Overview of obesity and breast cancer in Brazil: 24 year of follow up.

e13580 Background: Obesity is one of the major public health challenges of the 21st century. The prevalence of obesity is growing exponentially across all age groups and on all continents and it is associated with morbidities such as cardiovascular disease, diabetes mellitus type 2, dyslipidemia, hypertension and cancer. There is a higher risk of developing breast cancer in postmenopausal obese women, and with worse outcome for women of all ages. Objectives: To evaluate obesity prevalence in breast cancer patients and its association with recovering, survival, death, age, Human Epidermal Growth Factor Receptor 2 (HER2) and anti-human KI67 antibody(KI67). Methods: A retrospective cohort study was performed between 1994 and 2018 at the Breast Cancer Department, São Paulo State Government Women's Health Reference Center (Perola Byington Hospital), São Paulo, Brazil with 8824 breast cancer patients. From those, 2899 patients were excluded because they did not have description of weight and/or Body Mass Index (BMI). Survival analysis was performed according to BMI groups. Results: The participants had mean (SD) age of 54 (12.0) years and weight of 70 (15.0) kg. There were 769 (13%) deaths and the mean survival was 20 (2.0) years. 1787 (30%) participants were stratified in obese (BMI≥30Kg/m2) and 4138 (70%) non-obese Obese were older (p < 0,001) and had a higher frequency of HER2 negative (p < 0,04) than non-obese women. There were not a significant difference in frequencies of KI67, recovering and survival between groups. The prevalence of obesity was not different over 24 years. Conclusions: There was a relevant prevalence of obesity in breast cancer patients, which was associated with HER2 negative and age, but not with recovering or survival.

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Comparing the efficacy and side-effects of PDLASTA® (Pegfilgrastim) with PDGRASTIM® (Filgrastim) in breast cancer patients: a non-inferiority randomized clinical trial

BMC Cancer ◽

10.1186/s12885-021-08197-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Safa Najafi ◽

Maryam Ansari ◽

Vahid Kaveh ◽

Shahpar Haghighat

Keyword(s):

Breast Cancer ◽

Clinical Trial ◽

Single Dose ◽

Side Effects ◽

Randomized Clinical Trial ◽

Cancer Patients ◽

Injection Site Reaction ◽

Study Groups ◽

Breast Cancer Patients ◽

Significant Difference

Abstract Background The objective of this study was to compare the efficacy and side effects of a single dose (Pegfilgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial. Methods In this randomized clinical trial, 80 patients were recruited and allocated randomly to two equal arms. In one group, a single subcutaneous dose of PDL was injected the day after receiving the chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of PDG for six consecutive days in each cycle of treatment. The side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight cycles of chemotherapy. Results Hematologic parameters showed no significant differences in any of the treatment courses between the two study groups. The comparison of WBC (p = 0.527), Hgb (p = 0.075), Platelet (p = 0.819), Neutrophil (p = 0.575), Lymphocyte (p = 705) and ANC (p = 0.675) changes during the eight courses of treatment also revealed no statistically significant difference between the two study groups. Side effects including headache, injection site reaction and muscle pain had a lower frequency in patients receiving PDL drugs. Conclusion It seems that PDL is non-inferior in efficacy and also less toxic than PDG. Since PDL can be administered in a single dose and is also less costly, it can be regarded as a cost-effective drug for the treatment of chemotherapy-induced neutropenia. Trial registration IRCT20190504043465N1, May 2019.

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Relationship Between Obesity and Pathologic Response to Neoadjuvant Chemotherapy Among Women With Operable Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.4527 ◽

2008 ◽

Vol 26 (25) ◽

pp. 4072-4077 ◽

Cited By ~ 106

Author(s):

Jennifer K. Litton ◽

Ana M. Gonzalez-Angulo ◽

Carla L. Warneke ◽

Aman U. Buzdar ◽

Shu-Wan Kau ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Pathologic Complete Response ◽

Operable Breast Cancer ◽

Obese Patients ◽

Breast Cancer Patients ◽

Significant Difference ◽

Response To Neoadjuvant Chemotherapy

Purpose To understand the mechanism through which obesity in breast cancer patients is associated with poorer outcome, we evaluated body mass index (BMI) and response to neoadjuvant chemotherapy (NC) in women with operable breast cancer. Patients and Methods From May 1990 to July 2004, 1,169 patients were diagnosed with invasive breast cancer at M. D. Anderson Cancer Center and received NC before surgery. Patients were categorized as obese (BMI ≥ 30 kg/m2), overweight (BMI of 25 to < 30 kg/m2), or normal/underweight (BMI < 25 kg/m2). Logistic regression was used to examine associations between BMI and pathologic complete response (pCR). Breast cancer–specific, progression-free, and overall survival times were examined using the Kaplan-Meier method and Cox proportional hazards regression analysis. All statistical tests were two-sided. Results Median age was 50 years; 30% of patients were obese, 32% were overweight, and 38% were normal or underweight. In multivariate analysis, there was no significant difference in pCR for obese compared with normal weight patients (odds ratio [OR] = 0.78; 95% CI, 0.49 to 1.26). Overweight and the combination of overweight and obese patients were significantly less likely to have a pCR (OR = 0.59; 95% CI, 0.37 to 0.95; and OR = 0.67; 95% CI, 0.45 to 0.99, respectively). Obese patients were more likely to have hormone-negative tumors (P < .01), stage III tumors (P < .01), and worse overall survival (P = .006) at a median follow-up time of 4.1 years. Conclusion Higher BMI was associated with worse pCR to NC. In addition, its association with worse overall survival suggests that greater attention should be focused on this risk factor to optimize the care of breast cancer patients.

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To Determine the Prevalence of Obesity in Breast Cancer Patients

Liaquat National Journal of Cancer Care ◽

10.37184/lnjcc.2789-0112.2.1 ◽

2021 ◽

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Cancer Patients ◽

Body Mass ◽

Tertiary Care ◽

Overweight And Obesity ◽

World Health ◽

Care Hospital ◽

Breast Cancer Patients ◽

Prevalence Of Obesity

Background: Breast Cancer is one of the leading causes of death worldwide. Pakistan alone has the highest rate of Breast Cancer than any other Asian country as approximately 90000 new cases are diagnosed every year out of which 40000 dies. Obesity is also a critical public health problem growing with every passing year in Pakistan and worldwide. Research studies are being conducted worldwide regarding the relation between the two problems. Objective: The objective of this study is to determine the prevalence of obesity in breast cancer patients in a tertiary care hospital in Karachi, Pakistan. Methods: BMI is used as a screening tool for overweight and obesity. According to World Health Organization, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. A retrospective analysis of 262 patients diagnosed with Breast Cancer during 2019 and 2020 was performed. Patients’ hospital records in Oncology were reviewed. The weight in kilograms and height in centimeters of patients were reviewed. Their BMI was calculated and recorded using the SPSS system. Results: The median BMI was 28.25 kg/m2 with an interquartile range of 25.15 - 31.99 kg/m2. Nearly 80% of the study participants had body mass index higher than normal levels (n=203, 77.5%) and out of them approximately half were overweight (n=104, 51.2%) and the remaining were obese (n=99, 48.7%). Conclusion: We conclude from our study that body mass index is positively correlated with breast cancer occurrence and thus the proportion of females having BMI >= 25 was significantly higher among patients.

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Exploring The Clinical Significance of Serum Angiopoietin-2 In Breast Cancer Patients

QJM ◽

10.1093/qjmed/hcab091.014 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Abeer I Abd Elmagid ◽

Hala Abdel Al ◽

Wessam El Sayed Saad ◽

Seham Kamal Mohamed

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Serum Levels ◽

Tnm Staging ◽

Control Group ◽

Healthy Controls ◽

Breast Cancer Patients ◽

Female Patients ◽

Significant Difference ◽

Angiopoietin 2

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 < 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 > 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 > 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.

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ADRENAL FUNCTION IN BREAST CANCER: PRODUCTION AND METABOLIC CLEARANCE RATE OF CORTISOL IN PATIENTS WITH EARLY OR ADVANCED BREAST CANCER AND IN NORMAL WOMEN *

Journal of Endocrinology ◽

10.1677/joe.0.0420425 ◽

1968 ◽

Vol 42 (3) ◽

pp. 425-432 ◽

Cited By ~ 19

Author(s):

V. JENSEN ◽

N. DESHPANDE ◽

R. D. BULBROOK ◽

T. W. DOOUSS

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Cancer Patients ◽

Production Rate ◽

Clearance Rate ◽

Advanced Breast ◽

Metabolic Clearance ◽

Breast Cancer Patients ◽

Metabolic Clearance Rate ◽

Significant Difference

SUMMARY The production rate of cortisol in patients with early or advanced breast cancer was compared with that of controls of comparable age. The miscible pool of this hormone was raised in advanced breast-cancer patients due to a higher production rate. The plasma clearance of cortisol remained unaffected, resulting in a higher titre of cortisol (both total and unbound) in advanced breast-cancer patients. There was no significant difference in the production rate between the early breast-cancer cases and controls. The binding of cortisol to transcortin was studied in all cases. The amount of unbound cortisol was raised in advanced breast-cancer cases. There was a significant correlation between both total and unbound cortisol and the production rate of this hormone. The latter correlation suggests that there is no abnormality in the hepatic extraction of cortisol in these patients. The metabolic clearance rate was found to be of the order of the blood flow through the liver when unbound cortisol was used for its estimation, showing that it is the unbound cortisol which is removed by the liver.

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Dosimetric Comparison of Three Radiotherapy Techniques in Irradiation of Left-Sided Breast Cancer Patients after Radical Mastectomy

BioMed Research International ◽

10.1155/2020/7131590 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Jian Hu ◽

Guang Han ◽

Yu Lei ◽

Ximing Xu ◽

Wei Ge ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Volumetric Modulated Arc Therapy ◽

Intensity Modulated Radiation Therapy ◽

Radical Mastectomy ◽

Target Volume ◽

Conformity Index ◽

Breast Cancer Patients ◽

Ipsilateral Lung ◽

Significant Difference

Introduction. This study is aimed at evaluating the dosimetric differences among target segmented planning (TSP), conventional 9-field intensity modulated radiation therapy (9FIMRT) planning, and volumetric modulated arc therapy (VMAT) planning for postmastectomy radiotherapy of left-sided breast cancer patients. Material and Methods. Fifteen left-sided breast cancer patients who underwent radical mastectomy were enrolled. In TSP, the planning target volume (PTV) was divided into four regions (supra/infraclavicular, chest wall, external mammary region, and internal mammary region), and each individual PTV region was treated with respective fixed fields. Results. The VMAT plans showed superior to PTV dose conformity index (CI), homogeneity index (HI), protection of the ipsilateral lung, monitor units (MUs), and maximum dose (Dmax) to the contralateral breast compared with TSP and 9FIMRT plans. The TSP provided better protection for Dmean of the heart and left ventricle (p<0.05). A dose for left anterior descending artery from the three techniques had no significant difference. Compared with the 9FIMRT plans, the V5Gy (%) and V10Gy (%) for the ipsilateral lung were significantly reduced with TSP and VMAT (p<0.05). The V5Gy (%) and V10Gy (%) for the ipsilateral lung turned out to be similar between VMAT and TSP techniques. Conclusions. Our study indicates that VMAT should be a better choice of radiotherapy for left-sided breast cancer patients after radical mastectomy. If VMAT is unavailable, 9FIMRT can achieve better CI and HI values and be more MU-efficient compared with TSP; however, TSP can effectively reduce the low dose volume of the ipsilateral lungs and heart.

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Two months of doxorubicin-cyclophosphamide with and without interval reinduction therapy compared with 6 months of cyclophosphamide, methotrexate, and fluorouracil in positive-node breast cancer patients with tamoxifen-nonresponsive tumors: results from the National Surgical Adjuvant Breast and Bowel Project B-15.

Journal of Clinical Oncology ◽

10.1200/jco.1990.8.9.1483 ◽

1990 ◽

Vol 8 (9) ◽

pp. 1483-1496 ◽

Cited By ~ 436

Author(s):

B Fisher ◽

A M Brown ◽

N V Dimitrov ◽

R Poisson ◽

C Redmond ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Disease Free Survival ◽

Positive Node ◽

Breast Cancer Patients ◽

Free Survival ◽

National Surgical Adjuvant Breast ◽

Significant Difference ◽

Bowel Project ◽

Disease Free

The National Surgical Adjuvant Breast and Bowel Project (NSABP) implemented protocol B-15 to compare 2 months of Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) and cyclophosphamide (AC) with 6 months of conventional cyclophosphamide, methotrexate, and fluorouracil (CMF) in patients with breast cancer nonresponsive to tamoxifen (TAM, T). A second aim was to determine whether AC followed in 6 months by intravenous (IV) CMF was more effective than AC without reinduction therapy. Through 3 years of follow-up, findings from 2,194 patients indicate no significant difference in disease-free survival (DFS, P = .5), distant disease-free survival (DDFS, P = .5) or survival (S, P = .8) among the three groups. Since the outcome from AC and CMF was almost identical, the issue arises concerning which regimen is more appropriate for the treatment of breast cancer patients. AC seems preferable since, following total mastectomy, AC was completed on day 63 versus day 154 for conventional CMF; patients visited health professionals three times as often for conventional CMF as for AC; women on AC received therapy on each of 4 days versus on each of 84 days for conventional CMF; and nausea-control medication was given for about 84 days to conventional CMF patients versus for about 12 days to patients on AC. The difference in the amount of alopecia between the two treatment groups was less than anticipated. While alopecia was almost universally observed following AC therapy, 71% of the CMF patients also had hair loss and, in 41%, the loss was greater than 50%. This study and NSABP B-16, which evaluates the worth of AC therapy in TAM-responsive patients, indicate the merit of 2 months of AC therapy for all positive-node breast cancer patients.

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Randomized cooperative study of perioperative chemotherapy in breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.11.2712 ◽

1995 ◽

Vol 13 (11) ◽

pp. 2712-2721 ◽

Cited By ~ 22

Author(s):

M R Sertoli ◽

P Bruzzi ◽

P Pronzato ◽

P Queirolo ◽

D Amoroso ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Preliminary Evidence ◽

Breast Cancer Patients ◽

Free Survival ◽

Node Negative ◽

Significant Survival ◽

Significant Difference ◽

Estrogen Receptor Negative

PURPOSE The aim of this multicentric randomized trial was to determine whether reducing the interval between surgery and chemotherapy improves the outcome of breast cancer patients. PATIENTS AND METHODS Between June 1985 and July 1992, 600 breast cancer patients, clinical stages T1-3A,N0-2,M0 were randomly assigned to a perioperative cycle (PC) of cyclophosphamide 600 mg/m2, epidoxorubicin 60 mg/m2, and fluorouracil 600 mg/m2 (CEF). Node-negative (N-) patients did not receive any further treatment. Node positive (N+) patients received 11 cycles if previously given PC, or 12 cycles of CEF alternated with cyclophosphamide 600 mg/m2, methotrexate 40 mg/m2, and fluorouracil 600 mg/m2 (CMF). In addition, N+ patients received concomitant or sequential 5-year tamoxifen therapy. RESULTS At a median follow-up duration of 5.7 years, no significant difference in survival (88% v 84%, P = .3) between the two treatment arms was seen. However, a difference of borderline significance in relapse-free survival (RFS; 76% v 70%, P = .053) was evident. A significant survival advantage for the PC arm was detected only in the estrogen receptor-negative (ER-) patients (P = .003). RFS was significantly improved in N- patients, postmenopausal patients, and ER- patients. Multivariate analyses show that pathologic tumor size, nodal status, receptor status, and treatment (only in ER- patients) are significantly correlated with survival and RFS. PC toxicity did not influence wound healing. CONCLUSION This study provides preliminary evidence that PC positively affects relapse rate and survival in some subgroups, namely, ER- patients.

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Report of clinico-pathological features of breast cancer in HIV-infected and uninfected women in Botswana

Infectious Agents and Cancer ◽

10.1186/s13027-019-0245-6 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Rohini K. Bhatia ◽

Mohan Narasimhamurthy ◽

Yehoda M. Martei ◽

Pooja Prabhakar ◽

Jeré Hutson ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Stage Iii ◽

Disease Stage ◽

Breast Cancers ◽

Pathological Features ◽

Breast Cancer Patients ◽

Hiv Status ◽

Receptor Status ◽

Significant Difference

Abstract Background To characterize the clinico-pathological features including estrogen receptor (ER), progesterone receptor (PR) and Her-2/neu (HER2) expression in breast cancers in Botswana, and to compare them by HIV status. Methods This was a retrospective study using data from the National Health Laboratory and Diagnofirm Medical Laboratory in Gaborone from January 1, 2011 to December 31, 2015. Clinico-pathological details of patients were abstracted from electronic medical records. Results A total of 384 unique breast cancer reports met our inclusion criteria. Of the patients with known HIV status, 42.7% (50/117) were HIV-infected. Median age at the time of breast cancer diagnosis was 54 years (IQR 44–66 years). HIV-infected individuals were more likely to be diagnosed before age 50 years compared to HIV-uninfected individuals (68.2% vs 23.8%, p < 0.001). The majority of patients (68.6%, 35/51) presented with stage III at diagnosis. Stage IV disease was not presented because of the lack of data in pathology records surveyed, and additionally these patients may not present to clinic if the disease is advanced. Overall, 68.9% (151/219) of tumors were ER+ or PR+ and 16.0% (35/219) were HER2+. ER+ or PR+ or both, and HER2- was the most prevalent profile (62.6%, 132/211), followed by triple negative (ER−/PR−/HER2-, 21.3%, 45/211), ER+ or PR+ or both, and HER2+, (9.0%, 19/211) and ER−/PR−/HER2+ (7.1%, 15/211). There was no significant difference in receptor status noted between HIV-infected and HIV-uninfected individuals. Conclusions Majority of breast cancer patients in Botswana present with advanced disease (stage III) at diagnosis and hormone receptor positive disease. HIV-infected breast cancer patients tended to present at a younger age compared to HIV-uninfected patients. HIV status does not appear to be associated with the distribution of receptor status in breast cancers in Botswana.

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Effect of Flavor Enhancement on the Appreciation of Food in Breast Cancer Patients Undergoing Chemotherapy

Current Developments in Nutrition ◽

10.1093/cdn/nzaa044_019 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 320-320

Author(s):

Kenza Drareni ◽

Moustafa Bensafi ◽

Helene Lusson ◽

Damien Vansteene ◽

Agnès Giboreau ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hierarchical Cluster ◽

Cross Sectional Study ◽

Control Group ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Funding Sources ◽

Significant Difference ◽

The Impact

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 > 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 < 0.001). Patients in both ‘altered’ and ‘unaltered’ groups appreciated similarly the cumin appetizer (P > 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.

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