The Valuable Role of Armc1 in Invasive Breast Cancer as a Novel Biomarker

Background: Invasive breast carcinoma (BRCA) is a common type of breast cancer with high incidence in clinics, so it is significant to find an effective biomarker for BRCA diagnosis and treatment. Although some Armadillo (Arm)-repeat proteins families are confirmed to be biomarkers in cancers, the role of Armadillo repeat-containing 1 (ARMC1) in BRCA remains unknown.Methods: We analyzed the ARMC1 expression in normal breast tissues and BRCA samples, and its association with overall survival by the public database. χ² test evaluated the risks associated with ARMC1 expression in TCGA-BRCA patient samples. The ARMC1 mutations in BRCA were explored in the cBioportal database. Besides, the GO and KEGG analysis was used to explore the potential signaling pathways of ARMC1 in BRCA. Lastly, Immunohistochemistry and immunohistochemistry were performed to validate the ARMC1 expression in BRCA.Results: ARMC1 level in tumor sample was significantly higher than that in normal tissue, and it was also related to lower survival. The factors in clinical patients such as tumor stage and grade and histology were associated with ARMC1 expression. There were 32% of ARMC1 genetic mutations in BRCA, and the amplification and high expression made up the majority of them. Also, ARMC1 might regulate BRCA by involving in the cell cycle. Increased ARMC1 expression was found in clinical breast carcinoma tissues by our confirmatory experiments.Conclusions: All the results revealed that ARMC1 may play a significant role in BRCA as a biomarker, it provides valuable clues for the treatment and diagnosis of invasive breast cancer.

Breast cancer screening program for risk groups: facts and perspectives

ABSTRACT Objectives: to measure the frequency and compliance of breast cancer screening, according to the risk for this disease. Methods: a cross-sectional study with 950 female users of 38 public Primary Health Care services in São Paulo, between October and December 2013. According to UHS criteria, participants were grouped into high risk and standard risk, and frequency, association (p≤0.05), and screening compliance were measured. Results: 6.7% had high risk and 93.3% standard risk, respectively; in these groups, the frequency and compliance of clinical breast examination were 40.3% and 37.1%, and 43.5% and 43.0% (frequency p=0.631, compliance p=0.290). Mammograms were 67.7% and 35.5% for participants at high risk, and 57.4% and 25.4% for those at standard risk (frequency p=0.090, compliance p=0.000). Conclusions: in the groups, attendance and conformity of the clinical breast exam were similar; for mammography, it was higher in those at high risk, with assertiveness lower than the 70% set in UHS.

ARE WE DOING ENOUGH IN PROMOTING BREAST CANCER SCREENING: AN EVALUATION OF MALAYSIA BREAST CANCER SCREENING PROGRAM

Breast cancer is the most common cancer affecting women globally. Several ways of breast cancer screening tools are available. This study aims to evaluate Malaysia's breast cancer screening program using the national database based on participation and performance indicators for the past five years. A retrospective cumulative analysis of clinical breast examination and mammogram screening services were performed using the national dataset of 2016-2020 obtained from the Health Informatics Centres, Ministry of Health Malaysia. The performance indicator represents the percentage of breast abnormality detected during clinical breast examination and the proportion of confirmed cancer through mammogram screening. A reduction in the participation rate for clinical breast examination was noted from 2016 (25.8%) to 2020(25.1%). However, a high participation rate in 2019 (29.1%) was noted following active health promotion intervention. The rate of high-risk women who underwent mammogram screening fluctuated by years according to active breast awareness campaign. The average rate of confirmed breast cancer annually was 0.7% and was noted highest in 2020 (1.17%). Improving early diagnosis is an eminent strategy for cancer control in all settings, including strengthening health systems and providing universal health coverage. Successful breast cancer prevention and control programs require intersectoral planning and active community participation. Ensuring sustainability and accessibility of breast cancer screening programs is highly needed. Fostering good collaborative multiagency partnership and community participation for the cancer control program urges an innovative approach through a policy formulation.

Modern Breastfeeding Options for Preterm Children in Neonatal Hospital

The literature overview on the issue of breastfeeding in neonatal departments, including neonatal intensive care units, is presented. The importance of breastfeeding for newborns with perinatal pathology is justified, as breast milk is vital for these children due to its unique sanogenetic properties. Data on special preventive and therapeutic role of breastfeeding for premature infants is presented. Reasons that complicate the use of breast milk in neonatal hospitals were analyzed (including those related to insufficient bacteriological and virological safety of native breast milk due to methodological errors during its collection and usage). Particular attention was paid to ensuring the breastfeeding safety during new coronavirus infection pandemic. This difficult period has demonstrated and confirmed the expediency of combining two breastfeeding approaches in perinatal centers: use of maternal milk and use of donor breast milk. Another section of review is devoted to modern breast milk processing technologies. Use of electric clinical breast pumps is crucial for promoting and supporting breastfeeding in the perinatal center.

Breast cancer awareness and downstaging practices among adult women in the Gulu City Main Market, Northern Uganda: A cross-sectional study

Background: Breast cancer (BC) is one of the most common cancers that occur worldwide among women. There were more disability-adjusted life years (DALYs) lost to breast cancer among women worldwide than any other cancers, and DALYs occurred in women globally after puberty, with increasing rates later in life. Improvements in breast cancer survival began in the 1980s in countries where early detection programs combined with different modes of treatment to eradicate the invasive form of the disease were practiced. Recent data showed that there was a higher prevalence of breast cancer among women in Northern Uganda than among women in the rest of Uganda.The objective of this study was to determine factors associated with breast cancer awareness, breast self-examination (BSE), clinical breast examination (CBE), and other modalities for screening and early breast cancer detection among adult women in the Gulu main market.Methods: A cross-sectional study was conducted in the Gulu main market in 2020. A total of 98 adult women were recruited for the study by a random sampling method. The questionnaire had an internal validity of Cronbach’s α=0.72. The study was approved by a local IRB. SPSS version 26.0 was used for data analysis, and a p-value less than 0.05 was considered significant.Results: Most participants were 20-29 years 41(41.8%), married 44(44.9%), monthly incomes of >UGX1 million shillings 51(52.2%), Acholi 81(82.7%), Catholics 46(46.9%), vendors 75(76.5%), duration of work in the market (1-10 years) 64(65.4%), primary level of education 39(39.8%), and had 1-2 pregnancies 37(37.8%). The independent factors associated with breast cancer awareness, breast self-examination, and clinical breast examination were vendor (primary occupation) (β=-0.130, t=-2.979, p<0.004), duration of work in the market (1-10 years) (β=-0.186, t=-2.452, p<0.016), and higher level of education (β=-0.091, t=-2.506, p<0.014).Conclusions: Breast cancer awareness and downstaging practices in adult women in the Gulu main market were thought-provoking. Women with better socioeconomic status (higher education, moderate work duration in the market and primarily vendors) in the Gulu main market were more likely aware and practiced breast cancer downstaging activities. There is a need to strengthen publicity on breast cancer-related knowledge for lower-income occupational groups and those with lower education levels to better understand the importance of conducting BSE, CBE, and mammography for early breast cancer detection.

Concentrated Thermomics for Early Diagnosis of Breast Cancer

Thermography has been employed broadly as a corresponding diagnostic instrument in breast cancer diagnosis. Among thermographic techniques, deep neural networks show an unequivocal potential to detect heterogeneous thermal patterns related to vasodilation in breast cancer cases. Such methods are used to extract high-dimensional thermal features, known as deep thermomics. In this study, we applied convex non-negative matrix factorization (convex NMF) to extract three predominant bases of thermal sequences. Then, the data were fed into a sparse autoencoder model, known as SPAER, to extract low-dimensional deep thermomics, which were then used to assist the clinical breast exam (CBE) in breast cancer screening. The application of convex NMF-SPAER, combining clinical and demographic covariates, yielded a result of 79.3% (73.5%, 86.9%); the highest result belonged to NMF-SPAER at 84.9% (79.3%, 88.7%). The proposed approach preserved thermal heterogeneity and led to early detection of breast cancer. It can be used as a noninvasive tool aiding CBE.

Barriers and Facilitators to Integrating Clinical Breast Examinations With Cervical Cancer Screening Programs in Outpatient Clinics in Western Kenya

PURPOSE Nearly half of Kenyan women with breast cancer present with advanced disease—owing partially to limited patient education and screening limitations in low- and middle-income countries. With increasing access to nurse-led cervical cancer screening (CCS) in government clinics in Kenya, we investigated provider-perceived barriers and facilitators to integrating clinical breast examinations (CBEs) with ongoing CCS programs in Kisumu County, Kenya. METHODS CCS providers within the Ministry of Health Clinics in Kisumu County, Kenya, were recruited to participate in a two-phase, sequential, mixed methods study. Knowledge of CBE guidelines was assessed with a questionnaire. Providers with significant CCS and CBE experience then completed a one-on-one interview discussing barriers and facilitators to integration. RESULTS Sixty-nine providers from 20 randomly selected facilities participated in the survey. Providers all agreed that breast cancer screening was very important. Although 93% said that they routinely offered CBEs, only 22% of these providers screened at least eight of their last 10 patients. Forty-four percent identified four or more of five signs and symptoms of breast cancer, and 33% identified four to five risk factors. Although providers showed enthusiasm for integration of CBEs into their practices, barriers were identified and grouped into four themes: (1) fragmentation of services, (2) staffing shortage and inadequate on-the-job training, (3) limited space and referral system challenges, and (4) limited patient awareness on need for cancer screening. CONCLUSION Addressing providers' concerns by providing routine on-the-job clinical training, improving staffing shortages, strengthening the diagnostic and treatment referral pathway, and increasing patient education are some of the first steps in facilitating integration of CBEs with CCS services in primary care clinics in Kenya.

The randomized trial of mammography screening that was not—A cautionary tale

Two randomized trials were conducted in Canada in the 1980s to test the efficacy of breast cancer screening. Neither of the trials demonstrated benefit. Concerns were raised regarding serious errors in trial design and conduct. Here we describe the conditions that could allow subversion of randomization to occur and the inclusion of many symptomatic women in a screening trial. We examine anomalies in data where the balance would be expected between trial arms. “Open book” randomization and performance of clinical breast examination on all women before allocation to a trial arm allowed women with palpable findings to be mis-randomized into the mammography arm. Multiple indicators raising suspicion of subversion are present including a large excess in poor-prognosis cancers in the mammography trial arm at prevalence screen. Personnel described shifting of women from the control group into the mammography group. There is compelling evidence of subversion of randomization in Canadian National Breast Screening Study. Mis-randomization of even a few women with advanced breast cancer could markedly affect measured screening efficacy. The Canadian National Breast Screening Study trials should not influence breast screening policies.

Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers

Breast cancer (BC) is the commonest cancer in Malaysia. Delayed diagnosis is a significant cause of BC mortality in the country. Early diagnosis and screening are vital strategies in mortality reduction. This study assessed the level of utilisation and barriers for breast self-examination (BSE), clinical breast examination (CBE) and mammogram in a semi-rural population in Malaysia and compared these across the different ethnic groups. This cross-sectional study was conducted among women aged 40 years and above, embedded within a health and demographic surveillance site (HDSS) in Segamat, Malaysia. Trained data collectors collected data on screening and barriers during home visits. Study participants (n = 250) were aged 59.4 ± 10.9 years and represented Malaysia’s three major ethnic groups. Practice of regular BSE, CBE uptake (ever) and mammogram (ever) was 23.2%, 36% and 22.4%, respectively. Regular BSE practice was highest in the Malay ethnic group and least among the Chinese. Regular CBE was very low in all ethnic groups (<5%). Mammogram uptake was highest among Chinese (34.4%), followed by Indians (30.4%) and Malays (16.6%). After adjusting for other socio-demographic variables, Malay ethnicity was positively associated with regular BSE (adjusted OR = 5.26, 95% CI 2.05, 13.50) and negatively associated with having had a mammogram (adjusted OR = 0.3, 95% CI 0.15, 0.57). Lower education was negatively associated (adjusted OR = 0.36, 95% CI 0.17, 0.74) with mammogram attendance (ever). Emotional and financial barriers were the most reported types of barriers, specifically, fear of diagnosis (74.8%), cost of diagnosis (69.6%) and fear of losing a breast (66.4%). Malay women more commonly reported most barriers compared to other ethnic groups. Screening uptake was low among semi-rural women in Malaysia. Implementing culturally appropriate interventions that consider ethnic differences is crucial to empowering women to engage in BC screening initiatives in these communities.