Prior tonsillectomy and subsequent risk of breast cancer in females: Systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10568-10568
Author(s):  
Salah Eddine Oussama Kacimi ◽  
Mounir Ould Setti ◽  
Amira Yasmine Benmelouka ◽  
Mohammad Aloulou ◽  
Hanane Zoubida Sekkal ◽  
...  

10568 Background: Exposure to recurrent infections in childhood was linked to an increased risk of cancer in adulthood. There is also evidence that a history of tonsillectomy, a procedure often performed in children with recurrent infections, is linked to an increased risk of leukemia, and Hodgkin lymphoma. Tonsillectomy could be directly associated with cancer risk or it could be a proxy for another risk factor such as recurrent infections and chronic inflammation. Nevertheless, the role of recurrent childhood infections and tonsillectomy on the one hand, and the risk of breast cancer (BC) in adulthood remain understudied. Our study aims to verify whether a history of tonsillectomy increases the risk of BC in women. Methods: A systematic review was conducted using PubMed, Google Scholar, Scopus, Embase and Web of Science databases from inception through November 2020 to identify the studies which explored the association between history of tonsillectomy and BC in females. The Newcastle Ottawa Scale was used to assess the quality of included studies. Odds ratio (OR) was used to measure effect size. The Random/Fixed effects model was applied to synthesize the associations between tonsillectomy and BC risk based on heterogeneity. Heterogeneity was assessed using the I-squared statistic. A forest plot was generated, and publication bias was assessed. The leave-one-out sensitivity analysis was performed to check if results were driven by a single study. Results: Seven studies with a total of 7259 patients were included in our analysis; out of them, 2200 patients were diagnosed with BC. Patients with a history of tonsillectomy (n = 2843) showed higher subsequent risk of developing BC (OR = 1.252; 95% CI = 1.115 - 1.406; P < 0.001; I2 = 9%) as compared to patients without a history of tonsillectomy (n = 4416). Using the leave-one-out sensitivity analysis to iteratively remove one study at a time, we confirmed that no single study had a substantial influence on the overall effect size. Conclusions: Our study supports and confirms the evidence that a history of tonsillectomy is associated with an increased risk of breast cancer. These findings are also an argument in support of the hypothesis that recurrent childhood infections are linked with adulthood breast cancer.

2020 ◽  
Author(s):  
Francesco Oliva ◽  
Giulia di Girolamo ◽  
Francesca Malandrone ◽  
Noemi Iaia ◽  
Fiorella Biasi ◽  
...  

Abstract Background: To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood.Method: Childhood history of recurrent infections and a blood sample were collected in a sample of DSM-IV adult outpatients with ADHD. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer's specifications. Absolute titers were also collected as continuous variables.Results: Fourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had any other infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies.Conclusions: patients with ADHD might be more prone to infections during childhood and subclinical streptococcal infections during adulthood. Moreover, they seem to have an increased risk for basal ganglia autoimmunity in adulthood. Both infections and the ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.


2020 ◽  
Author(s):  
Francesco Oliva ◽  
Giulia di Girolamo ◽  
Francesca Malandrone ◽  
Noemi Iaia ◽  
Fiorella Biasi ◽  
...  

Abstract Background: To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood.Method: Childhood history of recurrent infections and a blood sample were collected in a sample of DSM-IV adult outpatients with ADHD. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer's specifications. Absolute titers were also collected as continuous variables.Results: Fourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had any other infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies.Conclusions: Patients with ADHD might be more prone to infections during childhood and subclinical streptococcal infections during adulthood, moreover they seem to have an increased risk for basal ganglia autoimmunity in adulthood. Both infections and ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Francesco Oliva ◽  
Giulia di Girolamo ◽  
Francesca Malandrone ◽  
Noemi Iaia ◽  
Fiorella Biasi ◽  
...  

Abstract Background To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood. Method Childhood history of recurrent infections and a blood sample were collected in a sample of DSM-IV adult outpatients with ADHD. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer’s specifications. Absolute titers were also collected as continuous variables. Results Fourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had any other infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies. Conclusions patients with ADHD might be more prone to infections during childhood and subclinical streptococcal infections during adulthood. Moreover, they seem to have an increased risk for basal ganglia autoimmunity in adulthood. Both infections and the ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.


Author(s):  
Judd Sher ◽  
Kate Kirkham-Ali ◽  
Denny Luo ◽  
Catherine Miller ◽  
Dileep Sharma

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.


2021 ◽  
Vol 22 (2) ◽  
pp. 889
Author(s):  
Ava Kwong ◽  
Cecilia Y. S. Ho ◽  
Vivian Y. Shin ◽  
Chun Hang Au ◽  
Tsun Leung Chan ◽  
...  

The germline carrier of the BRCA1 pathogenic mutation has been well proven to confer an increased risk of breast and ovarian cancer. Despite BRCA1 biallelic pathogenic mutations being extremely rare, they have been reported to be embryonically lethal or to cause Fanconi anemia (FA). Here we describe a patient who was a 48-year-old female identified with biallelic pathogenic mutations of the BRCA1 gene, with no or very subtle FA-features. She was diagnosed with ovarian cancer and breast cancer at the ages of 43 and 44 and had a strong family history of breast and gynecological cancers.


Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2506
Author(s):  
Mark van Barele ◽  
Bernadette A. M. Heemskerk-Gerritsen ◽  
Yvonne V. Louwers ◽  
Mijntje B. Vastbinder ◽  
John W. M. Martens ◽  
...  

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.


2021 ◽  
pp. 152483802110216
Author(s):  
Brooke N. Lombardi ◽  
Todd M. Jensen ◽  
Anna B. Parisi ◽  
Melissa Jenkins ◽  
Sarah E. Bledsoe

Background: The association between a lifetime history of sexual victimization and the well-being of women during the perinatal period has received increasing attention. However, research investigating this relationship has yet to be systematically reviewed or quantitatively synthesized. Aim: This systematic review and meta-analysis aims to calculate the pooled effect size estimate of the statistical association between a lifetime history of sexual victimization and perinatal depression (PND). Method: Four bibliographic databases were systematically searched, and reference harvesting was conducted to identify peer-reviewed articles that empirically examined associations between a lifetime history of sexual victimization and PND. A random effects model was used to ascertain an overall pooled effect size estimate in the form of an odds ratio and corresponding 95% confidence intervals (CIs). Subgroup analyses were also conducted to assess whether particular study features and sample characteristic (e.g., race and ethnicity) influenced the magnitude of effect size estimates. Results: This review included 36 studies, with 45 effect size estimates available for meta-analysis. Women with a lifetime history of sexual victimization had 51% greater odds of experiencing PND relative to women with no history of sexual victimization ( OR = 1.51, 95% CI [1.35, 1.67]). Effect size estimates varied considerably according to the PND instrument used in each study and the racial/ethnic composition of each sample. Conclusion: Findings provide compelling evidence for an association between a lifetime history of sexual victimization and PND. Future research should focus on screening practices and interventions that identify and support survivors of sexual victimization perinatally.


2016 ◽  
Vol 26 (4) ◽  
pp. 513 ◽  
Author(s):  
Kathleen A. Griffith ◽  
Seon Yoon Chung ◽  
Shijun Zhu ◽  
Alice S. Ryan

<p class="Pa7"><strong>Objective: </strong>After chemotherapy for breast cancer, Black women gain more weight and have an increased mortality rate compared with White women. Our study objective was to compare biomarkers associated with obesity in Black women with and without a history of breast cancer.</p><p class="Pa7"><strong>Design: </strong>Case-control</p><p class="Pa7"><strong>Setting: </strong>Academic/federal institution</p><p class="Pa7"><strong>Participants: </strong>Black women with a history of breast cancer (cases) and age-matched controls.</p><p class="Pa7"><strong>Methods: </strong>We compared insulin resistance, inflammation, and lipids in overweight and obese Black women with a history of breast cancer (n=19), age similar controls (n=25), and older controls (n=32). Groups did not differ on mean body mass index (BMI), which was 35.4 kg/m2, 36.0 kg/m2, and 33.0 kg/m2, respectively.</p><p class="Default"><strong>Main Outcome Measures: </strong>Insulin resis­tance (HOMA-IR); inflammation (TNF-α, IL-1b, IL-6, IL-8, CRP); lipids (cholesterol, triglycerides).</p><p class="Pa7"><strong>Results: </strong>Cases had 1.6 and 1.38 times higher HOMA-IR values compared with age similar and older controls, respectively (P≤.001 for both). TNF-α and IL-1b were significantly higher in cases compared with both control groups (P&lt;.001 for both). IL-6 was also higher in cases compared with age-similar controls (P=.007), and IL-8 was lower in cases compared with older controls (P&lt;.05). Lipids did not differ between cases and either control group.</p><p class="Default"><strong>Conclusions: </strong>Black women with breast cancer were significantly more insulin resis­tant with increased inflammation compared not only with age similar controls but with women who were, on average, a decade older. These biomarkers of insulin resistance and inflammation may be associated with increased risk of breast cancer recurrence and require ongoing evaluation, especially given the relatively abnormal findings com­pared with the controls in this underserved group. <em></em></p><p class="Default"><em>Ethn Dis. </em>2016;26(4):513-520; doi:10.18865/ed.26.4.513</p>


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18608-e18608
Author(s):  
Marco Tagliamento ◽  
Elisa Agostinetto ◽  
Marco Bruzzone ◽  
Marcello Ceppi ◽  
Kamal S. Saini ◽  
...  

e18608 Background: Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a diagnosis of cancer are at high risk of severe symptomatic disease (COVID-19) and death. We performed a systematic review and meta-analysis of published studies, to estimate the case-fatality rate (CFR) of patients with solid or hematological tumors and SARS-CoV-2 infection. Methods: A systematic search of PubMed library up to 31 January, 2021, was performed in order to identify publications reporting the CFR among adult patients with solid or hematological tumors and SARS-CoV-2 infection. CFR was defined as the rate of deaths among SARS-CoV-2-positive cancer patients. Moreover, we separately assessed the CFR among patients with lung and breast cancer. Studies with at least 10 patients were included. The CFR was assessed through a random effect model, and 95% confidence intervals (CI) were calculated. The Higgins I2 index was computed to assess the heterogeneity between studies. Results: The systematic search of the literaturereturned 1,727studies. 1,551 were excluded on the basis of the title, 29 based on the abstract, and 3 were duplicates. A total of 144 studies were selected, including 35,725 patients with solid or hematological tumors and SARS-CoV-2 infection. In total, 46 and 32 studies reported the CFR among COVID-19 patients with lung (total N = 1,555) and breast (total N = 1.398) cancer, respectively. Overall, the CFR was 25.5% (95% CI 23.1%-28.1%, Egger test p < 0.001). A sensitivity analysis, after excluding studies with less than 100 patients, showed a CFR of 22.1% (95% CI 19.4%-25.2%). The CFR among patients with lung cancer and SARS-CoV2 infection was 33.4% (95% CI 28.1%-39.6%) when including all studies and 26.3% (95% CI 17.6%-39.2%) at the sensitivity analysis after excluding studies with less than 100 patients. The CFR among patients with breast cancer and SARS-CoV2 infection was 13.7% (95% CI 9.1%-20.7%) when including all studies and 13.0% (95% CI 7.6%-22.1%) at the sensitivity analysis after excluding studies with less than 100 patients. Conclusions: One year after the outbreak of the pandemic, this large meta-analysis reports the impact of SARS-CoV-2 infection in patients with cancer. This population experienced a high probability of mortality, with a comparatively higher CFR in patients with lung cancer, and a comparatively lower CFR in patients with breast cancer. Patients with an underlying diagnosis of cancer require special attention with aggressive preventive measures that also include early access to COVID-19 vaccination.


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