Sonographic and Electrodiagnostic Evaluations in Patients With Aromatase Inhibitor–Related Arthralgia

2009 ◽  
Vol 27 (30) ◽  
pp. 4955-4960 ◽  
Author(s):  
Omer Dizdar ◽  
Levent Özçakar ◽  
Fevziye Ünsal Malas ◽  
Hakan Harputluoglu ◽  
Nilufer Bulut ◽  
...  

Purpose To investigate the prevalence of arthralgia in breast cancer patients taking aromatase inhibitors (AIs) and perform a detailed rheumatologic assessment including autoimmune serology, musculoskeletal sonography, and electromyography (EMG) in these patients. Patients and Methods Postmenopausal patients with stage I to III breast cancer who were taking adjuvant AIs were enrolled (n = 92). Patients who were not receiving hormone treatment were included as a control group (n = 28). Musculoskeletal sonography and EMG were applied to the patients and the controls along with markers of autoimmunity. Results Thirty patients (32.6%) reported to have AI-related new-onset or worsening arthralgia. The most commonly affected joints were knee (70%), wrist (70%), and small joints of the hand (63%). Patients taking AIs had increased tendon thicknesses compared with those who never received AIs (P < .001). Patients with AI-related arthralgia had higher rates of effusion in hand joints/tendons than those without arthralgia (P = .033). More patients with AI-related arthralgia had EMG findings consistent with carpal tunnel syndrome (CTS) than those without arthralgia (P = .024). No significant difference was observed in erythrocyte sedimentation rates, C-reactive protein, antinuclear antibody, antidouble stranded DNA antibody, rheumatoid factor, or anticyclic citrullinated peptide levels between patients and controls or between those with and without arthralgia. Conclusion Patients with AI-related arthralgia often show tenosynovial changes suggesting tenosynovitis, exerting local problems but lacking a systemic inflammatory component. Our finding of increased CTS frequency also supports this hypothesis.

This study was conducted to evaluate the association of serum leptin and hs C-reactive protein with breast cancer. Two groups were included in the study. The first group included 45 newly diagnosed women with breast cancer. The second group included 42 women with benign breast lump as a control group. Blood samples (5 mL) were taken from the patient and the control groups and analyzed for serum leptin and hs C-reactive protein. Serum CA15-3 was also measured in breast cancer patients. The epidermal growth factor receptor 2 (HER2/neu), estrogen and progesterone receptors were determined in breast cancer patients by using immune-chemical method. Serum leptin was significantly higher (p ≤ 0.05) in breast cancer patients than that in the control group; however, no significant difference was noticed between the two groups for serum hs C-reactive protein. No significant difference was noticed between HER2/neu positive or negative in breast cancer patients for serum leptin or hs C-reactive protein. However, serum CA15-3 in HER2/neu positive patients was significantly higher (p ≤ 0.05) than that in HER2/neu negative patients. No significant difference was noticed between positive and negative estrogen breast cancer patients for serum leptin, hs C-reactive protein or CA15-3. In addition, no significant difference was noticed between positive and negative progesterone for serum leptin, hs C-reactive protein or CA15-3. A strong significant positive correlation was noticed between serum leptin and BMI in the control group; however, no significant correlation was noticed between serum leptin and BMI in the breast cancer patients. In conclusion, serum leptin may be used as a prognostic factor for breast cancer. Serum C-reactive protein in HER2/neu positive breast cancer patients is higher than in HER2/neu negative patients.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abeer I Abd Elmagid ◽  
Hala Abdel Al ◽  
Wessam El Sayed Saad ◽  
Seham Kamal Mohamed

Abstract Background Breast cancer is the most common cancer among women and one of the most important causes of death among them.Angiogenesis is an important step for primary tumor growth, invasiveness, and metastases. Angiopoietins are well-recognized endothelial growth factors that are involved in angiogenesis associated with tumors. Aim To explore the diagnostic significance of serum angiopoietin-2 (Ang-2) in breast cancer and to evaluate its prognostic efficacy through studying the degree of its association with the TNM staging of the disease. Patients and Methods This study was conducted on (35) Egyptian female patients who were diagnosed as breast cancer according to histopathological examination of breast biopsy (Group 1, Breast Cancer Patients) and (25) female patients with benign breast diseases (Group II, Pathological Control Patients), in addition to (20) age - matched apparently healthy, free mammogram, females serving as healthy controls (Group III, Healthy Controls). For all participants, measurement of serum Ang-2 was done using enzyme linked immunosorbent assay (ELISA) technique. Results A highly significant increased levels of Ang-2 was observed in breast cancer patients when compared to healthy control group (Z = 4.95, p &lt; 0.01). However, no significant difference was observed in Ang-2 levels between breast cancer patients group and pathological control group (Z = 3.37, p &gt; 0.05). No significant difference was detected in Ang-2 levels in relation to TNM stage and histological grade. No significant correlation was found between Ang-2 levels and serum levels of CA15-3, hormone receptors, HER2/new receptor status (p &gt; 0.05, respectively). Conclusion This study revealed that Ang-2 serum levels were significantly increased in patient with breast cancer compared with healthy controls, indicating that high Ang-2 level is a promising non invasive biomarker for breast cancer diagnosis. However, no significant difference of Ang-2 levels was detected in relation of breast TNM staging in the population studied.


2019 ◽  
Vol 2 (2) ◽  
pp. 24-31
Author(s):  
Gulraj Singh ◽  
Mulawan Umar ◽  
Nur Qodir

Abstract Introduction: Modified radical mastectomy (MRM) is a breast cancer treatment option that is still operable. One of the postoperative complications that can be found is the formation of seroma. High negative suction drain is done to treat seroma after surgery but it can contribute to increase the length of stay in hospital. Methods: This study was a clinical randomized control trial (cRCT) conducted on 30 breast cancer patients in June - July 2019 at Moehammad Hoesin Hospital in Palembang. This study divided the two sample groups, each group consisting of 15 patients. One group was given half negative pressure on suction drain (experimental group) and the other used full negative pressure on suction drain (control group). Results: There was a significant difference (p <0.005) between the full and half negative pressure groups where there were more seroma events in the full vacuum group in 9 (60%) cases and half vacuum in 2 (30%) but there were no significant differences in long period of stay (p> 0.005). Conclusion: Half negative pressure is more effective in treating seroma than full negative pressure.


2020 ◽  
Vol 12 (2) ◽  
pp. 157-64
Author(s):  
Merlyna Savitri ◽  
Ugroseno Yudho Bintoro ◽  
Made Putra Sedana ◽  
Muhammad Noor Muhammad ◽  
Pradana Zaky Romadhon ◽  
...  

BACKGROUND: Carbohydrate antigens 15-3 (CA 15-3) is a conventional tumor marker in breast cancer, with low sensitivity and specificity. MicroRNA (miRNA)-21 showed its stability in circulation and could serve as powerful biomarker. The aim of this study was to evaluate miRNA-21 as breast cancer biomarker compared to CA 15-3 in Indonesian population.METHODS: Circulating plasma miRNA-21 expression was measured using qRT-PCR in 49 patients at various stages of breast cancer and 16 healthy controls. The relative expression value of miRNA-21 was calculated using 2-ΔΔCt. Meanwhile, CA 15-3 was quantified using electrochemiluminescence immunoassay (ECLIA) methods. The results of miRNA-21 and CA 15-3 plasma circulating expression were compared with controls at each stage and between stages of breast cancer.RESULTS: CA 15-3 median level in breast cancer group was 1.60 times higher compared to control group (p=0.019), 21.00 m/mL and 13.05 m/mL, respectively. Median miRNA-21 expression in breast cancer group was elevated 4.92 folds compared to control group (p=0.001), 4.43 and 0.90, respectively. There was no significant difference of CA 15-3 level between controls and all stages of breast cancer group. CA 15-3 cut-off value was 15.05 m/mL (p=0.016) with 59.2% sensitivity and 62.5% specificity. Meanwhile, there was a significant difference of miRNA-21 expression between controls and most stages of breast cancer group. Circulating miRNA-21 expression cut-off value was 2.07 (p=0.000) with 91.8% sensitivity and 87.5% specificity.CONCLUSION: Circulating miRNA-21 expression and CA 15-3 levels were significantly increased in breast cancer group compared to control group. The miRNA-21 expression increased consistently with breast cancer stage progression. miRNA-21 could serve as superior biomarker compared to CA 15-3.KEYWORDS: biomarker, breast cancer, circulating plasma, liquid biopsy, miRNA-21


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 320-320
Author(s):  
Kenza Drareni ◽  
Moustafa Bensafi ◽  
Helene Lusson ◽  
Damien Vansteene ◽  
Agnès Giboreau ◽  
...  

Abstract Objectives Given the influence of sensory signals on food intake regulation and the subsequent nutritional status, it is important to reduce the impact of commonly observed smell and taste alterations on the pleasure of eating during chemotherapy. This study aimed to examine the effect of various types of flavor enhancement on the appreciation of an appetizer by a group of patients undergoing chemotherapy. Methods Five eggplant appetizers with no seasoning (REF) or enhanced with either salt, lemon, garlic or cumin were developed. In this cross-sectional study, 36 healthy female subjects (age 58 ± 7 y) (control group) and 84 breast cancer patients (age 56 ± 11 y) treated with chemotherapy were recruited. A hierarchical cluster analysis based on patients' self-reported smell and taste abilities classified the patients in two groups: the ‘unaltered, (high sensory abilities) n = 49’ and the ‘altered, (poor sensory abilities), n = 35’ group. Participants tasted and assessed the appreciation of the reference appetizer on a visual analog scale and performed a randomized comparative liking task, by rating the appreciation for each flavor-enhanced appetizer relative to the REF (one-sample t-test). Results There was no significant difference in the appreciation of the REF appetizer between the three groups (P &gt; 0.05). In the comparative liking task, the control group rated similarly the appreciation between the flavor-enhanced and the REF appetizers except for the cumin-enhanced appetizer, which was appreciated significantly more than the REF (P &lt; 0.001). Patients in both ‘altered’ and ‘unaltered’ groups appreciated similarly the cumin appetizer (P &gt; 0.05), more the salt and garlic-enhanced appetizers (P ≤ 0.001, P = 0.005, respectively) and significantly less the lemon-enhanced appetizer relative to the REF (P = 0.029), confirming a tendency for patients to reject acid-flavored foods. Conclusions The salt and garlic enhancements were appreciated by the patients independent of the stage of chemotherapy or the severity of smell and taste alterations. Flavor enhancement seems a good strategy to maintain the pleasure of eating in patients undergoing chemotherapy. Further research is still needed on the appreciation and intake of a complete meal (starter, main course, dessert). Funding Sources APICIL and ELIOR groups.


2020 ◽  
Author(s):  
Xiujun Wang

BACKGROUND Background: Postoperative Fatigue Syndrome (POFS) occurs in almost every patient who has undergone major surgery. With the ever-increasing attention of people on rehabilitation treatment, POFS has received unprecedented attention. OBJECTIVE Objective: Based on modern data analysis, acupuncture treatment is optimized intelligently, and its efficacy in breast cancer patients with POFS is explored. METHODS Methods: In this study, the acupuncture and moxibustion in traditional Chinese medicine were combined to optimize the formation of warm acupuncture therapy, and then the research on warm acupuncture was optimized using modern data analysis methods. At first, the statistics of personal information and operation of 60 patients with breast cancer was carried out. The statistical results were analyzed by rank sum test and independent sample T test. The Visual Analogue Scale (VAS), Brief Profile Of Mood State (BPOMS), and Identity-Consequence Fatigue Scale (ICFS) were utilized to analyze the fatigue degree, mental state, and fatigue state of the patients. RESULTS Results: There was no significant difference in age (U = 473.34, P = 0.583) and education level (U = 479.20, P = 0.613) between the experimental group and the control group (P > 0.05), which were comparable. Compared with the control group, the VAS values of the experimental group on the 3rd day (P = 043), 7th day (P = 0.039), and 14th day (P = 0.030) of postoperative treatment were significantly reduced, with significant differences (P < 0.05). In the experimental group, the BPOMS values on the 3rd day (P = 0.042), 7th day (P = 0.035), and 14th day (P = 0.031) of postoperative treatment were significantly reduced, with significant differences (P < 0.05). The ICFS values of the experimental group on the 3rd day (P = 046), 7th day (P = 0.037), and 14th day (P = 0.031) of postoperative treatment were significantly reduced, with significant differences (P < 0.05). The variance of transferrin levels was uniform on the 7th day after operation (F = 0.679, P = 0.433 > 0.005), with a significant difference (T = -2.985, P = 0.008 < 0.05). CONCLUSIONS Conclusions: Warm acupuncture therapy could effectively improve the POFS of breast cancer patients, which was a safe and effective treatment. CLINICALTRIAL


Author(s):  
Kamli Prakash ◽  
Sunil Saini

Background: Breast cancer has ranked number one cancer among Indian females. Women undergoing chemotherapy experience many side effects including alteration in their body image. The present study assessed effectiveness of yoga on anxiety, depression and stress level of breast cancer patients undergoing chemotherapy.Methods: Quantitative Research approach and Randomized Clinical Controlled Trial with Time series design was adopted in the present study. The consecutive sampling technique was done to recruit 100 breast cancer patients fulfilling the eligibility criteria. Recruited patients were randomized to control (N=52) and experiment (N=48) groups by concealed randomization. Written informed consent was taken from each participant. Baseline data was collected during cycle one by using Anxiety depression and stress scale. The patients in the experimental group were taught Diaphragmatic breathing, systematic relaxation and alternate nostril breathing and Joints and Gland neck and shoulder exercises, and were instructed to practice them twice daily at home. They were supervised in practicing these when they received second, third, fourth, fifth and sixth cycles of chemotherapy. Participants in control group received routine care. Data was again collected after 21 days during second, third, fourth, fifth and sixth cycles of chemotherapy.Results: Analysis revealed that at the baseline breast cancer patients in control and experimental group were homogenous in terms of their Sociodemographic and anxiety depression and stress scores. After the yoga intervention the experimental group showed statistically significant difference in anxiety scores from control group during second, third and sixth cycles (p 0.01, p 0.02, p 0.02), in depression score during the second, third, fourth, fifth and sixth cycles (p 0.02, p 0.02, p 0.02, p 0.001, p 0.000), and in stress scores during third cycle (p 0.01) of chemotherapy.Conclusions: On the basis of findings of the study it was concluded that yoga was effective in reducing the anxiety, depression and stress of breast cancer patients undergoing chemotherapy. Therefore, it is recommended as complementary therapy for patients receiving treatment for cancer. 


2018 ◽  
Vol 5 (2) ◽  
pp. 62-66
Author(s):  
Tahereh Haji Seyed Javadi ◽  
Fakhri Tajikzadeh ◽  
Hossein Bayat ◽  
Nasim Eshraghi ◽  
Zahra Roshandel ◽  
...  

Background: The present study aimed to compare the effectiveness the metacognition treatment (MCT) and mindfulness-based cognitive therapy (MBCT) on anxiety, depression, and stress in the females with breast cancer. Methods: The planning of this study is through a quasi-experimental method of pretest and posttest type with control group. The target society of the research included every cancer patient who admitted to Tehran hospitals for breast cancer. Through assigned randomly, 12 patients were selected for the MCT group and 12 patients for the MBCT group, and the other were assigned control group. The data collection tools included depression, anxiety and stress scale - 21 items (DASS-21) questionnaire. For statistical analysis, descriptive tests and repeated measures analysis of variance were performed. Results: Data analysis with repeated multivariate measurements illustrated that there is a significant difference in the rate of depression, anxiety and stress, in three groups. Conclusion: According to our results, MBCT was more effective compared to metacognitive therapy.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14182-e14182
Author(s):  
Takahiro Takahiro ◽  
Tadahiko Shien ◽  
Naruto Taira ◽  
Mariko Kochi ◽  
Takayuki Iwamoto ◽  
...  

e14182 Background: Metformin is one of the most commonly prescribed drugs for type 2 diabetes, and some reports have suggested that metformin may reduce cancer risk. Diabetics treated with metformin have a 23% reduction in the risk of cancer, including breast cancer. In addition, it is reported that the breast cancer patients with metformin treatment for diabetes showed favorable prognosis compared with those without metformin treatment. However, the mechanism underlying the positive effects of metformin on cancer treatment remains unclear. Methods: We conducted a prospective study to evaluate the effect of preoperative metformin on early breast cancer patients. The patients took a daily dose of metformin orally for 7 to 21 days before surgery. We evaluated the effects on immunological factors (TILs, CD4+, CD8+, PD-L1 and ALDH1) by comparing core needle biopsies (CNB) obtained before surgery with surgical specimens. Results: Seventeen breast cancer patients were enrolled in this prospective study and administered metformin before surgery, during the period from January to December 2016. We analyzed 59 patients who received surgery during the same period as a control group. In the control group, there was no significant difference in TILs between CNB and surgical specimens (Rs = 0.63). In the metformin group, TILs were negative in CNB and surgical specimens of 15 (88%) and 8 (48%) cases, low in 2 (12%) and 8 (48%), and intermediate in 0 and 1 (6%), respectively. These TILs increases were confirmed in 5 (29%) patients (p = 0.09), while a decrease was confirmed in 2 (12%). The expressions of CD4+ and CD8+ by TILs were increased in 41% and 18% of surgical specimens, respectively. (p = 0.02, p = 0.09) However, there was no statistically significant difference in these immunological factors and PD-L1 or ALDH1 expression between before and after metformin. Conclusions: In our small cohort, preoperative metformin administration shows positive impact on CD4 positive lymphocytes significantly and has tendency of increasing both TILs and CD8 positive lymphocytes. However, we should keep in mind that our sample size is small. Further study is necessary to uncover the mechanisms of favorable effects of metformin on breast cancer patients.


Genetika ◽  
2019 ◽  
Vol 51 (2) ◽  
pp. 463-472
Author(s):  
Iva Pruner ◽  
Branko Tomic ◽  
Marija Dragojevic ◽  
Maja Gvozdenov ◽  
Mirjana Kovac ◽  
...  

Breast cancer is the leading cause of cancer-related death among women. An increased burden of thrombotic events among breast cancer patients, leading to higher mortality and morbidity rates, is well established. There are a number of genetic risk factors associated with thrombosis, but their contribution to thrombotic tendencies in patients with cancer is not completely elucidated. We aimed to investigate possible role of FV Leiden, FII G20210A, MTHFR C677T and PAI-1 4G/5G gene variants in etiopathology of breast cancer and accompanying thrombosis in cohort of Serbian patients. Our study included 316 subject divided in three groups: breast cancer patients with (97) or without (99) accompanying thrombosis and healthy control group (120). According to our results, the prevalence for all four prothrombotic gene variants were similar in cancer patients with and without thrombosis and no statistically significant difference was observed between these groups. We detected lower frequency of MTHFR 677TT genotype in breast cancer patients when compared to control group (P=0.014; OR=0.145 (95%CI 0.031-0.679)), indicated that MTHFR C677T homozygosity could play a protective role in breast cancer susceptibility. Our study noted the lack of association between common prothrombotic gene variants and increased prothrombotic risk in Serbian breast cancer patients. Also, our results point out possible role of MTHFR 677TT genotype in etiology of breast cancer, but further studies on larger cohort of patients are needed.


Sign in / Sign up

Export Citation Format

Share Document