scholarly journals First-in-human pharmacokinetics of tamoxifen and its metabolites in the milk of a lactating mother: a case study

ESMO Open ◽  
2020 ◽  
Vol 5 (5) ◽  
pp. e000859
Author(s):  
Fedro Alessandro Peccatori ◽  
Giovanni Codacci-Pisanelli ◽  
Gunnar Mellgren ◽  
Barbara Buonomo ◽  
Eleonora Baldassarre ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Normal Development ◽  
Tamoxifen Treatment ◽  
Human Pharmacokinetics ◽  
Childbearing Age ◽  
Lactating Women ◽  
Liquid Chromatography Tandem Mass ◽  
Clinically Significant ◽  
First Time

BackgroundBreast cancer represents the most frequent neoplasm diagnosed in women of childbearing age. When the tumour is oestrogen receptor-positive, tamoxifen is among the recommended endocrine treatments. Lactating women are advised not to breastfeed while receiving tamoxifen. However, information about tamoxifen transfer into breast milk is lacking.MethodsWe measured the concentration of tamoxifen and its metabolites by liquid chromatography-tandem mass spectrometry in the milk of a nursing mother that was treated for pregnancy-associated breast cancer diagnosed a few months after delivery. She was advised not to breastfeed her child and she collected milk samples for 23 days while the baby was fed with formula.ResultsTamoxifen concentrations in milk increased reaching a maximum of 214 nM. The two active metabolitesZ-4-hydroxy-tamoxifen and Z-endoxifen, could not be quantified in milk the first days after tamoxifen intake, but increased over time and reached clinically significant levels after day 18.ConclusionThis study demonstrates for the first time in human that tamoxifen and its metabolites transfer into milk. Since tamoxifen has a complete oral bioavailability, a long half-life (>7 days) and may interfere with the normal development of the infant, mothers should not breastfeed during tamoxifen treatment.

scholarly journals RIWAYAT USIA PERTAMA MENARCHE ≤12 TAHUN BERHUBUNGAN DENGAN KEJADIAN KANKER PAYUDARA PADA WANITA USIA SUBUR

2020 ◽  
Vol 8 (2) ◽  
pp. 168
Author(s):  
Siwi Ariana ◽  
Selamat Budijitno ◽  
Suhartono Suhartono
Keyword(s):  
Breast Cancer ◽  
Sampling Technique ◽  
Childbearing Age ◽  
Chi Square ◽  
History Of ◽  
New Variables ◽  
Age Of Menarche ◽  
Anatomical Pathology ◽  
Worse Prognosis

Breast cancer is a continuous cell growth that spreads without control in breast tissue. Young women especially those who are in reproductive ages with breast cancer tend to have more malignant cancer and worse prognosis. The purpose of this study is to prove history of first age menarche ≤12 years associated with the incidence of breast cancer in reproductive ages. Research design analytic observational study used a control case study design. The population in this study were reproductive women aged 15-49 years who were examined at the Oncology clinic in Tugurejo General Hospital with anatomical pathology results. The samples in this study were 42 cases and 42 controls with consecutive sampling technique. The data were analyzed univaraiate anda bivariate by chi-square. Results research history of first age menarche ≤12 years releted of breast cancer with value p= 0,005; OR= 4,015; 95% CI= 1,618-9,966. Conclusion history of the first age of menarche ≤12 years is related to the incidence of breast cancer in women of childbearing age. The researchers can add new variables about risk factors for breast cancer.

Supervision: A Case Study

1977 ◽  
Vol 8 (4) ◽  
pp. 256-263
Author(s):  
Roberta Chapey ◽  
Geraldine Chapey
Keyword(s):  
Organizational Communication ◽  
Behavioral Changes ◽  
Personal Problems ◽  
Clinically Significant

Occasionally, it is the responsibility of a supervisor to help a staff speech clinician resolve professional and or personal problems that interfere with the delivery of quality services. To deal with this situation, the supervisor must be equipped with the techniques and procedures for effective organizational communication. This article presents a case study in which a speech clinician demonstrated irresponsibility in various job areas. The supervisor’s philosophy and the procedures used in managing these problems are presented. The behavioral changes suggest that the supervisor’s interventive procedures were clinically significant and warrant further investigation.

Islamic and Jewish Religious Feminists Tackle Islamic and Jewish Oral Law: Maintenance and Rebellion of Wives

2017 ◽  
Vol 11 (1) ◽  
pp. 35-63
Author(s):  
Ruth Roded
Keyword(s):  
State Policy ◽  
Political System ◽  
Daily Life ◽  
The State ◽  
The Political ◽  
Jewish Law ◽  
Modern Times ◽  
Parallel Case ◽  
First Time

Beginning in the early 1970s, Jewish and Muslim feminists, tackled “oral law”—Mishna and Talmud, in Judaism, and the parallel Hadith and Fiqh in Islam, and several analogous methodologies were devised. A parallel case study of maintenance and rebellion of wives —mezonoteha, moredet al ba?ala; nafaqa al-mar?a and nush?z—in classical Jewish and Islamic oral law demonstrates similarities in content and discourse. Differences between the two, however, were found in the application of oral law to daily life, as reflected in “responsa”—piskei halacha and fatwas. In modern times, as the state became more involved in regulating maintenance and disobedience, and Jewish law was backed for the first time in history by a state, state policy and implementation were influenced by the political system and socioeconomic circumstances of the country. Despite their similar origin in oral law, maintenance and rebellion have divergent relevance to modern Jews and Muslims.

Breast cancer associated with pregnancy: a clinical case

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 102-108
Author(s):  
Yu E Dobrokhotova ◽  
S E Arakelov ◽  
S Zh Danelyan ◽  
E I Borovkova ◽  
A E Zykov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Clinical Case ◽  
First Trimester ◽  
First Year ◽  
Total Mastectomy ◽  
First Time

Associated with pregnancy is breast cancer, which was first detected during pregnancy, during the first year after childbirth or at any time against lactation. Diagnosis of the disease in the first trimester is an indication for abortion. The detection of the disease after 20 weeks and the desire of the woman to maintain pregnancy is the basis for conducting a total mastectomy followed by polychemotherapy with doxorubicin with cyclophosphamide or with fluorouracil. Radiation therapy during pregnancy is not applied. The timing and method of delivery are determined individually and depend on the stage of the process and the period of pregnancy, when it was identified. A clinical case of a patient with edematous-infiltrative form of breast cancer of the IV stage, diagnosed for the first time in 22 weeks of pregnancy, is presented.

Association of CYP2D6*10 (c. 100 C>T) Genotype with Z-END Concentration in Patients with Breast Cancer Receiving Tamoxifen Therapy in Indonesian Population

2019 ◽  
Vol 19 (8) ◽  
pp. 1198-1206 ◽  
Author(s):  
Yenny ◽  
Sonar S. Panigoro ◽  
Denni J. Purwanto ◽  
Adi Hidayat ◽  
Melva Louisa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Steady State ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Threshold Concentration ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Significant Difference ◽  
Pcr Rflp ◽  
Liquid Chromatography Tandem Mass

Background: Tamoxifen (TAM) is a frequently used hormonal prodrug for patients with breast cancer that needs to be activated by cytochrome P450 2D6 (CYP2D6) into Zusammen-endoxifen (Z-END). Objective: The purpose of the study was to determine the association between CYP2D6*10 (c.100C>T) genotype and attainment of the plasma steady-state Z-END minimal threshold concentration (MTC) in Indonesian women with breast cancer. Methods: A cross-sectional study was performed in 125 ambulatory patients with breast cancer consuming TAM at 20 mg/day for at least 4 months. The frequency distribution of CYP2D6*10 (c.100C>T) genotypes (C/C: wild type; C/T: heterozygous mutant; T/T: homozygous mutant) was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), the results of which were subsequently confirmed by sequencing. The genotypes were categorized into plasma Z- END concentrations of <5.9 ng/mL and ≥5.9 ng/mL, which were measured using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Results: Percentages of C/C, CT, and T/T genotypes were 22.4%, 29.6%, and 48.8%, respectively. Median (25-75%) Z-END concentrations in C/C, C/T, and T/T genotypes were 9.58 (0.7-6.0), 9.86 (0.7-26.6), and 3.76 (0.9-26.6) ng/mL, respectively. Statistical analysis showed a significant difference in median Z-END concentration between patients with T/T genotype and those with C/C or C/T genotypes (p<0.001). There was a significant association between CYP2D6*10 (c.100C>T) genotypes and attainment of plasma steady-state Z-END MTC (p<0.001). Conclusion: There was a significant association between CYP2D6*10 (c.100C>T) and attainment of plasma steady-state Z-END MTC in Indonesian breast cancer patients receiving TAM at a dose of 20 mg/day.

Adenosarcoma of the uterus following tamoxifen treatment for breast cancer

1998 ◽  
Vol 8 (2) ◽  
pp. 168-171 ◽  
Author(s):  
Mourits ◽  
Hollema ◽  
Willemse ◽  
de Vries ◽  
Aalders ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tamoxifen Treatment

scholarly journals Breast Cancer Cell Re-Dissemination from Lung Metastases—A Mechanism for Enhancing Metastatic Burden

2021 ◽  
Vol 10 (11) ◽  
pp. 2340
Author(s):  
Lucia Borriello ◽  
John Condeelis ◽  
David Entenberg ◽  
Maja H. Oktay
Keyword(s):  
Breast Cancer ◽  
Cancer Cells ◽  
Cancer Cell ◽  
Metastatic Disease ◽  
Breast Cancer Cells ◽  
Lung Metastases ◽  
Primary Tumors ◽  
Metastatic Burden ◽  
First Time ◽  
Do So

Although metastatic disease is the primary cause of mortality in cancer patients, the mechanisms leading to overwhelming metastatic burden are still incompletely understood. Metastases are the endpoint of a series of multi-step events involving cancer cell intravasation, dissemination to distant organs, and outgrowth to metastatic colonies. Here we show, for the first-time, that breast cancer cells do not solely disseminate to distant organs from primary tumors and metastatic nodules in the lymph nodes, but also do so from lung metastases. Thus, our findings indicate that metastatic dissemination could continue even after the removal of the primary tumor. Provided that the re-disseminated cancer cells initiate growth upon arrival to distant sites, cancer cell re-dissemination from metastatic foci could be one of the crucial mechanisms leading to overt metastases and patient demise. Therefore, the development of new therapeutic strategies to block cancer cell re-dissemination would be crucial to improving survival of patients with metastatic disease.

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