Effects of Cancer, Chemotherapy and Cytokines on Subjective and Objective Cognitive Functioning Among Patients with Breast Cancer

Background: We aimed to investigate the associations of breast cancer (BC) and cancer-related chemotherapies with cytokine levels, and cognitive function. Methods: We evaluated subjective and objective cognitive function in BC patients before chemotherapy and 3~9 months after the completion of chemotherapy. Healthy volunteers without cancer were also compared as control group. Interleukins (IL) 2, 4, 5, 6, 10, 12p70, 13, 17A, 1β, IFNγ, and TNFα were measured. Associations of cancer status, chemotherapy and cytokine levels with subjective and objective cognitive impairments were analyzed using a regression model, adjusting for covariates, including IQ and psychological distress. Results: After adjustment, poorer performance in semantic verbal fluency was found in the post-chemotherapy subgroup compared to controls (p = 0.011, η2 = 0.070); whereas pre-chemotherapy patients scored higher in subjective cognitive perception. Higher IL-13 was associated with lower semantic verbal fluency in the post-chemotherapy subgroup. Higher IL-10 was associated with better perceived cognitive abilities in the pre-chemotherapy and control groups; while IL-5 and IL-13 were associated with lower perceived cognitive abilities in pre-chemotherapy and control groups. Our findings from mediation analysis further suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Conclusions: Our findings suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Different cytokines and their interactions may have different roles of neuroinflammation or neuroprotection that need further research.

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Evaluation of high-dose versus standard FAC chemotherapy for advanced breast cancer in protected environment units: a prospective randomized study.

Journal of Clinical Oncology ◽

10.1200/jco.1987.5.3.354 ◽

1987 ◽

Vol 5 (3) ◽

pp. 354-364 ◽

Cited By ~ 89

Author(s):

G N Hortobagyi ◽

G P Bodey ◽

A U Buzdar ◽

D Frye ◽

S S Legha ◽

...

Keyword(s):

Breast Cancer ◽

Response Rate ◽

Metastatic Breast ◽

Ambulatory Setting ◽

Survival Duration ◽

Control Group ◽

High Dose ◽

Control Groups ◽

Median Response ◽

And Control

Fifty-nine evaluable patients under 65 years of age with measurable metastatic breast cancer and without prior chemotherapy were randomly assigned to treatment with fluorouracil, Adriamycin (Adria Laboratories, Columbus, OH), and cyclophosphamide (FAC) at standard or high doses (100% to 260% higher than standard FAC) following a dose escalation schedule. Patients randomized to the high-dose FAC received the first three cycles of therapy within a protected environment. Subsequent cycles for this group were administered at standard doses of FAC in an ambulatory setting, the same as for the control group. After reaching 450 mg/m2 of Adriamycin, patients in both groups continued treatment with cyclophosphamide, methotrexate, and fluorouracil until there was disease progression. Analysis of pretreatment patient characteristics showed an even distribution for most known pretreatment factors, although the control group had slightly (but nonsignificantly) more favorable prognostic characteristics. Fourteen patients (24%) achieved a complete remission (CR) and 32 (54%) achieved a partial remission (PR), for an overall major response rate of 78%. There were no differences in overall, CR, or PR rates between the high-dose FAC and control groups. The median response durations were 11 and 10 months for the protected environment and control groups, respectively, and the median survival was 20 months for both groups. Hematologic, gastrointestinal (GI), and infection-related complications were significantly more frequent and severe in the group treated with high-dose chemotherapy. Stomatitis, diarrhea, and skin toxicity were dose-limiting. However, there were no treatment-related deaths. High-dose induction combination chemotherapy with the agents used in this study failed to increase the response rate or survival duration, and resulted in a substantial increase in toxicity.

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The effect of reflexology on quality of life in Iranian patients with breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.26_suppl.90 ◽

2016 ◽

Vol 34 (26_suppl) ◽

pp. 90-90

Author(s):

Shadan Pedramrazi

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Placebo Group ◽

Test Group ◽

Control Group ◽

Relaxation Techniques ◽

Control Groups ◽

Significant Difference ◽

And Control

90 Background: Breast cancer is one the most prevalent cancers among Iranian women. One of the complementary therapies is reflexology. The extant paper has been provided with the objective of determining the effect of reflexology on quality of life of patients with breast cancer undergoing chemotherapy in the breast disease center. Methods: This study is a randomized clinical trial which has been applied to 60 patients suffering from breast cancer under chemotherapy in breast diseases center, in 2012. The patients were selected randomly in three test, control and placebo groups. In test group, reflexology was implemented for 3 weeks and each session lasted half an hour. In placebo group, only relaxation techniques were implemented for 3 weeks, each session lasted 20-30 minutes. Control group received the routine therapies of breast cancer center. Results: Data were collected by standard questionnaires of EORTIC QLQ-C30.V.3 and EORTIC QLQ-BR23.V.3. The questionnaires were filled before intervention and two weeks after applying study. There was no significant difference in demographic characteristics or quality of life score of three groups, before intervention. Total score of quality of life was higher in interventional group compared to placebo group before and two weeks after intervention (p < 0.001) Results also indicated a significant difference in total score of quality of life between three test, placebo, and control groups after intervention (p < 0.001). A considerable improvement was noticed in the different aspects of quality of life in the test group compared to two other placebo and control groups. Conclusions: Reduction of pain, anxiety, nausea, and other symptoms related to cancer in patients suffering from cancer are assumed as the important cases of nursing cares focus, and precise nursing may diminish these symptoms considerably. Using reflexology in patients suffering from breast cancer may improve the quality of life as an effective method, and can be recommended for use in patients with breast cancer if it is supervised by health system personnel.

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An Overview of the Swedish Randomised Mammography Trials: Total Mortality Pattern and the Representivity of the Study Cohorts

Journal of Medical Screening ◽

10.1177/096914139600300208 ◽

1996 ◽

Vol 3 (2) ◽

pp. 85-87 ◽

Cited By ~ 40

Author(s):

Lennarth Nyström ◽

Lars-Gunnar Larsson ◽

Stig Wall ◽

Lars Erik Rutqvist ◽

Ingvar Andersson ◽

...

Keyword(s):

Breast Cancer ◽

Cause Of Death ◽

Mammography Screening ◽

Breast Cancer Mortality ◽

Total Mortality ◽

Control Group ◽

Control Groups ◽

Mortality Pattern ◽

And Control ◽

Screening Trials

Objectives –To analyse the cause of death pattern in the cohorts of women included in the Swedish randomised mammography screening trials by comparing the groups of invited and control women both with each other and with the general population of Swedish women. Setting –Since 1977 four randomised trials of mammography screening have been performed in Sweden: Malmö, Kopparberg and ÖOstergötland (the two county trial), Stockholm, and Gothenburg. Design –Overview of four randomised mammography screening trials. Results –The total numbers of deaths in the invited and control groups respectively were 15 695 and 11 887 corresponding to a relative risk (RR) of 1.00. There were no significant differences between the invited and control groups for cause-specific mortality, except for breast cancer. When the total mortality in the invited and the control groups was compared with that for Swedish women in general the standardised mortality ratio was close to 100. Conclusions –The cause of death pattern in the invited group was, except for breast cancer, very similar to that in the control group, showing that the groups were comparable. Similarly, the total mortality including breast cancer mortality in the control group was almost identical to that in Swedish women in general. The same was true, with the exception of breast cancer, for the invited group. These observations confirm that the trial cohorts are representative of Swedish women and indicate that the quantitative results from these trials may safely be generalised to the Swedish population.

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Impact of preoperative breast MRI on 10-year survival of patients included in the Swedish randomized multicentre POMB trial

BJS Open ◽

10.1093/bjsopen/zrab088 ◽

2021 ◽

Vol 5 (5) ◽

Author(s):

V Gonzalez ◽

B Arver ◽

L Löfgren ◽

L Bergkvist ◽

K Sandelin ◽

...

Keyword(s):

Breast Cancer ◽

Breast Mri ◽

Control Group ◽

Conventional Imaging ◽

Newly Diagnosed ◽

Control Groups ◽

Risk Of Death ◽

Preoperative Breast Mri ◽

And Control

Abstract Background The value of preoperative breast MRI as an adjunct technique regarding its effect on re-excision rates has been a subject of discussion. No survival data regarding preoperative breast MRI are available from randomized studies. Methods Ten-year follow-up of the POMB randomized multicentre study was analysed, evaluating MRI and its effect on disease-free survival (DFS) and overall survival (OS). Patients with newly diagnosed breast cancer were randomized to either preoperative MRI or conventional imaging. Kaplan–Meier plots were used to analyse DFS and OS, and Cox regression to estimate hazard ratios (HRs). Results A total of 440 patients, aged 56 years or less, with newly diagnosed breast cancer were randomized to either preoperative MRI (220) or conventional imaging (220; control). Median follow-up for each group was 10 years. DFS rates were 85.5 and 80.0 per cent for the MRI and control groups respectively (P = 0.099). The risk of relapse or death was 46 per cent higher in the control group (HR 1.46, 95 per cent c.i. 0.93 to 2.29). OS rates after 10 years were 90.9 and 88.6 per cent in the MRI and control groups respectively (P = 0.427). The risk of death was 27 per cent higher in the control group (HR 1.27, 0.71 to 2.29). Locoregional, distant, and contralateral recurrence outcomes combined were increased in the control group (P = 0.048). A subgroup analysis of patients with breast cancer stages I–III showed that preoperative MRI improved DFS compared with conventional imaging, but this did not reach statistical significance (P = 0.057). Conclusion After 10 years of follow-up, preoperative breast MRI as an adjunct to conventional imaging resulted in slightly, but non-significantly, improved DFS and OS. Registration number: NCT01859936 (http://www.clinicaltrials.gov).

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Prophylactic Effect of Memantine in Docetaxel Induced Neuropathy in Patients With Breast Cancer

10.21203/rs.3.rs-692391/v1 ◽

2021 ◽

Author(s):

Pegah Mohammadzadeh ◽

Elnaz Shaseb ◽

Zohreh Sanaat ◽

Parvin Sarbakhsh ◽

Nasrin Gholami ◽

...

Keyword(s):

Breast Cancer ◽

Peripheral Neuropathy ◽

Intervention Group ◽

Metastatic Breast ◽

Control Group ◽

P Value ◽

Control Groups ◽

Significant Difference ◽

And Control

Abstract Purpose Peripheral neuropathy is a complication of taxane that in severe cases can limit the optimal treatment. The aim of this study was to evaluate the efficacy of memantine in prevention of docetaxel induced peripheral neuropathy in patients with breast cancer. Methods In this randomized clinical trial, 40 women between the ages of 18 and 64 years with non-metastatic breast cancer (stages I to III) were included (registry number: IRCT20160310026998N9 and registry date: 26 March 2019). All patients were treated with the AC-T regimen (with docetaxel). Patients in intervention group received memantine at a dose of 20 mg for 8 weeks at the beginning of the first cycle of docetaxel. Patients in control group did not take any medication for neuropathy prevention. To assess the neuropathy, DN4 and CTCAE questionnaires were used at baseline, one months, three months and six months after the intervention. Results The DN4 questionnaire score was remarkably less in memantine group in follow up one (p-value: 0.033) and three (p < 00.1). The CTCAE follow up score did not change during study. The Neuropathy duration and Neuropathy onset, were shown significant difference between the intervention and control groups, p = 0.050 and p = 0.001, respectively. From 40 patients, 8 (40%) in memantine group and 2 (10%) in control group, did not experience any kind of neuropathy. Conclusion Data showed that prophylactic administration of memantine 20 mg/day has been effective in prevention of severity and incidence of docetaxel induced neuropathy in patients with breast cancer.

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EFFECTIVENESS OF AN EDUCATIONAL PROGRAM ABOUT BREAST CANCER AND BREAST CANCER SELF-EXAMINATION ON PERCEPTION AND PRACTICE AMONG WOMEN IN ALJEERAIF WEST ADMINISTRATIVE UNIT (2)

10.36106/ijsr/4646294 ◽

2021 ◽

pp. 38-42

Author(s):

Amel Eltaib Elagib ◽

Ibrahim Ismail Mohammed ◽

SamiaYousif Idris ◽

Jaafar Abdelrahman Omar ◽

Somia Bilal Babiker ◽

...

Keyword(s):

Breast Cancer ◽

Educational Program ◽

Intervention Group ◽

T Test ◽

Control Group ◽

P Value ◽

Control Groups ◽

Administrative Unit ◽

Self Examination ◽

And Control

In Sudan, cancer incidence has been growing considerably in recent years and is likely to continue to grow creating a big burden on the health system resources. The aim of this study is to assess the baseline Perception and Practice about breast cancer and breast self-examination (BSE) and to nd out the effectiveness of an educational program about breast cancer and BSE on Perception and Practice among women in AlJeeraif West Administrative Unit. Community based intervention study with pre-post and control was carried out among 200 women who were recruited by means of multistage sampling. The sample size was divided equally into intervention and control groups. Baseline data was collected from both groups through direct interview, using structured close ended questionnaire. Educational program was implemented for the intervention group. Four months after the intervention, women in the study and control groups were exposed to the same questionnaire. Chi-square, paired t-test and independent t-test (difference of difference) were conducted in the course of the data analyses. There was statistically signicant difference in the intervention group pre-post program in all of the HBM components in the intervention group (p value0.000), while in the control group statistically signicant difference existed only in perceived barrier (p value.004) and perceived benet (p value.000) and over all perception (p value .016) with no signicant difference in other (HBM) components. In the intervention group practice and performance scores were highly signicant pre-post program (p value 0.000), where as in the control group only practice was signicant (p value 0.001). There were statistically signicant differences in the mean difference of performance, practice and perceptions between the intervention and control groups (p-value .000). The results of this study have conrmed the effectiveness of educational program based on the health belief model on improving perceptions and practice of breast cancer and breast self-examination.

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A Case-Control Study on the p73 G4A Gene Polymorphism and Susceptibility to Breast Cancer in an Iranian Population

Iranian Journal of Public Health ◽

10.18502/ijph.v48i10.3493 ◽

2020 ◽

Author(s):

Zeinab TAVAKKOL AFSHARI ◽

Zahra GHOLIZADEH ◽

Amin Reza NIKPOOR ◽

Jalil TAVAKKOL AFSHARI ◽

Rashin GANJALI ◽

...

Keyword(s):

Breast Cancer ◽

Case Control Study ◽

Case Control ◽

Iranian Population ◽

Control Group ◽

Case Group ◽

Medical Sciences ◽

Control Groups ◽

And Control ◽

Control Study

Background: The tumor protein p73 (TP73) is a homolog of TP53 family. Ectopic p73 overexpression largely mimics p53 activities as a tumor suppressor and activates the transcription of p53-responsive genes and as a result induce apoptosis. This study aimed to investigate the association between p73 G4A polymorphism and the risk of breast cancer in a northeastern Iranian population. Methods: This case-control study was performed on 105 patients who admitted in educational hospitals of Mashhad University of Medical Sciences, Iran during 2013-2015, with breast cancer as case group and 120 healthy women as the control group. PCR-CTPP method was used to investigate the relationship between the p73 G4A polymorphism and the risk of breast cancer. Results: There was no significant association between the AA genotype of the p73 G4A polymorphism and breast cancer in case and control groups. Although G allele frequency was higher in the case group, the abundance of this allele between case and control groups was not statistically meaningful and, as a result, not associated with the risk of breast cancer in this study group. Conclusion: There was no association between G4A p73 polymorphism and the risk of breast cancer in a northeastern Iranian population.

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High Serum Estradiol Reduces Acute Hepatotoxicity Risk Induced by Epirubicin Plus Cyclophosphamide Chemotherapy in Premenopausal Women with Breast Cancer

Frontiers in Pharmacology ◽

10.3389/fphar.2020.572444 ◽

2021 ◽

Vol 11 ◽

Author(s):

Shunmin Huang ◽

Maobai Liu ◽

Fangmeng Fu ◽

Hangmin Liu ◽

Baochang He ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Linear Trend ◽

Menopausal Status ◽

High Serum ◽

Control Group ◽

Control Groups ◽

Significant Difference ◽

Premenopausal Patients ◽

And Control

Aim: We evaluated whether acute drug-induced liver injury (DILI) caused by adjuvant chemotherapy with epirubicin plus cyclophosphamide for early breast cancer was associated with estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH).Methods: Reproductive hormone test results of breast cancer patients were collected in the first chemotherapy cycle. E2, LH, and FSH levels were loge-transformed to normally distributed variables and were assessed using Student’s t-test to determine significant differences between the case and control groups. Hormone levels were classified according to the interquartile range and analyzed by logistic regression to determine their association with DILI caused by chemotherapy.Results: Among the 915 enrolled patients (DILI group: 204; control group: 711), menopausal status, along with serum E2, LH, and FSH levels, did not substantially differ between case and control groups. However, in the premenopause subgroup (n = 483), we found a significant difference in the E2 level between the case and control groups (p = 0.001). After adjusting for age and body mass index, premenopausal patients with 152–2,813 pg/mL E2 showed a lower risk of chemotherapy-induced DILI than patients with ≤20 pg/mL E2 (odds ratio: 0.394; 95% confidence interval: 0.207–0.748). The linear trend χ2 test revealed that E2 levels in premenopausal patients with breast cancer were inversely associated with the development of DILI.Conclusion: High serum E2 levels are associated with a reduced DILI risk in premenopausal patients with breast cancer undergoing epirubicin plus cyclophosphamide adjuvant chemotherapy.

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LIPID PROFILE AND ITS SIGNIFICANCE IN BREAST CANCER

International Journal of Advanced Research ◽

10.21474/ijar01/11961 ◽

2020 ◽

Vol 8 (10) ◽

pp. 1241-1248

Author(s):

Sharmin Arif ◽

◽

Fauzia Abdus Samad ◽

Syed Abdus Samad ◽

Asif Riaz Khan ◽

...

Keyword(s):

Breast Cancer ◽

Lipid Profile ◽

Cancer Patients ◽

Morbidity And Mortality ◽

Control Group ◽

Breast Cancer Patients ◽

Control Groups ◽

Common Cancer ◽

And Control ◽

The Relationship

Background: According to WHO, breast cancer is the most common cancer in the women worldwide, soearly diagnosis is the best way to reduce its morbidity and mortality. Among various risk factors, the relationship between serum lipid profile and breast cancer is still unclear. Therefore, this study was conducted to evaluate this relationship. Methodology: Prospective, descriptive observational study with a comparative study designconducted at Fauji Foundation Hospital, Rawalpindi between November 2018 to April 2019. Results: 140 patients were divided into two groups i.e. cases and controls. Both groups were equally sub divided based on menstrual status. Independent student t-test was applied for comparison between the groups. BMI was significantly higher in the study group as compared to control group (p=0.002). Serum TG and LDL levels were higher in breast cancer patients (p= 0.032 and p=0.07 respectively). Cholesterol level was not statistically different in any group (p= >0.05). Higher HDL levels were seen in pre-menopausal cases (p=0.004) but there was no statistical difference when studied across cases and control groups. Conclusion: As breast cancer is the most common tumor in females, so early diagnosis is the key to reduce its morbidity and mortality. In this study, higher BMI, TG and LDL levels were seen in breast cancer patients as compared to controls. So, it may be concluded that BMI and dyslipidemia have some role in the etiology of breast cancer.

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Preoperative Paravertebral Block and Chronic Pain after Breast Cancer Surgery: A Double-blind Randomized Trial

Anesthesiology ◽

10.1097/aln.0000000000003989 ◽

2021 ◽

Author(s):

Aline Albi-Feldzer ◽

Sylvain Dureau ◽

Abdelmalek Ghimouz ◽

Julien Raft ◽

Jean-Luc Soubirou ◽

...

Keyword(s):

Breast Cancer ◽

Chronic Pain ◽

Odds Ratio ◽

Breast Surgery ◽

Paravertebral Block ◽

Breast Cancer Surgery ◽

Control Group ◽

Control Groups ◽

Double Blind ◽

And Control

Background The effectiveness of paravertebral block in preventing chronic pain after breast surgery remains controversial. The primary hypothesis of this study was that paravertebral block reduces the incidence of chronic pain 3 months after breast cancer surgery. Methods In this prospective, multicenter, randomized, double-blind, parallel-group, placebo-controlled study, 380 women undergoing partial or complete mastectomy with or without lymph node dissection were randomized to receive preoperative paravertebral block with either 0.35 ml/kg 0.75% ropivacaine (paravertebral group) or saline (control group). Systemic multimodal analgesia was administered in both groups. The primary endpoint was the incidence of chronic pain with a visual analogue scale (VAS) score greater than or equal to 3 out of 10, 3 months after surgery. The secondary outcomes were acute pain, analgesic consumption, nausea and vomiting, chronic pain at 6 and 12 months, neuropathic pain, pain interference, anxiety, and depression. Results Overall, 178 patients received ropivacaine, and 174 received saline. At 3 months, chronic pain was reported in 93 of 178 (52.2%) and 83 of 174 (47.7%) patients in the paravertebral and control groups, respectively (odds ratio, 1.20 [95% CI, 0.79 to 1.82], P = 0.394). At 6 and 12 months, chronic pain occurred in 104 of 178 (58.4%) versus 79 of 174 (45.4%) and 105 of 178 (59.0%) versus 93 of 174 (53.4%) patients in the paravertebral and control groups, respectively. Greater acute postoperative pain was observed in the control group 0 to 2 h (area under the receiver operating characteristics curve at rest, 4.3 ± 2.8 vs. 2.9 ± 2.8 VAS score units × hours, P < 0.001) and when maximal in this interval (3.8 ± 2.1 vs. 2.5 ± 2.5, P < 0.001) but not during any other interval. Postoperative morphine use was 73% less in the paravertebral group (odds ratio, 0.272 [95% CI, 0.171 to 0.429]; P < 0.001). Conclusions Paravertebral block did not reduce the incidence of chronic pain after breast surgery. Paravertebral block did result in less immediate postoperative pain, but there were no other significant differences in postoperative outcomes. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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