A high age (> 65 years), a very low BMI, lower education, not being employed, smoking, and no alcohol consumption were correlated with lower re-attendance rates. Moderate or high levels of pain, discomfort, or anxiety experienced during the previous MRI screening round were correlated with lower re-attendance rates. Finally, a plurality of women mentioned an examination-related inconvenience as a reason to discontinue screening (39.1% and 34.8% in the second and third screening round, respectively). Conclusions: The willingness of women with dense breasts to re-attend an ongoing MRI screening study is high. However, emphasis should be placed on improving the MRI experience to increase the re-attendance rate if widespread supplemental MRI screening is implemented. Clinical relevance statement: For many women, MRI is an acceptable screening method, as re-attendance rates were high — even for screening in a clinical trial setting. To further enhance the (re-)attendance rate, one possible approach could be improving the overall MRI experience. Key Points: • The willingness to re-attend in an ongoing MRI screening study is high. • Pain, discomfort, and anxiety in the previous MRI screening round were related to lower re-attendance rates. • Emphasis should be placed on improving MRI experience to increase the re-attendance rate in supplemental MRI screening. [ABSTRACT FROM AUTHOR]

In this essay, I discuss my personal experience with breast cancer, exploring three intertwined choices: declining medical egg freezing, choosing not to bear children, and opting out of breast reconstruction after a double mastectomy. Through autoethnography, I narrate how being an immigrant Latina cisgender lesbian in Europe influenced my decision-making processes. Challenging common assumptions about the invariably negative emotional impact on survivors of bilateral mastectomy and infertility, I emphasize the importance for me of minimizing additional pain by eliminating "unnecessary" medical interventions. Likewise, I address concerns about body changes, bodily integrity, and the impact of a positive genetic mutation on my family. My aim is to shed light on knowledge production gaps by sharing my journey from a minority perspective. [ABSTRACT FROM AUTHOR]

Introduction: Adjuvant treatment with aromatase inhibitors (AI) in oestrogen receptor-positive and/or progesterone receptor-positive breast cancer (BC) has been shown to increase overall survival. However, arthralgias and myalgias are common adverse effects in patients treated with AI. Objective: To evaluate the frequency and characteristics of arthralgias and myalgias in patients with early BC-treated adjuvantly with AI in the Mastology Unit of the Oncology Service of the Hospital de Clínicas and the Departmental Hospital of Soriano. Materials and methods: A prospective, cross-sectional and descriptive study was performed. A questionnaire was administered to patients to assess the presence and characteristics of arthralgias and myalgias associated with AI. Statistical analysis: 'Age' was described with measures of central tendency and dispersion. Qualitative variables were presented in absolute and relative frequencies. Logistic models were used to evaluate the association between patient characteristics, tumour characteristics, treatment characteristics and the presence of pain. Results were presented by odds ratio and p-value, using R software (version 4.1.2) with a significance threshold of 5%. Results: 83 patients were included, with a median age of 69 years. 75.9% presented arthralgias and/or myalgias related to treatment, with an average intensity of 5-7. 80.9% received non-steroidal anti-inflammatory drugs (NSAIDs), achieving satisfactory analgesia. The presence of arthralgias and myalgias was significantly associated with age and time since the last menstrual period (LMP), being more frequent in patients older than 50 years and those with more than 5 years since the LMP. Conclusion: Approximately 70% of the patients presented arthralgias or myalgias. These findings suggest a possible role of oestrogen withdrawal in its mechanism of development. Multidisciplinary and translational research is crucial to evaluate the ethology and therapeutic options for patients with AI-related arthralgia. [ABSTRACT FROM AUTHOR]

This study examined mental adjustment to breast cancer, that is, coping strategies. Participants were 130 women undergoing breast cancer treatment in two medical settings in Accra, Ghana. They completed questionnaires assessing mental adjustment to cancer, psychological distress (anxiety and depression), negative religious coping, body change stress, and illness perceptions. Data were analyzed using hierarchical linear regression. Results showed that patients who reported higher depression were more likely to engage in anxious preoccupation (worry and thinking about breast cancer). Higher depression was associated with a greater sense of helplessness/hopelessness. Moreover, patients higher in negative religious coping were more likely to experience a greater sense of helplessness/hopelessness. Illness perception facets of personal control and emotional response were positively associated with fatalism and anxious preoccupation, respectively. The results suggest that screening breast cancer patients for psychological morbidity could help identify patients with increased risks for maladaptive adjustment to the disease. [ABSTRACT FROM AUTHOR]

A diagnosis of a chronic illness, such as cancer, can lead to a crisis in one's life. Although cancer patients face many biopsychosocial challenges, the literature has pointed to resilience as a key factor in coming to terms with the diagnosis and treatment. Though resilience has been discussed in various disciplines, and also from a socio-cultural perspective, there is still no universal consensus about its defining features. Furthermore, most studies have employed a quantitative approach in the understanding of what causes resilience. This qualitative study discusses the results of interviews among 18 Malaysian women with breast cancer, exploring what made these woman resilient. A thematic analysis uncovered seven themes related to the participants pathways towards resilience: drastic changes of body-image; self-reflection; spiritual resources; restoration of confidence; informal and formal support; and life appreciation. This study is vital to understanding the impact that resilience has on the experience of women with breast cancer. [ABSTRACT FROM AUTHOR]

Postoperative adjuvant chemotherapy could improve the life quality of patients with breast cancer but also bring side effects and cause adverse reactions. Yiqi Yangyin decoction has been reported to possess anti-cancer activity and has been employed in the postoperative treatment of various cancers. A total of 128 patients with breast cancer who received surgical therapy were enrolled in this study and were randomly grouped as the control and the test group to receive different therapies. Patients in the control group received single chemotherapy of fluorouracil and hydrochloride, while the therapy of the test group patients supplemented Yiqi Yangyin decoction based on the control group. Both two therapeutic strategies improved life quality and TCM syndrome scores of enrolled patients, and the supplement of Yiqi Yangyin decoction significantly improved the therapeutic effect. Adverse reactions including nausea, vomiting, thrombocytopenia, diarrhea, leukopenia, and hemoglobinia occurred in both two groups, but the application of Yiqi Yangyin decoction significantly alleviated adverse reactions. Additionally, patients in the test group showed a better 1-year disease-free survival. The combination of adjuvant chemotherapy with Yiqi Yangyin decoction could improve postoperative life quality, improve therapeutic efficacy, and reduce adverse reactions in patients with breast cancer. [ABSTRACT FROM AUTHOR]

Less than two-thirds of US adolescents are up-to-date with HPV vaccination. While mothers engaged in preventive care are more likely to seek preventive care for their children, current studies on associations between maternal cervical cancer screening (CCS) and adolescent HPV vaccination are needed. We assessed associations between maternal preventive service utilization and adolescent HPV vaccination using electronic health record data from a healthcare system in Washington State. We included adolescents (11–17 years) and their mothers with ≥ 1 primary care visit between 2018 and 2020. Outcomes were HPV vaccine initiation and completion. The primary exposure was maternal adherence to guideline-recommended CCS. Secondary exposures were maternal breast cancer screening adherence (for mothers ≥ 52 years) and ≥ 1 wellness visit ≤ 2 years. We used Generalized Estimating Equations to estimate prevalence ratios, and explore effect modification by adolescent sex, adolescent provider characteristics, and maternal language interpreter use. Of 4121 adolescents, 66% had a CCS-adherent mother, 82% initiated HPV vaccination, and 49% completed the series. CCS adherence was associated with higher initiation (adjusted prevalence ratio (APR):1.10, 95%CI:1.06–1.13) and completion (APR:1.16, 95%CI:1.08–1.23). Associations were stronger for male vs. female adolescents, adolescents who had a primary care provider in family practice vs. pediatrics, and adolescents who had the same primary care provider as their mother vs. not. Recent maternal wellness visit was also associated with higher initiation (APR:1.04, 95%CI:1.01–1.07) and completion (APR:1.12, 95%CI:1.05–1.20). Results suggest that delivering healthcare through a family-centered approach and engaging mothers in broad preventive care could increase adolescent HPV vaccination coverage. [ABSTRACT FROM AUTHOR]

Background To describe reasons for deviations from planned chemotherapy treatments in women with nonmetastatic breast cancer that contribute to less-than-planned receipt of chemotherapy. Methods Electronic medical records for patients receiving chemotherapy were reviewed for adverse events and treatment modifications. Log-binomial regression models were used to estimate relative risks (RRs) with 95% CIs to examine associations between chemotherapy modifications, patient characteristics, and treatment modalities. Results Delays in chemotherapy initiation (7%) were for surgical complications (58%), personal reasons (16%), and other (26%; port malfunction, infections, and obtaining extra imaging). Delays during chemotherapy (38%) were for infections (20%), neutropenia (13%), and personal reasons (13%). Dose reductions (38%) were for neuropathy (36%), unknown causes (9%), anemia (9%), and neutropenia (8%). Early treatment discontinuations (23%) were for neuropathy (29%). Patients receiving paclitaxel/nab-paclitaxel (RR 2.05; 95% CI, 1.47-2.87) and an anthracycline (RR 1.89; 95% CI, 1.39-2.57) reported more dose delays during chemotherapy. Black race (RR 1.46; 95% CI, 1.07-2.00), stage 3 (RR 1.79; 95% CI, 1.09-2.93), and paclitaxel/nab-paclitaxel receipt (RR 1.39; 95% CI, 1.02-1.90) increased the likelihood of dose reduction. Both Black race (RR 2.06; 95% CI, 1.35-3.15) and receipt of paclitaxel/nab-paclitaxel (RR 1.93; 95% CI, 1.19-3.13) increased the likelihood of early discontinuation. Patients receiving anthracyclines had higher rates of hospitalizations during chemotherapy (RR: 1.79; 95% CI, 1.11-2.89). Conclusion Toxicities are the most common reason for treatment modifications and need close monitoring in high-risk groups for timely intervention. Dose reductions and early treatment discontinuations occurred more for Black patients and need further study. [ABSTRACT FROM AUTHOR]

Introduction Early discontinuation of endocrine therapy (ET) is higher among patients with early breast cancer (EBC) compared to patients with metastatic hormone receptor-positive (HR+) breast cancer (MBC). In our clinical experience the reasons for this may include a significant burden of ET side effects impacting quality of life (QOL) in patients with EBC. We hypothesized that QOL is lower in patients with HR + EBC compared to patients with HR + MBC on ET. Methods We conducted a cross-sectional observational study to assess QOL utilizing FACT-ES & EORTC QLQ C30 tools among patients with EBC and MBC receiving ET across 5 Irish hospitals. Results A total of 417 patients were enrolled—EBC (79% n  = 331) and MBC 21% (n  = 86). Using the FACT-ES, we found no difference in overall QOL by stage (139.2 vs 141, P  = .33). Patients with HR + MBC had a lower symptom burden from ET compared to HR + EBC (61.4 vs 54, P  < .01). In adjusted multivariate linear regression models, there was no difference in QOL for patients with EBC and MBC receiving ET. Conclusions There was no significant difference in overall QOL for patients with EBC and MBC. However, patients with EBC experienced more endocrine symptoms. In adjusted multivariate linear regression models, the stage did not predict QOL. Our results suggest that endocrine symptoms are significant contributors to impaired QOL for patients with EBC but the role of other determinants of QOL (eg, stage) is less clear. Future work could include the development of stage-specific QOL tools and utilization of electronic patient-reported outcomes (ePROs) to identify and manage emergent toxicities. [ABSTRACT FROM AUTHOR]

Background Frailty is a dynamic syndrome characterized by reduced physiological reserve to maintain homeostasis. Prospective studies have reported frailty worsening in women with breast cancer during chemotherapy, with improvements following treatment. We evaluated whether the Faurot frailty index, a validated claims-based frailty measure, could identify changes in frailty during chemotherapy treatment and identified predictors of trajectory patterns. Methods We included women (65+ years) with stage I-III breast cancer undergoing adjuvant chemotherapy in the SEER-Medicare database (2003-2019). We estimated the Faurot frailty index (range: 0-1; higher scores indicate greater frailty) at chemotherapy initiation, 4 months postinitiation, and 10 months postinitiation. Changes in frailty were compared to a matched noncancer comparator cohort. We identified patterns of frailty trajectories during the year following chemotherapy initiation using K-means clustering. Results Twenty-one thousand five hundred and ninety-nine women initiated adjuvant chemotherapy. Mean claims-based frailty increased from 0.037 at initiation to 0.055 4 months postchemotherapy initiation and fell to 0.049 10 months postinitiation. Noncancer comparators experienced a small increase in claims-based frailty over time (0.055-0.062). We identified 6 trajectory patterns: a robust group (78%), 2 resilient groups (16%), and 3 nonresilient groups (6%). Black women and women with claims for home hospital beds, wheelchairs, and Parkinson's disease were more likely to experience nonresilient trajectories. Conclusions We observed changes in a claims-based frailty index during chemotherapy that are consistent with prior studies using clinical measures of frailty and identified predictors of nonresilient frailty trajectories. Our study demonstrates the feasibility of using claims-based frailty indices to assess changes in frailty during cancer treatment. [ABSTRACT FROM AUTHOR]

Introduction: Levels of the human epidermal growth factor receptor 2 (HER2) gene are low in normal breast tissue, but half of the patients with breast cancer exhibit higher levels of this receptor. The differential expression of the HER2 gene in normal and malignant cells makes it an excellent biomarker for therapeutic purposes. In this study, we evaluated the degree of HER2 overexpression in patients and its relationship with age and the occurrence of metastases. Materials & Methods: In this retrospective, registry-based, two-center cohort study, information on 1500 breast cancer patients recruited from Shahid Mostafa Khomeini Hospital in Ilam Province was collected from 2020 to 2023. Results: The likelihood of metastasis in cancer patients with HER2 gene expression was three times higher (adjusted OR: 2.82; 95% CI: 1.79-3.29; P=0.001). Additionally, the involvement of lymph nodes (adjusted OR: 2.01; 95% CI: 0.87-3.79; P=0.03) was significantly associated with increased metastasis. Conclusion: This study demonstrates that HER2 gene expression and the number of involved lymph nodes are significant prognostic factors that increase the risk of metastasis. Therefore, implementing comprehensive breast cancer screenings can play an important role in the treatment and prevention of metastasis in breast cancer patients. [ABSTRACT FROM AUTHOR]

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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]

A Polydimethylsiloxane (PDMS) based antenna is designed for skin tumor detection. The antenna functions at 2.45 GHz with a bandwidth of 2.30–2.64 GHz working in the ISM (Industrial, Scientific, and Medical) band. The size of the antenna is 40 × 40 × 1 mm3. This antenna detects tumors in the skin by considering the variations in values of the E-field, J-surf, and H-field. Various analyses such as the distance between the patch and stacked layer skin phantom for different tumor sizes and input power to the antenna are changed and antenna performance is observed. A significant amount of changes is attained which denotes the presence of the tumor. The proposed antenna is fabricated and the corresponding results are analyzed in the Anechoic Chamber. The antenna has an efficiency of 99 % with a Specific Absorption Rate of 1.3846 W/kg which is lower than 1.6 W/kg as per the recommendations of FCC standard. [ABSTRACT FROM AUTHOR]

Breast cancer remains a leading cause of morbidity and mortality among women worldwide, emphasizing the urgent need for enhanced diagnostic and therapeutic approaches. Leucine-rich-alpha-2-glycoprotein 1 (LRG1) has emerged as a notable target due to its markedly elevated expression in breast tumors, suggesting the viability of LRG1 as a theranostic target. In our study, we employed phage display technology to identify a peptide, termed ET, that binds to LRG1 with a dissociation constant of 48.4 µM. After modified with fluorescent cyanine dye, the ET peptide showcased effective tumor-targeting imaging across three different primary breast tumor models and a metastatic breast tumor model. We also undertook a comprehensive safety evaluation, which verified the good biosafety credentials of ET peptide. In summary, the ET peptide identified in this study shows effective LRG1-targeting ability both in vitro and in vivo, thus exhibiting immense potential for clinical translation. [ABSTRACT FROM AUTHOR]

Background. Breast cancer is an important cause of cancer‐related death in women worldwide and represents the second most frequent cause of brain metastases after lung cancer. The aim of this study was to determine the characteristics and outcomes of triple‐negative breast cancer (TNBC) patients with brain metastasis (BM). Methods. We retrospectively reviewed a cohort of patients diagnosed with TNBC at the "Instituto Nacional de Enfermedades Neoplasicas" (period 2000–2014) to evaluate patients who developed BM. Survival rates were assessed by the Kaplan–Meier method, and prognostic factors were identified with the Cox regression analysis. Results. Of a total of 2007 TNBC patients, 193 (9.62%) developed BM. Of these, 169 stages I–III patients with a median age of 45 years (range:21–78) were included. The stage in this cohort was 4 (2.4%) clinical stage (CS) I, 23 (13.6%) with CS II and 142 (84.0%) with CS III. Most of these patients presented ECOG ≥2 (68.6%). The most common symptom was headache (74.0%), followed by nausea‐vomiting (46.7%). Imaging showed that 80 patients (53.0%) had ≥1 metastatic brain lesion. Regarding the treatment of BM in this cohort, 132 patients (84.6%) received radiotherapy (RT), 2 (1.5%) surgery, and 6 (4.5%) surgery plus RT. The overall survival (OS) rate of BM was 59.8%, 37.3%, and 15.0% at 3, 6, and 12 months, respectively. A multivariate analysis showed RT to be the only factor with a positive impact on the OS of BM (hazard ratio (HR) = 0.48, 95% confidence interval (CI):0.30‐0.77, and p = 0.002), while ECOG ≥2 was associated with a worse OS (HR = 1.69, 95%CI:1.15–2.48, and p = 0.007). Conclusion. Despite the poor prognosis of TNBC patients who develop BM, RT showed a benefit in OS rates, while ECOG ≥2 was the only prognostic factor associated with a worse OS. These results may be useful for multidisciplinary teams for treatment planning in patients with TNBC and BM. [ABSTRACT FROM AUTHOR]

Isoliquiritigen (ISL), a constituent of licorice, has been shown to possess antitumorigenic effects in diverse cancer types. In this study, we observed that ISL suppressed breast tumor development significantly more effectively in immunocompetent mice than in immunocompromised ones. In exploring the cause of such a discrepancy, we detected robust tumor infiltration of CD8+ T lymphocytes in mice treated with ISL, not seen in tumors derived from vehicle-treated mice. Moreover, we found a dramatic reduction in PD-L1 in both experimental breast tumors and cultured breast cancer cells upon ISL treatment. In further experiments, we showed that ISL selectively elevated miR-200c in breast cancer and confirmed that PD-L1 mRNA is the target of miR-200c in both murine and human breast cancer cells. ISL suppression of PD-L1 was functionally linked to miR-200c/ZEB1/2 because (1) ISL diminished ZEB1/2; (2) knockdown of ZEB1/2 led to the disappearance of PD-L1; and (3) miR-200c antagomiR disabled ISL to reduce PD-L1. We found evidence that ISL reduced the level of PD-L1 by simultaneously intercepting the ERK and Src signaling pathways. In agreement with clinical finding that PD-L1 antibodies enhance efficacy of taxane-based therapy, we showed that ISL improved the tumoricidal effects of paclitaxel in an orthopedic murine breast tumor model. This study demonstrates that ISL-led tumor suppression acts through the augmentation of host antitumor immunity. [ABSTRACT FROM AUTHOR]

Estrogens regulate eosinophilia in asthma and other inflammatory diseases. Further, peripheral eosinophilia and tumor-associated tissue eosinophilia (TATE) predicts a better response to immune checkpoint blockade (ICB) in breast cancer. However, how and if estrogens affect eosinophil biology in tumors and how this influences ICB efficacy has not been determined. Here, we report that estrogens decrease the number of peripheral eosinophils and TATE, and this contributes to increased tumor growth in validated murine models of breast cancer and melanoma. Moreover, estrogen signaling in healthy female mice also suppressed peripheral eosinophil prevalence by decreasing the proliferation and survival of maturing eosinophils. Inhibiting estrogen receptor (ER) signaling decreased tumor growth in an eosinophil-dependent manner. Further, the efficacy of ICBs was increased when administered in combination with anti-estrogens. These findings highlight the importance of ER signaling as a regulator of eosinophil biology and TATE and highlight the potential near-term clinical application of ER modulators to increase ICB efficacy in multiple tumor types. [ABSTRACT FROM AUTHOR]

Breast cancer, a prevalent and life-threatening disease, necessitates early detection for the effective intervention and the improved patient health outcomes. This paper focuses on the critical problem of identifying breast cancer using a model called Attention U-Net. The model is utilized on the Breast Ultrasound Image Dataset (BUSI), comprising 780 breast images. The images are categorized into three distinct groups: 437 cases classified as benign, 210 cases classified as malignant, and 133 cases classified as normal. The proposed model leverages the attention-driven U-Net's encoder blocks to capture hierarchical features effectively. The model comprises four decoder blocks which is a pivotal component in the U-Net architecture, responsible for expanding the encoded feature representation obtained from the encoder block and for reconstructing spatial information. Four attention gates are incorporated strategically to enhance feature localization during decoding, showcasing a sophisticated design that facilitates accurate segmentation of breast tumors in ultrasound images. It displays its efficacy in accurately delineating and segregating tumor borders. The experimental findings demonstrate outstanding performance, achieving an overall accuracy of 0.98, precision of 0.97, recall of 0.90, and a dice score of 0.92. It demonstrates its effectiveness in precisely defining and separating tumor boundaries. This research aims to make automated breast cancer segmentation algorithms by emphasizing the importance of early detection in boosting diagnostic capabilities and enabling prompt and targeted medical interventions. [ABSTRACT FROM AUTHOR]

Background: The presence of lymphovascular invasion (LVI) in cases with breast cancer is considered a bad prognostic sign. The purpose of this study is to compare the efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) versus unenhanced magnetic resonance imaging (UE-MRI + DBT) in predicting LVI in women with pathologically confirmed breast cancer. Methods: This prospective self-controlled study enrolled a total of 70 cases of pathologically proven breast cancer. All the patients underwent tomosynthesis, non-contrast, and post-contrast MRI. Depending on the broken halo sign seen in tomosynthesis, peritumoral edema, dark rim diffusion at diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) values evaluated in MRI. Results: The accuracy of LVI detection by tomosynthesis was 58%; unenhanced and enhanced MRI had the same results at 60%. The accuracy of detecting LVI was raised to 64% by combining the tomosynthesis results with unenhanced MRI. Conclusions: Tomosynthesis parameters are promising tools in detecting LVI in breast cancer with better diagnostic accuracy in combination with unenhanced MRI. [ABSTRACT FROM AUTHOR]

Radiotherapy (RT) serves as one of the key adjuvant treatments in management of breast cancer. Nevertheless, RT has two major problems: side effects and radioresistance. Given that patients respond differently to RT, it is imperative to understand the molecular mechanisms underlying these differences. Two-thirds of human genes do not encode proteins, as we have realized from genome-scale studies conducted after the advent of the genomic era; nevertheless, molecular understanding of breast cancer to date has been attained almost entirely based on protein-coding genes and their pathways. Long non-coding RNAs (lncRNAs) are a poorly understood but abundant class of human genes that yield functional non-protein-coding RNA transcripts. Here, we canvass the field to seek evidence for the hypothesis that lncRNAs contribute to radioresistance in breast cancer. RT-responsive lncRNAs ranging from "classical" lncRNAs discovered at the dawn of the post-genomic era (such as HOTAIR, NEAT1, and CCAT), to long intergenic lncRNAs such as LINC00511 and LINC02582, antisense lncRNAs such as AFAPAS1 and FGD5-AS1, and pseudogene transcripts such as DUXAP8 were found during our screen of the literature. Radiation-related pathways modulated by these lncRNAs include DNA damage repair, cell cycle, cancer stem cells phenotype and apoptosis. Thus, providing a clear picture of these lncRNAs' underlying RT-relevant molecular mechanisms should help improve overall survival and optimize the best radiation dose for each individual patient. Moreover, in healthy humans, lncRNAs show greater natural expression variation than protein-coding genes, even across individuals, alluding to their exceptional potential for targeting in truly personalized, precision medicine. [ABSTRACT FROM AUTHOR]

Background: Studies in the United States are scarce that assess the survival differences between breast-conserving surgery plus radiation (Breast-Conserving Therapy; BCT) and mastectomy groups using population-based data while accounting for sociodemographic and clinical factors that affect the survival of women with early-stage breast cancer (ESBC). Objective: To assess whether BCT provides superior long-term overall survival (OS) and breast cancer-specific survival (BCSS) compared with mastectomy in women with ESBC, while considering key factors that impact survival. Design: Cohort study. Methods: We analyzed data on women aged 20 years and older diagnosed with stage I-II breast cancer (BC) in 2004 who received either BCT or mastectomy. The data were collected by 5 state cancer registries through the Centers for Disease Control and Prevention-funded Patterns of Care study. Multivariable Cox proportional hazard models, accounting for sociodemographic and clinical factors, were used to calculate hazard ratios (HRs) with 95% confidence intervals (CI). Sensitivity analysis involved optimal caliper propensity score (PS) matching to address residual confounding. Results: Of the 3495 women, 41.5% underwent mastectomy. The 10-year OS and BCSS were 82.7% and 91.1% for BCT and 72.3% and 85.7% for mastectomy, respectively. Adjusted models showed that mastectomy recipients had a 22% higher risk of all-cause deaths (ACD) (HR = 1.22, 95% CI = [1.06, 1.41]) and a 26% higher risk of breast cancer-specific deaths (BCD) (HR = 1.26, 95% CI = [1.02, 1.55]) than BCT recipients. Sensitivity analysis demonstrated that mastectomy was associated with a higher risk of ACD (P <.05) but did not exhibit a statistically significant risk for BCD. Women with HR+/HER2+ (luminal B) or invasive ductal carcinoma BC who underwent mastectomy had higher risks of ACD and BCD compared with BCT recipients, while the hazards for ACD in triple-negative BC did not remain significant after adjusting for covariates. Conclusion: ESBC BCT recipients demonstrate superior OS and BCSS compared with mastectomy recipients. Plain Language Summary: Breast-preserving treatment leads to higher 10-year survival in early-stage breast cancer This study compared the long-term survival outcomes of breast-conserving therapy (BCT) and mastectomy for early-stage breast cancer. Analyzing data from over 3400 women diagnosed in 2004, researchers found that BCT recipients had higher 10-year overall and breast cancer-specific survival rates compared with mastectomy recipients. Adjusted models showed a 22% higher risk of all-cause death [ABSTRACT FROM AUTHOR]

Objective: Metaplastic breast carcinoma (MBC) is a special type of morphologically heterogeneous and aggressively invasive breast cancer. MBC is characterized by the transformation of tumor epithelium into squamous epithelium and/or mesenchymal components, including differentiation into spindle cells, chondrocytes, and osteocytes. Due to its rarity and invasiveness, there is a paucity of research on MBC prognosis. Furthermore, there are currently no treatment guidelines for MBC. This study analyzed the clinicopathological characteristics, immunophenotype, and prognostic features of MBC. Our aim was to better characterize MBC, thereby identifying potential prognostic factors and new treatment methods. Moreover, we also describe an MBC case treated experimentally with anti-vascular targeted therapy. Material and Methods: We retrospectively analyzed clinical pathological data on 54 female patients with MBC from Shaanxi Provincial People's Hospital and the XiJing Hospital of Air Force Medical University. These cases were diagnosed with MBC between January 1st, 2013, and October 1st, 2018. All patients were from the northwest region of China. The gross morphological, histological, and immunohistochemical features of MBC were analyzed. Kaplan–Meier analysis was used to calculate the survival rate, and univariate analysis was performed to identify significant prognostic factors. In addition, the treatment of an MBC patient with anti-angiogenic therapy was described, and a relevant literature review was conducted. Results: MBC was diagnosed in 32 left breasts and 22 right breasts from 54 women aged 21–76 years (median age of 57 years). The maximum tumor diameter ranged from 0.6 to 14 cm (average of 4.1 cm). Of the 54 patients, 47 underwent surgical treatment, with lymph node metastasis found in 17.0% (8/47). According to the World Health Organization classification criteria for breast tumors, the study cohort consisted of 15 cases of squamous cell carcinoma, ten cases of spindle cell carcinoma, nine cases of carcinoma with associated stromal differentiation, 18 cases of mixed carcinoma, and two cases of adenocarcinoma with squamous differentiation. Based on the American Joint Committee on Cancer clinical staging criteria, the patients were classified as Stage I (10 cases, 18.5%), Stage II (26 cases, 48.1%), Stage III (11 cases, 20.4%), and Stage IV (7 cases, 13.0%). Immunohistochemical analysis revealed that 94.4% of patients had triple-negative breast cancer (TNBC), 47 cases showed mutant tumor protein 53 (TP53) expression, 29 cases showed positive epidermal growth factor receptor (EGFR) expression, 43 cases showed positive E-cadherin expression, and 37 cases showed positive Cluster of Differentiation 24 expression. The Ki-67 index ranged from 20% to 90%. Univariate analysis showed that the Ki-67 index was not significantly associated with either progression-free survival (PFS) or overall survival (OS) in MBC patients. Patients with negative axillary lymph nodes had significantly better PFS and OS than those with positive nodes (P < 0.05), and patients with clinical stage I-II disease had better PFS and OS than those with stage III-IV disease (P < 0.05). Patients treated with anthracycline-containing chemotherapy had significantly better PFS than those who did not receive chemotherapy. Univariate analysis revealed that the high expression of EGFR correlated with worse PFS (P < 0.05). The type of surgical approach employed did not affect the prognosis of MBC patients. Following the application of anti-angiogenic therapy, a rapid partial response was observed in an MBC patient with carcinoma and associated stromal differentiation. This patient subsequently underwent surgery and radiation therapy and has now achieved over 6 years of PFS. Conclusion: MBC is a heterogeneous group of tumors with high malignancy and poor prognosis. The large majority is TNBC and exhibits unique immune phenotypes. The poor PFS of MBC patients may be related to EGFR expression, which could become a potential therapeutic target in these patients. Surgery remains the primary treatment method for MBC. The present study found that sentinel lymph node biopsy was feasible in appropriate patients, and that chemotherapy regimens incorporating anthracycline-class drugs did not appear to improve OS. Anti-angiogenic therapy holds promise as a potentially effective treatment approach for MBC, and the optimization of systemic treatment strategies should be a priority in the management of these patients. [ABSTRACT FROM AUTHOR]

Objective: Challenging differential diagnosis Background: Occult breast cancer (OBC) is diagnosed when regional or distant metastases are found without evidence of a primary tumor. The low overall incidence is a great challenge for the management strategy of OBC. Aggressive diagnosis and personalized treatment are feasible treatment strategies for OBC. We report the case of an OBC patient who achieved pathological complete response (pCR) after neoadjuvant chemotherapy. Case Report: A 43-year-old woman was admitted to the hospital 6 months after detecting a lump in her left axilla, about the size of a quail egg, but not red or swollen, and the lump gradually grew. Mammography, ultrasound, and magnetic resonance imaging showed a visible left axilla lesion but no nodules in bilateral breasts. A core-needle biopsy of the axilla lesion revealed an invasive carcinoma of breast origin. The tumor cells were estrogen receptors (ER)-negative, progesterone receptor (PR)-negative, and HER2-positive (3+) by immunohistochemistry. The patient was finally diagnosed with HER2-positive, hormone receptor-negative occult breast cancer of the left breast, cT0N2M0, stage IIIA. The TCbHP regimen (docetaxel, carboplatin, trastuzumab, and pertuzumab) as neoadjuvant chemotherapy was given. She underwent a modified radical mastectomy, showing a pCR. Subsequent radiotherapy and HER2-targeted therapy were administrated. Conclusions: This case highlights that even aggressive HER2-positive breast cancer can present as an occult primary tumor. Our clinical experience suggests that neoadjuvant chemotherapy followed by modified radical mastectomy can be effective for treating such rare cases. The patient achieved pCR, which can provide a therapeutic strategy for effective treatment of similar OBCs [ABSTRACT FROM AUTHOR]

Aims: This evaluation combines clinical and non-clinical collaborative breast referral triage to gain an understanding relating to the value of triage, by identifying 'suspected cancer' and 'cancer not suspected' populations, improve the patient pathway, and facilitate optimised resource availability. Method: An iterative service improvement method was used, with distinct phases of the process outlined to facilitate testing of ideas. The evaluation ran for 13 weeks in 2022. Regular team member meetings were arranged to discuss and agree improvement aims and outcomes. Findings: A triage flowchart was developed collaboratively, and subsequently adopted by the non-clinical booking team. Bespoke clinics were established, demonstrating no evidence of increased risk to patients, and meeting 28-day Faster Diagnosis Standard (FDS) requirements. Conclusion: breast referral triage of 'suspected cancer' and 'cancer not suspected' patients, using a clinical and non-clinical collaborative approach facilitates improved service visibility, prioritisation, management, and measurement. This also supports delivery of the 2019 NHS Long Term Plan to enhance earlier and faster cancer diagnosis by optimising access to diagnostic resources where required. [ABSTRACT FROM AUTHOR]

Introduction. Breast cancer is currently the most frequently detected cancer in women and the primary cause of cancer‐related deaths globally. The incidence of breast cancer has significantly increased in countries across sub‐Saharan Africa, counting Ethiopia. There are multiple determinants of breast cancer, a few of these can be changeable whereas others are not. Evidence suggests that breastfeeding, which is a changeable determinant, reduces breast cancer risk. However, there is a lack of evidence specifically linking the duration of breastfeeding to breast cancer risk. To date, no study has been conducted on the association between the duration of breastfeeding and the likelihood of breast cancer among Ethiopian women. Objective. The aim of this study was to evaluate the relationship between breastfeeding duration and breast cancer risk in Ethiopian mothers who had breastfed, taking into account other significant determinants. Methods. A hospital‐based case‐control study was carried out in Bahir Dar, Ethiopia, involving 203 women (70 cases and 133 controls). Face‐to‐face interviews were performed using a standardized, validated questionnaire that assessed various sociodemographic, reproductive, lifestyle, and dietary characteristics. Differences between cases and controls were evaluated using the chi‐square test. The associations among factors were examined through bivariate and multivariable binary logistic regression, with results presented as odds ratios and 95% confidence intervals. Results. The multivariable investigation revealed that an inverse relationship between breastfeeding duration and breast cancer risk. Mothers who breastfed for a longer period had a 93% lower risk of breast cancer (AOR = 0.07; 95% CI: 0.021–0.21) compared to those who breastfed for a shorter duration. Younger mothers had a 95% lower likelihood of developing breast cancer (AOR = 0.05; 95% CI: 0.003–0.91) than older mothers. Additionally, mothers with sedentary behaviour were 10.53 times more likely to develop breast cancer (AOR = 10.53; 95% CI: 5.21–21.36) than those who were moderately or highly active. Mothers who experienced chest therapy were 6.43 times more likely to develop breast cancer (AOR = 6.43; 95% CI: 3.20–13.90) compared to those who had not. Conclusions. Interventions such as breastfeeding counselling and promoting the recommended duration of breastfeeding are crucial in minimizing the risk of breast cancer. Enhancing physical activity should also be viewed as a vital approach for lowering breast cancer risk. Additionally, healthcare professionals need to limit exposure to chest radiation therapy to reduce the likelihood of breast cancer. [ABSTRACT FROM AUTHOR]