Protein biomarkers for subtyping breast cancer and implications for future research

The coronavirus pandemic (COVID-19) has had multilevel effects on non-COVID-19 health and health care, including deferral of routine cancer prevention and screening and delays in surgical and other procedures. Health and health care use has also been affected by pandemic-related loss of employer-based health insurance, food and housing disruptions, and heightened stress, sleep disruptions and social isolation. These disruptions are projected to contribute to excess non-COVID-19 deaths over the coming decades. At the same time municipalities, health systems and individuals are making changes in response to the pandemic, including modifications in the environmental to promote health, implementation of telehealth platforms, and shifts towards greater self-care and using remote platforms to maintain social connections. We used a multi-level biopsychosocial model to examine the available literature on the relationship between COVID-19-related changes and breast cancer prevention to identify current gaps in knowledge and identify potential opportunities for future research. We found that COVID-19 has impacted several aspects of social and economic life, through a variety of mechanisms, including unemployment, changes in health care delivery, changes in eating and activity, and changes in mental health. Some of these changes should be reduced, while others should be explored and enhanced.

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Understanding low chemoprevention uptake by women at high risk of breast cancer: findings from a qualitative inductive study of women’s risk-reduction experiences

BMC Women s Health ◽

10.1186/s12905-021-01279-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tasleem J. Padamsee ◽

Megan Hils ◽

Anna Muraveva

Keyword(s):

Breast Cancer ◽

African American ◽

High Risk ◽

Risk Reduction ◽

White Women ◽

Future Research ◽

Structured Interviews ◽

Critical Gap ◽

High Risk Women ◽

Parent Project

Abstract Background Chemoprevention is one of several methods that have been developed to help high-risk women reduce their risk of breast cancer. Reasons for the low uptake of chemoprevention are poorly understood. This paper seeks a deeper understanding of this phenomenon by drawing on women’s own narratives about their awareness of chemoprevention and their risk-related experiences. Methods This research is based on a parent project that included fifty in-depth, semi-structured interviews with a purposive sample of African American and White women at elevated risk of breast cancer. This specific study draws on the forty-seven interviews conducted with women at high or severe risk of breast cancer, all of whom are eligible to use chemoprevention for breast cancer risk-reduction. Interviews were analyzed using grounded theory methods. Results Forty-five percent of participants, and only 21% of African American participants, were aware of chemoprevention options. Women who had seen specialists were more likely to be aware, particularly if they had ongoing specialist access. Aware and unaware women relied on different types of sources for prevention-related information. Those whose main source of information was a healthcare provider were more likely to know about chemoprevention. Aware women used more nuanced information gathering strategies and worried more about cancer. Women simultaneously considered all risk-reduction options they knew about. Those who knew about chemoprevention but were reluctant to use it felt this way for multiple reasons, having to do with potential side effects, perceived extreme-ness of the intervention, similarity to chemotherapy, unknown information about chemoprevention, and reluctance to take medications in general. Conclusions Lack of chemoprevention awareness is a critical gap in women’s ability to make health-protective choices. Future research in this field must consider complexities in both women’s perspectives on chemoprevention and the reasons they are reluctant to use it.

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Sub-Ethnicity and Survivorship Experience: Asian American Breast Cancer Survivors

Western Journal of Nursing Research ◽

10.1177/01939459211031990 ◽

2021 ◽

pp. 019394592110319

Author(s):

Wonshik Chee ◽

Eun-Ok Im

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Asian American ◽

Breast Cancer Survivors ◽

Short Form ◽

Secondary Analysis ◽

Future Research ◽

Japanese American ◽

Personal Resource ◽

Cancer Data

The purpose of the study was to explore the associations of sub-ethnicity to the survivorship experience of Asian American breast cancer survivors and identify the multiple factors that influenced their survivorship experience. This was a secondary analysis of the data among 94 Asian American breast cancer survivors from a larger ongoing study. Instruments included: questions on background characteristics, the perceived isolation scale, the Personal Resource Questionnaire, the Memorial Symptom Assessment Scale-Short Form, and the Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using hierarchical logistic and multiple regression analyses. After controlling for other factors, being a Japanese American (ref. = being a Chinese American) was significantly associated with pain scores (odds ratio [OR] = −0.32, p < .01), symptom distress scores ( β = −0.27, p < .01), and the quality of life scores ( β = 0.22, p = .03). Sub-ethnic variations in cultural attitudes, values, and beliefs need to be considered in future research/practice with Asian American breast cancer survivors.

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Low abundance protein enrichment for discovery of candidate plasma protein biomarkers for early detection of breast cancer

Journal of Proteomics ◽

10.1016/j.jprot.2011.07.030 ◽

2011 ◽

Vol 75 (2) ◽

pp. 366-374 ◽

Cited By ~ 36

Author(s):

Rong Meng ◽

Michael Gormley ◽

Vadiraja B. Bhat ◽

Anne Rosenberg ◽

Andrew A. Quong

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Plasma Protein ◽

Protein Enrichment ◽

Protein Biomarkers

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Role of n-3 Polyunsaturated Fatty Acids and Exercise in Breast Cancer Prevention: Identifying Common Targets

Nutrition and Metabolic Insights ◽

10.4137/nmi.s39043 ◽

2016 ◽

Vol 9 ◽

pp. NMI.S39043 ◽

Cited By ~ 7

Author(s):

Salma A. Abdelmagid ◽

Jessica L. MacKinnon ◽

Sarah M. Janssen ◽

David W.L. Ma

Keyword(s):

Breast Cancer ◽

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

Cancer Prevention ◽

Breast Cancer Prevention ◽

Future Research ◽

Pufa Intake ◽

Diet And Exercise ◽

Important Study

Diet and exercise are recognized as important lifestyle factors that significantly influence breast cancer risk. In particular, dietary n-3 polyunsaturated fatty acids (PUFAs) have been shown to play an important role in breast cancer prevention. Growing evidence also demonstrates a role for exercise in cancer and chronic disease prevention. However, the potential synergistic effect of n-3 PUFA intake and exercise is yet to be determined. This review explores targets for breast cancer prevention that are common between n-3 PUFA intake and exercise and that may be important study outcomes for future research investigating the combined effect of n-3 PUFA intake and exercise. These lines of evidence highlight potential new avenues for research and strategies for breast cancer prevention.

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Advances in Adjuvant Endocrine Therapy for Postmenopausal Women

Journal of Clinical Oncology ◽

10.1200/jco.2007.15.0946 ◽

2008 ◽

Vol 26 (5) ◽

pp. 798-805 ◽

Cited By ~ 74

Author(s):

Nancy U. Lin ◽

Eric P. Winer

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Endocrine Therapy ◽

Hormone Receptor ◽

Disease Free Survival ◽

Breast Cancer Diagnosis ◽

Endocrine Treatment ◽

Future Research ◽

Sequential Approach ◽

Hormone Receptor Positive

Hormone receptor-positive cancers are the most common tumor subtype among postmenopausal women with breast cancer. Despite substantial improvements in disease-free survival and overall survival with tamoxifen and chemotherapy, recurrences still occur, and may ultimately lead to death from breast cancer. Importantly, disease recurrence includes both early and late events, with over half of all recurrences detected more than 5 years from initial breast cancer diagnosis. In recent years, a number of large, randomized trials have evaluated the role of the aromatase inhibitors (AIs) in postmenopausal women with hormone receptor-positive breast cancer. These studies have tested one of three approaches: (1) an upfront AI, (2) a sequential approach after 2-3 years of tamoxifen, and (3) extended endocrine therapy beyond 5 years. Results of these studies have challenged the previous standard of a 5-year course of tamoxifen alone. While the AIs have become a standard component of treatment for most postmenopausal women, many questions remain as to how best tailor endocrine treatment to individual patients. In addition, despite the gains achieved with the AIs, many recurrences are not prevented, and novel strategies are urgently needed, particularly for those women at high risk of recurrence. In this article, we review the efficacy and toxicity data from the available trials of endocrine therapy in the postmenopausal setting. We outline controversies in choosing the optimal endocrine approach, and we discuss selected ongoing studies. Finally, we highlight future research directions, such as the need to understand host and tumor heterogeneity.

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Potential Epigenetic Mechanism(s) Associated With the Persistence of Psychoneurological Symptoms in Women Receiving Chemotherapy for Breast Cancer

Biological Research For Nursing ◽

10.1177/1099800413483545 ◽

2013 ◽

Vol 16 (2) ◽

pp. 160-174 ◽

Cited By ~ 20

Author(s):

Debra Lyon ◽

Lynne Elmore ◽

Noran Aboalela ◽

Jacqueline Merrill-Schools ◽

Nancy McCain ◽

...

Keyword(s):

Breast Cancer ◽

Sleep Disturbances ◽

Alternative Hypothesis ◽

Epigenetic Mechanism ◽

Future Research ◽

Epigenetic Alterations ◽

Inflammatory Activation ◽

Epigenetic Patterns ◽

Psychoneurological Symptoms ◽

Circulating Levels

Due to recent treatment advances, there have been improvements in the proportion of women surviving a diagnosis of breast cancer (BC). However, many of these survivors report persistent adverse side effects following treatment, such as cognitive dysfunction, depressive symptoms, anxiety, fatigue, sleep disturbances, and pain. Investigators have examined circulating levels of inflammatory markers, particularly serum cytokines, for a potential causal relationship to the development/persistence of these psychoneurological symptoms (PNS). While inflammatory activation, resulting from perceived stress or other factors, may directly contribute to the development of PNS, we offer an alternative hypothesis, suggesting that these symptoms are an early step in a cascade of biological changes leading to epigenetic alterations at the level of deoxyribonucleic acid (DNA) methylation, histone modifications, and/or chromatin structure/chromosomal instability. Given that epigenetic patterns have plasticity, if this conjectured relationship between epigenomic/acquired genomic alterations and the development/persistence of PNS is confirmed, it could provide foundational knowledge for future research leading to the recognition of predictive markers and/or treatments to alleviate PNS in women with BC. In this article, we discuss an evolving theory of the biological basis of PNS, integrating knowledge related to inflammation and DNA repair in the context of genetic and epigenetic science to expand the paradigm for understanding symptom acquisition/persistence following chemotherapy.

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Use of Protein Biomarkers for the Early Detection of Breast Cancer

OMICS ◽

10.1201/b14289-14 ◽

2013 ◽

pp. 299-313 ◽

Cited By ~ 1

Author(s):

Birendra Kumar ◽

Purnmasi Yadav ◽

Surender Singh

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Protein Biomarkers

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A common goal to CARE: Cancer Advocates, Researchers, and Clinicians Explore current treatments and clinical trials for breast cancer brain metastases

npj Breast Cancer ◽

10.1038/s41523-021-00326-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Natalie S. Joe ◽

Christine Hodgdon ◽

Lianne Kraemer ◽

Kristin J. Redmond ◽

Vered Stearns ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Brain Metastases ◽

Detection Methods ◽

Future Research ◽

Breast Cancer Brain Metastasis ◽

Patient Advocates ◽

Breast Cancer Brain Metastases ◽

The Brain

AbstractBreast cancer is the most commonly diagnosed cancer in women worldwide. Approximately one-tenth of all patients with advanced breast cancer develop brain metastases resulting in an overall survival rate of fewer than 2 years. The challenges lie in developing new approaches to treat, monitor, and prevent breast cancer brain metastasis (BCBM). This review will provide an overview of BCBM from the integrated perspective of clinicians, researchers, and patient advocates. We will summarize the current management of BCBM, including diagnosis, treatment, and monitoring. We will highlight ongoing translational research for BCBM, including clinical trials and improved detection methods that can become the mainstay for BCBM treatment if they demonstrate efficacy. We will discuss preclinical BCBM research that focuses on the intrinsic properties of breast cancer cells and the influence of the brain microenvironment. Finally, we will spotlight emerging studies and future research needs to improve survival outcomes and preserve the quality of life for patients with BCBM.

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Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study

PLoS ONE ◽

10.1371/journal.pone.0262468 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262468

Author(s):

Susanna Hilda Hutajulu ◽

Yayi Suryo Prabandari ◽

Bagas Suryo Bintoro ◽

Juan Adrian Wiranata ◽

Mentari Widiastuti ◽

...

Keyword(s):

Breast Cancer ◽

Educational Interventions ◽

Disease Stage ◽

Future Research ◽

Multivariable Logistic Regression Analysis ◽

Initial Symptom ◽

Diagnosis Delay ◽

Cancer Stage ◽

Breast Cancer Patients ◽

Cross Sectional

Purpose To investigate factors associated with delays in presentation and diagnosis of women with confirmed breast cancer (BC). Methods A cross-sectional study nested in an ongoing prospective cohort study of breast cancer patients at Dr Sardjito Hospital, Yogyakarta, Indonesia, was employed. Participants (n = 150) from the main study were recruited, with secondary information on demographic, clinical, and tumor variables collected from the study database. A questionnaire was used to gather data on other socioeconomic variables, herbal consumption, number of healthcare visits, knowledge-attitude-practice of BC, and open-ended questions relating to initial presentation. Presentation delay (time between initial symptom and first consultation) was defined as ≥3 months. Diagnosis delay was defined as ≥1 month between presentation and diagnosis confirmation. Impact on disease stage and determinants of both delays were examined. A Kruskal-Wallis test was used to assess the length and distribution of delays by disease stage. A multivariable logistic regression analysis was conducted to explore the association between delays, cancer stage and factors. Results Sixty-five (43.3%) patients had a ≥3-month presentation delay and 97 (64.7%) had a diagnosis confirmation by ≥1 month. Both presentation and diagnosis delays increased the risk of being diagnosed with cancer stage III-IV (odds ratio/OR 2.21, 95% CI 0.97–5.01, p = 0.059 and OR 3.03, 95% CI 1.28–7.19, p = 0.012). Visit to providers ≤3 times was significantly attributed to a reduced diagnosis delay (OR 0.15, 95% CI 0.06–0.37, p <0.001), while having a family history of cancer was significantly associated with increased diagnosis delay (OR 2.28, 95% CI 1.03–5.04, p = 0.042). The most frequent reasons for delaying presentation were lack of awareness of the cause of symptoms (41.5%), low perceived severity (27.7%) and fear of surgery intervention (26.2%). Conclusions Almost half of BC patients in our setting had a delay in presentation and 64.7% experienced a delay in diagnosis. These delays increased the likelihood of presentation with a more advanced stage of disease. Future research is required in Indonesia to explore the feasibility of evidence-based approaches to reducing delays at both levels, including educational interventions to increase awareness of BC symptoms and reducing existing complex and convoluted referral pathways for patients suspected of having cancer.

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