Incidence of breast cancer and methylation of PCDH gene: a single ratio meta analysis of single rate

IntroductionBreast cancer presents one of the highest rates of prevalence. With the development of genetics and biotechnology, we have learned that the occurrence and development of many cancers are closely related to abnormal gene expression. At present, some pieces of literature have reported that there may be a correlation between the expression of PCDH and the occurrence of breast cancer.Therefore, we selected some loci from PCDH gene to explore the correlation between the methylation of PCDH gene and breast cancer.Material and methodsThis research is a systematic review and critical appraisal, make a meta-analysis of prospective and retrospective cohort study. Research was conducted through computer Science, Wanfang and Chinese knowledge network databases PubMed, Embase and Network. In a literature search, seven cohort studies were identified. This I2 statistic is used to quantify heterogeneity. A fixed effect model was used to synthesize the results. Regression tests of linear funnel plot asymmetry were used to estimate potential publication bias.ResultsThe methylation rate of PCDH gene in breast cancer with lymph node metastasis was 75%, and that in breast cancer without lymph node metastasis was 70%. The methylation rate of PCDH gene was 75% in breast cancer group with high expression of the Ki-67 gene and 71% in breast cancer group with low expression of Ki-67 gene.ConclusionsAccording to previous studies, the positive rate of methylation of PCDH gene in breast cancer tissues is higher than that in adjacent tissues, and there is no obvious statistical difference in the correlation between lymphatic metastasis and Ki-67.

ANÁLISE DA RETIRADA PARCIAL DO TECIDO MAMÁRIO EM PACIENTES ONCOLÓGICOS

Introdução: O câncer é uma das doenças mais prevalentes no mundo. Todos os anos várias pessoas passam pela cirurgia de mastectomia que visa a retirada do tecido mamário para auxiliar no tratamento oncológico. Objetivos: Revisar o estudo da análise da recorrência de câncer oncológico através da análise do tecido mamário individual. Métodos: Este trabalho trata-se de um revisão de literatura na qual foi feita com base no levantamento de dados através de artigos do National Center for Biotechnology Informations.Resultados: Nota se que durante o tratamento de pacientes oncológicos mamários a necessidade em sua maioria da retirada do tecido mamário, buscando estética do paciente faz se á uma mastectomia que retire o mínimo possível. tornando se cada vez mais comum caso em que os pacientes fazem mastectomia em que a pele ou o mamilo são preservados. Contudo deve-se levar em conta outros aspectos além da estética. A prevalência da eficácia e segurança desses procedimentos, especialmente NSM e mastectomia poupadora de aréola, no tratamento do câncer de mama permanecem questionáveis. Uma revisão recente do Cochrane Breast Cancer Group concluiu que a qualidade das evidências para todos os resultados, incluindo sobrevida global e local livre de doença, foi considerada muito baixa.¹ Embora exista um valor de referência oncologicamente seguro (5 mm) para o retalho cutâneo, na prática clínica e nos exames de imagem, observamos resultados variáveis, como retalhos não homogêneos finos em alguns pontos, mas espessos em outros bem como como visível e grandes quantidades de RBT². A falta de padronização desses procedimentos cirúrgicos e análises de imagem tem impacto significativo na decisão quanto à radioterapia adjuvante (RT) após mastectomias menos radicais. A diferença entre os diferentes níveis entre o resíduo de tecido mamário em pacientes que passaram por cirurgia devido a tratamento oncológico.³ Conclusões: Este trabalho permitiu observar a necessidade da retirada total do tecido mamário, para melhor eficácia no tratamento de câncer.

The Association Between Triglyceride-Glucose Index as a Marker of Insulin Resistance and the Risk of Breast Cancer

BackgroundThis study aims to evaluate the association and dose-response between triglyceride-glucose (TyG) index and breast cancer.MethodThis is a multicenter case-control study conducted in six public referral hospitals in Indonesia. Cases are individuals aged 19 years or above who were diagnosed with breast cancer within 1 year of diagnosis, based on histopathology and immunohistochemistry. Controls were recruited from corresponding hospitals. TyG index was determined by the formula: ln (fasting TG [mg/dl] × fasting glucose [mg/dl]).ResultsThere were 212 participants in the breast cancer group and 212 participants in the control group. TyG index was higher in patients with breast cancer (median 8.65 [7.38, 10.9] vs. 8.30 [7.09, 10.84], p < 0.001). When compared with TyG quartile of Q1, Q4 was associated with an OR of 2.42 (1.77, 3.31), p < 0.001, Q3 was associated with an OR of 1.53 (1.21, 1.93), p < 0.001, Q2 was associated with an OR of 1.39 (1.12, 1.73), p = 0.002 for the risk of breast cancer. The dose-response relationship was nonlinear (p < 0.001). On univariate analysis, smoking (OR 2.15 [1.44, 3.22], p < 0.001), use of contraception (1.73 [1.15, 2.60], p = 0.008), alcohol consumption (OR 2.04 [0.96, 4.35], p = 0.064), and TyG Index >8.87 (OR 3.08 [1.93, 4.93], p < 0.001) were associated with risk of breast cancer. Independently associated with increased risk of breast cancer included smoking (OR 1.93 [1.23, 3.01], p = 0.004), use of contraception (OR 1.59 [1.02, 2.48], p = 0.039), and TyG Index >8.87 (OR 2.93 [1.72, 4.98], p < 0.001)ConclusionTyG index was associated with breast cancer in a nonlinear dose-response fashion.

Outcome of breast cancer patients treated with chemotherapy during pregnancy compared with non-pregnant controls.

515 Background: Overall a diagnosis of breast cancer during pregnancy (BCP) appears not to impact maternal prognosis if standard treatment is offered. However, caution is warranted as gestational changes in pharmacokinetics with respect to the distribution, metabolism and excretion of drugs may lead to reduced chemotherapy concentration in pregnant patients. This cohort study was designed to focus on the maternal prognosis of BCP patients that receive chemotherapy during pregnancy. Methods: The outcome of BCP patients treated with chemotherapy during pregnancy was compared to non-pregnant breast cancer patients treated with chemotherapy, diagnosed after 2000, excluding postpartum diagnosis and with an age limit of 45 years. The data was registered by two multicentric registries (the International Network of Cancer, Infertility and Pregnancy and the German Breast Cancer Group) that collect both retro-and prospectively breast cancer data. Cox proportional hazards regression was used to compare disease-free (DFS) and overall survival (OS) between both groups, adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor 2 status and histology, weighted by propensity scoring in order to account for the differences in baseline characteristics between pregnant patients and controls. Results: In total, 662 pregnant and 2081 non-pregnant patients, were eligible for analysis. Median age at diagnosis was 34 (range 22-47) years for pregnant and 38 (range 19-45) years for non-pregnant patients. Pregnant patients were more likely to have stage II breast cancer (60.1% vs 56.1%, p = 0.035), grade 3 tumors (74.0% vs 62.2%, p < 0.001), hormone receptor-negative tumors (48.4% vs 34.0%, p < 0.001) or triple-negative breast cancer (38.9% vs 26.9%, p < 0.001). Median follow-up was 66 months. DFS and OS were comparable for pregnant and non-pregnant patients (DFS: HR 1.02, 95%CI 0.82-1.27, p = 0.83; OS: HR 1.08, 95% CI 0.81-1.45, p = 0.59). A subgroup analysis of 339 women that received more than 60% of chemotherapy during pregnancy (cut-off at median) revealed a comparable survival compared to non-pregnant women (DFS: HR 0.81, 95%CI 0.62-1.06, p = 0.13; OS: HR 0.85 95% CI 0.58-1.23, p = 0.39). Conclusions: Pregnancy-induced alternations in chemotherapy concentration do not seem to affect maternal prognosis in breast cancer patients. These results support initiation of chemotherapy for BCP where indicated for oncological reasons.

Road Map to Safe and Well-Designed De-escalation Trials of Systemic Adjuvant Therapy for Solid Tumors

An important challenge in the field of cancer is finding the balance between delivering effective treatments and avoiding adverse effects and financial toxicity caused by innovative, yet expensive, drugs. To address this, several treatment de-escalation trials have been conducted, but only a few of these have provided clear answers. A few trials had poor accrual or had design flaws that led to conflicting results. Members of the Breast International Group (BIG) and North American Breast Cancer Group (NABCG) believe the way forward is to understand the lessons from these trials and listen more carefully to what truly matters to our patients. We reviewed several adjuvant trials of different cancer types and developed a road map for improving the design and implementation of future de-escalation trials. The road map incorporates patients’ insights obtained through focused group discussions across the BIG-NABCG networks. Considerations for the development of de-escalation trials for systemic adjuvant treatment, including noninferiority trial design, choice of end points, and prioritization of a patient’s perspectives, are presented in this consensus article.