Value of Procollagen Type I Aminoterminal Propeptide in Women with Breast Cancer with regard to Metastases

Background. The aim of this study was to show the importance of the bone marker procollagen type 1 aminoterminal propeptide (P1NP) in detecting bone metastases in women suffering from breast cancer. We furthermore investigated to what degree P1NP is correlated to the degree of bone metastases, and if P1NP is increased in patients with metastases other than bone. Patients and Methods. We analyzed 80 serum samples of women (17 premenopausal/63 postmenopausal) with breast cancer. Therefore we used a specific immunoassay “ELECSYS 2010” by Roche Diagnostics. We divided our group of patients with regard to menopausal status, sites of metastases and number of bone metastases. Results. As a result we found higher concentrations of P1NP in women with radiologically confirmed bone metastases (median: 125.75 ng/mL) in comparison to the collective without bone involvement (median: 73.61 ng/mL). However, both groups showed values above the applied cutoff values of median 27.8 ng/mL for premenopausal women and median: 37.1 ng/mL for the postmenopausal group due to the fact that all patients had cancer. Furthermore higher P1NP concentrations were found in women with more than 5 sites of bone metastases (median: 183.9 ng/mL) than in patients with only one site of bone metastases (median: 37 ng/mL). Also patients with no bone involvement but other sites of metastases showed quite high P1NP concentrations (median: 73.61 ng/mL). Conclusion. The marker of bone turnover procollagen type 1 aminoterminal propeptide can be considered as a useful tool for estimating the extent of bone involvement and for the detection of bone metastases. P1NP cannot replace conventional methods for detecting bone metastases such as radiological methods but it can help clarify unclear radiological results. This study does not take into account the change of P1NP concentration during the course of therapy.

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Height, weight, weight change and risk of breast cancer in Rio de Janeiro, Brazil

Sao Paulo Medical Journal ◽

10.1590/s1516-31802001000200005 ◽

2001 ◽

Vol 119 (2) ◽

pp. 62-66 ◽

Cited By ~ 15

Author(s):

Anelise Bezerra de Vasconcelos ◽

Gulnar Azevedo e Silva Mendonça ◽

Rosely Sichieri

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Rio De Janeiro ◽

Menopausal Status ◽

Premenopausal Women ◽

Positive Association ◽

State University ◽

Weight Changes ◽

Potential Risk Factors ◽

Incident Cases

CONTEXT: The relationship between body size and breast cancer still remains controversial in considering menopausal status. OBJECTIVE: To evaluate the association of height, weight and weight changes with breast cancer in the city of Rio de Janeiro, Brazil. DESIGN: Case-control study. SETTING: National Cancer Institute (INCA), Rio de Janeiro, Brazil, and State University of Rio de Janeiro (UERJ). SAMPLE: 177 incident cases of invasive breast cancer admitted to the main hospital of INCA between May 1995 and February 1996, and 377 controls recruited from among female visitors to the same hospital. MAIN MEASUREMENTS: Height and weight were measured and information on maximum weight, weight at ages 18 and 30 years, and potential risk factors were ascertained by interview at the hospital. RESULTS: Height was not related to risk of breast cancer among both pre and postmenopausal women. Nevertheless, women in this study were shorter than in studies that have found a positive association. Premenopausal women in the upper quartile of recent body mass index (BMI) and maximum BMI showed a reduced risk of breast cancer (P for trend <= 0.03). Weight loss between ages 18 and 30 years and from 18 years to present was also associated with breast cancer among premenopausal women. CONCLUSIONS: These findings may merely indicate the known association between leanness and breast cancer. Further studies should explore the role of weight loss on breast cancer risk.

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Low Levels of Omega-3 Long-Chain Polyunsaturated Fatty Acids Are Associated with Bone Metastasis Formation in Premenopausal Women with Breast Cancer: A Retrospective Study

Nutrients ◽

10.3390/nu12123832 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3832

Author(s):

Caroline Goupille ◽

Philippe G. Frank ◽

Flavie Arbion ◽

Marie-Lise Jourdan ◽

Cyrille Guimaraes ◽

...

Keyword(s):

Breast Cancer ◽

Adipose Tissue ◽

Bone Metastases ◽

Premenopausal Women ◽

Lymph Node Involvement ◽

Axillary Lymph ◽

Breast Adipose Tissue ◽

Breast Adipose ◽

Node Involvement ◽

Low Levels

In the present study, we investigated various biochemical, clinical, and histological factors associated with bone metastases in a large cohort of pre- and postmenopausal women with breast cancer. Two hundred and sixty-one consecutive women with breast cancer were included in this study. Breast adipose tissue specimens were collected during surgery. After having established the fatty acid profile of breast adipose tissue by gas chromatography, we determined whether there were differences associated with the occurrence of bone metastases in these patients. Regarding the clinical and histological criteria, a majority of the patients with bone metastases (around 70%) had tumors with a luminal phenotype and 59% of them showed axillary lymph node involvement. Moreover, we found a negative association between the levels of n-3 long-chain polyunsaturated fatty acids (LC-PUFA) in breast adipose tissue and the development of bone metastases in premenopausal women. No significant association was observed in postmenopausal women. In addition to a luminal phenotype and axillary lymph node involvement, low levels of n-3 LC-PUFA in breast adipose tissue may constitute a risk factor that contributes to breast cancer bone metastases formation in premenopausal women.

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Bone Metastasis Prognostic Factors in Breast Cancer

Breast Cancer Basic and Clinical Research ◽

10.1177/1178223419830978 ◽

2019 ◽

Vol 13 ◽

pp. 117822341983097 ◽

Cited By ~ 2

Author(s):

Akram Yazdani ◽

Sara Dorri ◽

Alireza Atashi ◽

Hoda Shirafkan ◽

Hedieh Zabolinezhad

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Bone Metastasis ◽

Lymph Nodes ◽

Bone Metastases ◽

Tumor Size ◽

Menopausal Status ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Factors Associated

Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P < .05). There was no significant difference between mean groups with and without bone metastases regarding serum concentration of CEA, CA-153, HB, and histopathologic type ( P > .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.

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Severely restricting energy intake for 24 h does not affect markers of bone metabolism at rest or in response to re-feeding

European Journal of Nutrition ◽

10.1007/s00394-020-02186-4 ◽

2020 ◽

Vol 59 (8) ◽

pp. 3527-3535

Author(s):

David J. Clayton ◽

Lewis J. James ◽

Craig Sale ◽

Iain Templeman ◽

James A. Betts ◽

...

Keyword(s):

Bone Metabolism ◽

Energy Intake ◽

Type I Collagen ◽

Plasma Concentrations ◽

Energy Restriction ◽

Type I ◽

Procollagen Type ◽

Markers Of Bone Turnover ◽

Ad Libitum

Abstract Purpose Intermittent energy restriction commonly refers to ad libitum energy intake punctuated with 24 h periods of severe energy restriction. This can improve markers of metabolic health but the effects on bone metabolism are unknown. This study assessed how 24 h severe energy restriction and subsequent refeeding affected markers of bone turnover. Methods In a randomised order, 16 lean men and women completed 2, 48 h trials over 3 days. On day 1, participants consumed a 24 h diet providing 100% [EB: 9.27 (1.43) MJ] or 25% [ER: 2.33 (0.34) MJ] of estimated energy requirements. On day 2, participants consumed a standardised breakfast (08:00), followed by an ad libitum lunch (12:00) and dinner (19:30). Participants then fasted overnight, returning on day 3. Plasma concentrations of C-terminal telopeptide of type I collagen (CTX), procollagen type 1 N-terminal propeptide (P1NP) and parathyroid hormone (PTH) were assessed as indices of bone metabolism after an overnight fast on days 1–3, and for 4 h after breakfast on day 2. Results There were no differences between trials in fasting concentrations of CTX, P1NP or PTH on days 1–3 (P > 0.512). During both trials, consuming breakfast reduced CTX between 1 and 4 h (P < 0.001) and PTH between 1 and 2 h (P < 0.05), but did not affect P1NP (P = 0.773) Postprandial responses for CTX (P = 0.157), P1NP (P = 0.148) and PTH (P = 0.575) were not different between trials. Ad libitum energy intake on day 2 was greater on ER [12.62 (2.46) MJ] than EB [11.91 (2.49) MJ]. Conclusions Twenty-four hour severe energy restriction does not affect markers of bone metabolism.

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Chemotherapy in Premenopausal Breast Cancer Patients

Breast Care ◽

10.1159/000441371 ◽

2015 ◽

Vol 10 (5) ◽

pp. 307-310 ◽

Cited By ~ 10

Author(s):

Ann H. Partridge

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Menopausal Status ◽

Premenopausal Women ◽

Optimal Strategies ◽

Cytotoxic Chemotherapy ◽

Breast Cancer Patients ◽

Premenopausal Breast Cancer ◽

Hormone Receptor Positive ◽

Breast Cancer Outcomes

Evidence has long demonstrated that premenopausal women obtain the greatest benefit from adjuvant chemotherapy overall, with risk reduction increasing with decreasing age. The chemoendocrine effect of chemotherapy has only more recently been documented as impacting on outcomes for women with hormone receptor-positive breast cancer, and recent data have elucidated the optimal strategies for manipulating the menopausal status to improve disease outcomes, without necessarily including cytotoxic chemotherapy. Still, many premenopausal women will require adjuvant cytotoxic chemotherapy, and the effects of treatment on women diagnosed with breast cancer in the premenopausal setting can have important implications both on their breast cancer outcomes and on comorbidities and psychosocial outcomes. This article describes the most recent information and issues surrounding the indications, effects, and special considerations for adjuvant chemotherapy in premenopausal women with breast cancer, in an effort to inform their care.

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Obesity and Breast Cancer: A Paradoxical and Controversial Relationship Influenced by Menopausal Status

Frontiers in Oncology ◽

10.3389/fonc.2021.705911 ◽

2021 ◽

Vol 11 ◽

Author(s):

Laura García-Estévez ◽

Javier Cortés ◽

Silvia Pérez ◽

Isabel Calvo ◽

Isabel Gallegos ◽

...

Keyword(s):

Breast Cancer ◽

Menopausal Status ◽

Premenopausal Women ◽

Premature Death ◽

Health Concern ◽

Clinical Factors ◽

Inflammatory Status ◽

Pathway Activation ◽

The Impact ◽

The Relationship

Breast cancer is the most common tumor in women worldwide, and an increasing public health concern. Knowledge of both protective and negative risk factors is essential for a better understanding of this heterogenous disease. We undertook a review of the recent literature and evaluated the relationship between obesity mediators and breast cancer development depending on menopausal status. Excess weight is now pandemic and has replaced tobacco as the main lifestyle-related risk factor for premature death. Although the prevalence of obesity/overweight has increased globally over the last 50 years, the potential harm attributable to excess fat has generally been underestimated. The relationship between overweight/obesity, breast cancer and overall risk appears to be highly dependent on menopausal status. Thus, obesity increases the risk of breast cancer in postmenopausal women but, conversely, it appears to be protective in premenopausal women. We evaluate the role of different clinical factors potentially involved in this seemingly contradictory relationship, including estrogen, mammogram density, adipokines, insulin-signaling pathway activation, and inflammatory status. A key focus of this review is to better understand the impact of body mass index and menopausal status on these clinical factors and, hence, provide some clarity into the inter-relationships involved in this controversial issue.

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Low-Dose Tamoxifen for Mammographic Density Reduction: A Randomized Controlled Trial

Journal of Clinical Oncology ◽

10.1200/jco.20.02598 ◽

2021 ◽

pp. JCO.20.02598 ◽

Cited By ~ 1

Author(s):

Mikael Eriksson ◽

Martin Eklund ◽

Signe Borgquist ◽

Roxanna Hellgren ◽

Sara Margolin ◽

...

Keyword(s):

Breast Cancer ◽

Mammographic Density ◽

Screening Program ◽

Standard Dose ◽

Controlled Trial ◽

Menopausal Status ◽

Premenopausal Women ◽

Secondary Outcome ◽

Double Blind ◽

Density Reduction

PURPOSE Tamoxifen prevents breast cancer in high-risk women and reduces mortality in the adjuvant setting. Mammographic density change is a proxy for tamoxifen therapy response. We tested whether lower doses of tamoxifen were noninferior to reduce mammographic density and associated with fewer symptoms. PATIENTS AND METHODS Women, 40-74 years of age, participating in the Swedish mammography screening program were invited to the 6-month double-blind six-arm randomized placebo-controlled noninferiority dose-determination KARISMA phase II trial stratified by menopausal status (EudraCT 2016-000882-22). In all, 1,439 women were accrued with 1,230 participants accessible for intention-to-treat analysis. The primary outcome was proportion of women treated with placebo, 1, 2.5, 5, and 10 mg whose mammographic density decreased at least as much as the median reduction in the 20 mg arm. The noninferior margin was 17%. Secondary outcome was reduction of symptoms. Post hoc analyses were performed by menopausal status. Per-protocol population and full population were analyzed in sensitivity analysis. RESULTS The 1,439 participants, 566 and 873 pre- and postmenopausal women, respectively, were recruited between October 1, 2016, and September 30, 2019. The participants had noninferior mammographic density reduction following 2.5, 5, and 10 mg tamoxifen compared with the median 10.1% decrease observed in the 20 mg group, a reduction confined to premenopausal women. Severe vasomotor symptoms (hot flashes, cold sweats, and night sweats) were reduced by approximately 50% in the 2.5, 5, and 10 mg groups compared with the 20 mg group. CONCLUSION Premenopausal women showed noninferior magnitude of breast density decrease at 2.5 mg of tamoxifen, but fewer side effects compared with the standard dose of 20 mg. Future studies should test whether 2.5 mg of tamoxifen reduces the risk of primary breast cancer.

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Dietary consumption of phytochemicals and breast cancer risk in Mexican women

Public Health Nutrition ◽

10.1017/s136898000800325x ◽

2009 ◽

Vol 12 (6) ◽

pp. 825-831 ◽

Cited By ~ 22

Author(s):

Luisa Torres-Sanchez ◽

Marcia Galvan-Portillo ◽

Mary S Wolff ◽

Lizbeth Lopez-Carrillo

Keyword(s):

Breast Cancer ◽

Menopausal Status ◽

Reproductive Factors ◽

Premenopausal Women ◽

Protective Role ◽

Mexican Women ◽

Dietary Consumption ◽

History Of ◽

High Dietary Intake

AbstractObjectiveTo perform an evaluation of selected phytochemicals intake and breast cancer (BC) risk in Mexican women.DesignWe conducted hospital-based case–control study.SettingMexico City between 1994 and 1996.SubjectsA total of 141 histologically confirmed BC cases were age-matched (±3 years) to an equal number of hospital controls. The reproductive history of each woman was obtained by direct interview. The dietary consumption of flavonols, flavones, flavan-3-ols, cinnamic acid, lariciresinol, pinoresinol, secoisolariciresinol, matairesinol and coumestrol was obtained by means of a validated FFQ.ResultsAmong postmenopausal women, high dietary intake of flavonols and flavones was associated with a significant reduction of BC risk (high v. low tertile: OR = 0·21, 95 % CI 0·07, 0·60, P for trend = 0·004 and OR = 0·29, 95 % CI 0·10, 0·82, P for trend = 0·025, respectively); consumption of lignans (lariciresinol and pinoresinol) showed a similar effect, but only among premenopausal women (high v. low tertile: OR = 0·32, 95 % CI 0·10, 0·99, P for trend = 0·051 and OR = 0·19, 95 % CI 0·06, 0·62, P for trend = 0·006, respectively).ConclusionsOur results support a protective role of specific dietary phytochemicals in BC risk by menopausal status, independent of other reproductive factors.

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