Breast Cancer Screening, Management, and a Review of Case Study Literature in Transgender Populations

AbstractBecause of a lack of uniform collection of gender identity data, population-level breast cancer statistics in the transgender community are unknown. With recent estimates that at least 0.6% (1 in every 167 people) of the U.S. population is transgender, guidance on breast cancer risk, screening, and management in this population is needed. Such guidance should examine modifications, if any, to recommendations in cisgender populations, taking into consideration any history of hormone therapy exposure or breast surgery. This article describes existing evidence on breast cancer incidence in transgender women and men, and attempts to make rational recommendations regarding the screening for and approach to managing breast cancer in transgender populations. Current data are mostly limited to case reports which are reviewed here. More prospective, population-level research is needed to better understand the risks and predictors of breast cancer in this population, as well as to better inform the most appropriate screening modality, age of starting screening, and interval. Ultimately, a risk score calculator similar to existing risk models such as the Gail score, as well as an approach to shared decision making that involves patient-centered perspectives, is needed to best guide practices in this area.

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Acute Liver Failure with Diffuse Liver Metastasis from Breast Cancer, Not Detected by Computed Tomography: 2 Case Reports

Case Reports in Oncology ◽

10.1159/000493848 ◽

2018 ◽

Vol 11 (3) ◽

pp. 699-704 ◽

Cited By ~ 3

Author(s):

Takatsugu Ogata ◽

Yuichiro Kikawa ◽

Misato Ogata ◽

Hironaga Satake ◽

Yukimasa Hatachi ◽

...

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Liver Metastasis ◽

Liver Failure ◽

Acute Liver Failure ◽

Hepatic Failure ◽

Poor Prognosis ◽

Alcoholic Hepatitis ◽

Case Reports ◽

History Of

Diffuse liver metastasis is a rare pattern of liver metastasis that is associated with hepatic failure and poor prognosis. We experienced 2 cases of acute liver failure due to diffuse metastasis that could not be detected using computed tomography. In case 1, it was difficult to differentiate diffuse metastasis from alcoholic hepatitis. In case 2, it was difficult to diagnose diffuse liver metastasis because the patient had no history of malignancy. When liver enzyme levels are elevated, it is necessary to consider liver metastasis as a potential cause, regardless of computed tomography findings.

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Drug-induced liver injury after switching from tamoxifen to anastrozole in a patient with a history of breast cancer being treated for hypertension and diabetes

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622320964152 ◽

2020 ◽

Vol 11 ◽

pp. 204062232096415

Author(s):

Petr Potmešil ◽

Radka Szotkowská

Keyword(s):

Breast Cancer ◽

Liver Injury ◽

Early Stage ◽

Case Reports ◽

Cancer Resistance ◽

Cytochrome P450 Enzymes ◽

Drug Induced ◽

Peripheral Tissues ◽

History Of ◽

Resistance Protein

Anastrozole is a selective non-steroidal aromatase inhibitor that blocks the conversion of androgens to estrogens in peripheral tissues. It is used as adjuvant therapy for early-stage hormone-sensitive breast cancer in postmenopausal women. Significant side effects of anastrozole include osteoporosis and increased levels of cholesterol. To date, seven case reports on anastrozole hepatotoxicity have been published. We report the case of an 81-year-old woman with a history of breast cancer, arterial hypertension, type 2 diabetes mellitus, hyperlipidemia, and chronic renal insufficiency. Four days after switching hormone therapy from tamoxifen to anastrozole, icterus developed along with a significant increase in liver enzymes (measured in the blood). The patient was admitted to hospital, where a differential diagnosis of jaundice was made and anastrozole was withdrawn. Subsequently, hepatic functions quickly normalized. The observed liver injury was attributed to anastrozole since other possible causes of jaundice were excluded. However, concomitant pharmacotherapy could have contributed to the development of jaundice and hepatotoxicity, after switching from tamoxifen to anastrozole since several the patient’s medications were capable of inhibiting hepatobiliary transport of bilirubin, bile acids, and metabolized drugs through inhibition of ATP-binding cassette proteins. Telmisartan, tamoxifen, and metformin all block bile salt efflux pumps. The efflux function of multidrug resistance protein 2 is known to be reduced by telmisartan and tamoxifen and breast cancer resistance protein is known to be inhibited by telmisartan and amlodipine. Moreover, the activity of P-glycoprotein transporters are known to be decreased by telmisartan, amlodipine, gliquidone, as well as the previously administered tamoxifen. Finally, the role of genetic polymorphisms of cytochrome P450 enzymes and/or drug transporters cannot be ruled out since the patient was not tested for polymorphisms.

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Breast Density and Breast Cancer Incidence in the Lebanese Population: Results from a Retrospective Multicenter Study

BioMed Research International ◽

10.1155/2017/7594953 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Christine Salem ◽

David Atallah ◽

Joelle Safi ◽

Georges Chahine ◽

Antoine Haddad ◽

...

Keyword(s):

Breast Cancer ◽

Breast Density ◽

Breast Cancer Incidence ◽

Menopausal Status ◽

Western Society ◽

Dense Breasts ◽

Menopausal Women ◽

Diagnostic Mammography ◽

History Of ◽

Retrospective Multicenter Study

Purpose. To study the distribution of breast mammogram density in Lebanese women and correlate it with breast cancer (BC) incidence.Methods. Data from 1,049 women who had screening or diagnostic mammography were retrospectively reviewed. Age, menopausal status, contraceptives or hormonal replacement therapy (HRT), parity, breastfeeding, history of BC, breast mammogram density, and final BI-RADS assessment were collected. Breast density was analyzed in each age category and compared according to factors that could influence breast density and BC incidence.Results. 120 (11.4%) patients had BC personal history with radiation and/or chemotherapy; 66 patients were postmenopausal under HRT. Mean age was52.58±11.90years. 76.4% of the patients (30–39 years) had dense breasts. Parity, age, and menopausal status were correlated to breast density whereas breastfeeding and personal/family history of BC and HRT were not. In multivariate analysis, it was shown that the risk of breast cancer significantly increases 3.3% with age (P=0.005), 2.5 times in case of menopause (P=0.004), and 1.4 times when breast density increases (P=0.014).Conclusion. Breast density distribution in Lebanon is similar to the western society. Similarly to other studies, it was shown that high breast density was statistically related to breast cancer, especially in older and menopausal women.

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Simulating the Impact of Risk-Based Screening and Treatment on Breast Cancer Outcomes with MISCAN-Fadia

Medical Decision Making ◽

10.1177/0272989x17711928 ◽

2018 ◽

Vol 38 (1_suppl) ◽

pp. 54S-65S ◽

Cited By ~ 9

Author(s):

Jeroen J. van den Broek ◽

Nicolien T. van Ravesteyn ◽

Eveline A. Heijnsdijk ◽

Harry J. de Koning

Keyword(s):

Breast Cancer ◽

Natural History ◽

Tumor Growth ◽

Life Histories ◽

Breast Cancer Incidence ◽

Detection Threshold ◽

Tumor Diameter ◽

Incidence And Mortality ◽

History Of ◽

The Impact

The MISCAN-Fadia microsimulation model uses continuous tumor growth to simulate the natural history of breast cancer and has been used extensively to estimate the impact of screening and adjuvant treatment on breast cancer incidence and mortality trends. The model simulates individual life histories from birth to death, with and without breast cancer, in the presence and in the absence of screening and treatment. Life histories are simulated according to discrete events such as birth, tumor inception, the tumor’s clinical diagnosis diameter in the absence of screening, and death from breast cancer or death from other causes. MISCAN-Fadia consists of 4 main components: demography, natural history of breast cancer, screening, and treatment. Screening impact on the natural history of breast cancer is assessed by simulating continuous tumor growth and the “fatal diameter” concept. This concept implies that tumors diagnosed at a size that is between the screen detection threshold and the fatal diameter are cured, while tumors diagnosed at a diameter larger than the fatal tumor diameter metastasize and lead to breast cancer death. MISCAN-Fadia has been extended by including a different natural history for molecular subtypes based on a tumor’s estrogen receptor (ER) status and human epidermal growth factor receptor 2 (HER2) status. In addition, personalized screening strategies that target women based on their risk such as breast density have been incorporated into the model. This personalized approach to screening will continue to develop in light of potential polygenic risk stratification possibilities and new screening modalities.

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Capecitabine-Induced Hyperosmolar Hyperglycemic State

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.754 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A370-A371

Author(s):

Carly Yim ◽

Terra G Arnason ◽

Nassrein Hussein

Keyword(s):

Breast Cancer ◽

Diabetes Mellitus ◽

Blood Glucose ◽

Case Reports ◽

Family Doctor ◽

Metastatic Breast ◽

Insulin Regimen ◽

Her Family ◽

Hyperglycemic Hyperosmolar State ◽

History Of

Abstract Capecitabine is an orally administered prodrug of 5-fluorouracil (5-FU) which is often used for treatment of solid tumour cancers such as breast cancer and gastrointestinal tumours. Common adverse effects include nausea, diarrhea, anorexia and erythrodysthesia (hand-foot syndrome). However, there have been case reports of metabolic disturbances linked to capecitabine including hyperlipidemia, and less commonly, hyperglycemia. We report a case of a new diagnosis of persistent diabetes mellitus following an acute presentation of hyperosmolar hyperglycemic syndrome (HHS) subsequent to treatment with the chemotherapy agent, capecitabine. A 72 year old female with a history of metastatic breast cancer was admitted to hospital for management of hyperglycemic hyperosmolar state (HHS) after bloodwork from her family doctor revealed an elevated random blood glucose (40.2 mmol/L). Leading up to her presentation, the patient had completed 7 cycles of capecitabine treatment for her breast cancer. Prior to her capecitabine treatment, the patient did not have a history of diabetes mellitus. However, on admission, her hemoglobin A1C (HbA1C) was found to elevated into the diabetic range. Offending medications were considered and given the temporal dysglycemia following the patient’s chemotherapy regimen, capecitabine was thought to be a probable offending agent. The patient was acutely treated for HHS, and eventually transitioned to a basal-bolus insulin regimen at discharge. Her capecitabine was held pending review with her oncology team and she was closely followed up by her family doctor. The patient’s insulin regimen was ultimately titrated down to basal insulin only. Given the increasing use of capecitabine therapy in breast cancer, it is important to recognize the risk of hyperglycemia and hyperglycemic emergencies as a potential adverse effect of this treatment. It highlights the need to ensure that blood glucose is monitored throughout treatment to prevent hyperglycemic emergencies.

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Trends in Leading Cancer Incidence among Iranian Women: Annual Cancer Registry Reports, 2003-2015

Iranian Journal of Public Health ◽

10.18502/ijph.v50i8.6818 ◽

2021 ◽

Author(s):

Razieh Bidhendi-Yarandi ◽

Mohammad Hossein Panahi

Keyword(s):

Breast Cancer ◽

Cancer Registry ◽

Cancer Incidence ◽

Breast Cancer Incidence ◽

Iranian Women ◽

Annual Percent Change ◽

National Cancer Registry ◽

Incidence Trends ◽

History Of ◽

Increasing Trends

Background: Cancer is one of the most important causes of death in the world and has an increasing trend globally. We aimed at investigating the five leading cancers in Iranian women based on a 10-year history of cancer registry reports and illustrating the trends in all cancer sites and breast cancer as the top leading one from 2003 to 2015. Methods: Data were obtained from national cancer registry study. Age-Specific Incidence Rate (ASR) data were obtained from Iran’s annual national cancer registry reports between 2003 to 2010 and 2014 to 2015. Using Joinpoint regression, we analyzed incidence trends over time for all cancer sites and the top leading cancer from 2003 to 2015. Results: Breast cancer was ranked first in Iranian women. Its ASR raised from 15.96 in 2003 to 32.63 in 2015. Results of trend analysis based on Annual Percent Change (APC) index showed 5.6 (95%CI: 2.9 to 8.3) and 4.6 (95%CI: 2.0 to 7.2) annual increase in the incidence of all cancer sites and breast cancer from 2003 to 2015, respectively. Conclusion: This study indicates significant increasing trends in all cancer sites and breast cancer incidence in Iran. Despite the national coverage of cancer registry over the past decade, more considerations should be taken into account, especially in Breast cancer.

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Studying the Association Between Breast Cancer and Renal Cell Carcinoma

10.21203/rs.3.rs-841536/v1 ◽

2021 ◽

Author(s):

Khalid A Jazieh ◽

Firas Baidoun ◽

Nataly Torrejon ◽

Zahi Merjaneh ◽

Anas Saad ◽

...

Keyword(s):

Breast Cancer ◽

Renal Cell Carcinoma ◽

Genetic Testing ◽

Family History ◽

Cell Carcinoma ◽

Renal Cell ◽

Case Reports ◽

Population Data ◽

Seer Database ◽

History Of

Abstract Purpose: There are case reports of patients with both primary breast cancer (BC) and renal cell carcinoma (RCC). We explore the association between these two malignancies using SEER population data and our institutional records.Methods: We studied the association between BC and RCC in the 2000-2016 Surveillance, Epidemiology and End Results (SEER) database. We then reviewed our hospital records of patients with both BC and RCC and collected information including personal and family history of cancers, genetic testing, and patient outcomes.Results: Of the 813,477 females diagnosed with BC in the SEER database, 1,914 later developed RCC. The risk of developing RCC was significantly increased within the first six months, 7-12 months, and 1-5 years following BC diagnosis with standardized incidence ratios (SIRs) of 5.08 (95% CI, 4.62- 5.57), 2.09 (95% CI, 1.8-2.42), and 1.15 (95% CI, 1.06-1.24), respectively. Of 56,200 females with RCC, 1,087 later developed BC. The risk of developing BC following RCC was elevated within the first six months (SIR of 1.45 [95% CI, 1.20-1.73]). For our hospital patients, 437 had both BC and RCC. 427 (97.71%) were female, and 358 (81.92%) were white, and breast cancer was diagnosed before RCC in 246 (61.5%) patients. There were 15 germline mutations in those with genetic testing. Conclusion:Our findings suggest that BC patients are at higher risk of developing RCC and vice versa. BC tended to precede RCC, and patients frequently had personal histories of other malignancies and a family history of cancer, particularly BC.

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Epidemiology of Moderate Alcohol Consumption and Breast Cancer: Association or Causation?

Cancers ◽

10.3390/cancers10100349 ◽

2018 ◽

Vol 10 (10) ◽

pp. 349 ◽

Cited By ~ 7

Author(s):

Samir Zakhari ◽

Jan Hoek

Keyword(s):

Breast Cancer ◽

Alcohol Consumption ◽

Alcohol Use ◽

Breast Cancer Incidence ◽

Epidemiological Studies ◽

Moderate Alcohol Consumption ◽

Molecular Pathological Epidemiology ◽

History Of ◽

Giant Step ◽

Meta Analyses

Epidemiological studies have been used to show associations between modifiable lifestyle habits and the incidence of breast cancer. Among such factors, a history of alcohol use has been reported in multiple studies and meta-analyses over the past decades. However, associative epidemiological studies that were interpreted as evidence that even moderate alcohol consumption increases breast cancer incidence have been controversial. In this review, we consider the literature on the relationship between moderate or heavy alcohol use, both in possible biological mechanisms and in variations in susceptibility due to genetic or epigenetic factors. We argue that there is a need to incorporate additional approaches to move beyond the associations that are reported in traditional epidemiological analyses and incorporate information on molecular pathologic signatures as a requirement to posit causal inferences. In particular, we point to the efforts of the transdisciplinary field of molecular pathological epidemiology (MPE) to evaluate possible causal relationships, if any, of alcohol consumption and breast cancer. A wider application of the principles of MPE to this field would constitute a giant step that could enhance our understanding of breast cancer and multiple modifiable risk factors, a step that would be particularly suited to the era of “personalized medicine”.

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Induction of Lactation After Adoption in a Muslim Mother With History of Breast Cancer: A Case Study

Journal of Human Lactation ◽

10.1177/0890334420976333 ◽

2020 ◽

pp. 089033442097633

Author(s):

Zainab AbdulHadi Al-Mohsen ◽

Hasan Frookh Jamal

Keyword(s):

Breast Cancer ◽

Human Milk ◽

Milk Production ◽

Main Issue ◽

Biological Mothers ◽

History Of ◽

Maternal Bond ◽

Breast Pump

Introduction With the prevalence of infertility increasing worldwide, many are seeking adoption to fulfill the need to start or expand their family. However, one of the challenges mothers face is the lack of the early maternal bond with the adopted infant, which typically starts during pregnancy, and then continues after birth, while providing care and nourishment to the infant. Breastfeeding is proven to strengthen the maternal–infant bond and provides numerous benefits to the dyad. Reports of induced lactation in non-biological mothers are uncommon, they are even more uncommon to find in women with a history of breast cancer. Main issue The induction of lactation in a Muslim adoptive mother who had a history of breast cancer. Management Pharmacologic methods, which included galactagogues Domperidone and fenugreek, in addition to non-pharmacologic methods that included breast stimulation by using a breast pump. The participant was able to provide her own milk for her adopted infant. Conclusion When provided with proper support, an adopting mother with a history of breast radiation was able to breastfeed. The participant’s need to provide her own expressed milk was met; although, she was counseled on the possibility that her milk production will most likely not be sufficient to entirely meet the infant’s needs. Determination and support definitely have a role in cases where the influence of past treatment on human milk production is not known.

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