Pathology
Nasrin Ziamajidi; Nazi Moini; Hiva Danesh; Roghayeh Abbasalipourkabir; Nahid Radnia; Zeinab Barartabar
Articles in Press, Accepted Manuscript, Available Online from 05 September 2023
Abstract
Background & Objective: Breast cancer has the highest incidence of all cancers and the incidence of this disease is increasing rapidly in many countries around the world, including Iran. In this study, some epidemiological and pathological factors have been investigated in breast cancer patients.Methods: ...
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Background & Objective: Breast cancer has the highest incidence of all cancers and the incidence of this disease is increasing rapidly in many countries around the world, including Iran. In this study, some epidemiological and pathological factors have been investigated in breast cancer patients.Methods: This is a cross-sectional study which contains 476 patients with a confirmed diagnosis of breast cancer, was conducted in Tehran, Dr. Moini Breast Clinic from 2019 to 2021. Results: The mean age of patients was 50.2±11.40 years, of which 80.9% patients over 40 years. Ductal carcinoma was the most common in terms of histology (81.7%) and most patients are in grade 2 (63.6%). According to hormonal receptors, 73.8% of women had estrogen receptor positive and 68.9% of women had progesterone receptor positive and 18.9% of patients were triple negative. There is a significant relationship between grade and lymph node involvement (P-value=0.00) and also a significant relationship between metastasis with grade (P-value = 0.00 (and metastasis with lymph node involvement (P-value = 0.00) was seen.Conclusion The results of this study show that breast cancer has a high prevalence in Iranian women in Tehran, mainly seen in the 4th and 5th decades of breast cancer. HER-2 (epidermal growth factor 2 receptor overexpression) and triple negatives were the least subgroups. Considering that diagnosis happens late and about 63.6% of patients are in grade 2, it is necessary to implement programs in the field of screening and prevention in the female population of this province.
Gynecology Oncology
Roya Dolatkhah; Mehrnaz Hosseinalifam; Zohreh Sanaat; Neda Dolatkhah; Saeed Dastgiri
Volume 8, Issue 5 , September and October 2023, , Pages 426-434
Abstract
Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the ...
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Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most well-known and prominent genes susceptible to breast cancer were BRCA1 and BRCA2. They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer.
Gynecology Oncology
Batool Hossein Rashidi; Marjan Ghaemi; Ensieh Shahrokh Tehrani; Marzieh Mohebbi; Marzieh Savari
Volume 8, Issue 5 , September and October 2023, , Pages 450-460
Abstract
Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials ...
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Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
Gynecology Oncology
Fereshteh Fakour; Zahra Rafiei Sorouri; Amirhossein hajizadeh Fallah; Atefeh Mousavi; maral farahmand
Volume 8, Issue 2 , March and April 2023, , Pages 173-180
Abstract
Background and objective: In Iranian women, the age of breast cancer is 10-20 years earlier than women living in developed countries. Moreover, HPV infection has increased among Iranian women and it is more common compared to European women. The purpose of the present study is to investigate the role ...
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Background and objective: In Iranian women, the age of breast cancer is 10-20 years earlier than women living in developed countries. Moreover, HPV infection has increased among Iranian women and it is more common compared to European women. The purpose of the present study is to investigate the role of HPV as a potential risk factor for breast cancer at younger ages.Results: The results showed a significant difference between the two groups of women with breast cancer and without malignancy in the age of first pregnancy and gravidity. There was a significant difference in human papillomavirus type 16 infection between the two groups with breast cancer and without malignancy. The logistic regression model examined the effect of all variables and showed that infection with human papillomavirus type 16 increased the risk of breast cancer by 4.6 times, taking into account other variables.Conclusion: The present study, independent of other studies, showed that human papillomavirus type 16 could be a risk factor for breast cancer. If the virus is found in an individual, it is recommended that the patient be monitored frequently and more detailed examinations for breast malignancies be performed.
Gynecology Oncology
Hakimeh Akbari; Hossein Forouzandeh; Tooraj Reza Mirshekari; Seyed Adnan Kashfi; Mehdi Ghavamizadeh
Volume 7, Issue 6 , September and October 2022, , Pages 507-512
Abstract
Background & Objective: Breast cancer has a pivotal role in many deaths caused by malignancies. Epidermal growth factor receptor-2 (EGFR-2 or HER-2) and estrogen receptor (ER) have immense predictive values as prognostic factors. Breast cancers that have steroid receptors and respond to hormone ...
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Background & Objective: Breast cancer has a pivotal role in many deaths caused by malignancies. Epidermal growth factor receptor-2 (EGFR-2 or HER-2) and estrogen receptor (ER) have immense predictive values as prognostic factors. Breast cancers that have steroid receptors and respond to hormone therapy show a better prognosis than cancers without steroid receptors.Materials & Methods: A retrospective cross-sectional study was performed on 500 pathology blocks of women with breast cancer sent to the pathology department of Amir-al-Momenin medical and educational center, Gerash, Iran, from 2016 to 2019. Data were analyzed by SPSS software (Version-16) via ANOVA test followed by Chi-square and t-tests. P-value <0.05 was considered as significant.Results: The utmost type of malignancy was invasive ductal carcinoma (IDC) at 35.03%. Among ER-positive patients 59.67% were HER-2-positive. Nonetheless, among the PR-positive patients 54.74% were HER-2-positive. ER-positive patients were correlated with p53 receptor, distant metastasis and HER-2 significantly (P < /i><0.01). However, PR-positive patients just correlated with p53 receptor significantly (P < /i><0.01).Conclusion: Investigated samples were more ER-negative and less PR-positive compared to similar studies. Meanwhile, ER-positive patients were HER-2-positive. Regarding the correlation with prognosis of breast cancer, especially in HER-2-positive patients, there is a need to perform profound screening programs for HER-2 in breast cancer patients, especially with histopathological characteristics of invasive ductal carcinoma.
Gynecology Oncology
Maryam Rahimi; Setareh Talebi Kakroodi; Mansoureh Tajvidi
Volume 7, Issue 4 , March and April 2022, , Pages 258-271
Abstract
Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, ...
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Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit A (PIK3CA), involved in cell proliferation, survival, and growth. AKT is a serine/threonine-specific protein kinase that has an important role in several processes, such as apoptosis and cell proliferation. The importance of mutations and overexpression of KIT, PI3K, and AKT genes in breast cancer has been previously demonstrated. This review investigated the relationship between gene mutations and overexpression and clinicopathological variable of KIT, PI3K, and AKT in breast cancer. Finally, the role of inhibitor drugs of these genes in breast cancer treatment. These data were collected from PubMed and Google Scholar databases from 2000 to 2021. The expression of KIT, PI3K, and AKT genes in normal breast tissues has been observed. However, mutations and overexpression of these genes are associated with malignancies. The mutations in KIT, PI3K, and AKT genes are different from those found in other malignancies. Also, most of the drugs that inhibit the RTK signaling are being tested in clinical trials for the treatment of breast cancer. Monitoring and timely management of adverse effects are critical to minimize toxicities and optimize the efficacy of this targeted therapy. Therefore, further development of predictive biomarkers can better select patients who will benefit from RTK inhibitors.
Gynecology Oncology
Sharon Baisil; Rashmi Kundapur; Sachin Chandramoha; Maria Nelliyanil; Prince Abhraham; Vijith Shetty; Rajesh Ballal
Volume 7, Issue 3 , January and February 2022, , Pages 221-225
Abstract
Background and Objective: Breast cancer is the most common cancer among females globally and its toll is rapidly rising in India. Accurate knowledge about prognostic factors could assist oncologists in making correct treatment decisions and acquiring a better understanding of the survival of patients. ...
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Background and Objective: Breast cancer is the most common cancer among females globally and its toll is rapidly rising in India. Accurate knowledge about prognostic factors could assist oncologists in making correct treatment decisions and acquiring a better understanding of the survival of patients. In patients with hormone receptor-positive, early diagnosis along with socioeconomic factors like education, income, etc., are said to play a vital role. Hence, the present study aimed to analyze the survival pattern depending on hormone receptor status, stages of breast cancer, and socioeconomic status.Methods: An Ambi directional cohort study was conducted among 300 patients with breast cancer registered and treated in a tertiary care hospital in Dakshina Kannada, India, in the last 3 years. A validated proforma was used to collect data. The post-treatment survival was analyzed depending on their income, family history, staging (clinical & histopathological), and hormone receptor status (HER-2/ER).Results: The pattern of receptor among these patients showed 45% ER, 43% PR, and 14.3% HER2 positivity. Among the patients, 83% had undergone hormonal therapy as per the receptor status. The overall survival rate of breast cancer patients was found to be 81%. The clinical stage of disease had a statistically significant association with survival using the log-rank test. However, monthly income and hormonal status showed no significance.Conclusion: A 3-year survival rate was 100% for stage Ⅰ patients, 96.6% for stage Ⅱ, 82.1% for stage Ⅲ, and 40% for stage Ⅳ. Hormone receptor positivity is highly predictive for better prognosis in breast cancer patients.
General surgery
Atefeh Moridi; Sudabeh Mahmoodi; Nayereh Rahmati; Marzieh Fathi; Zahra Naeiji
Volume 6, Issue 4 , August 2021, , Pages 188-194
Abstract
Background & Objective: Awareness of breast cancer risk factors, clinical presentations and screening rules and methods may encourage women to use preventive measures more commonly. Materials & Methods: A total of 691 women from general population were interviewed using a standardized ...
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Background & Objective: Awareness of breast cancer risk factors, clinical presentations and screening rules and methods may encourage women to use preventive measures more commonly. Materials & Methods: A total of 691 women from general population were interviewed using a standardized questionnaire. Demographic data, level of awareness about risk factors, presentations and screening the breast cancer and their general perception about the treatment’s efficacy were evaluated.Results: Of the participants, 45.7% had “good” knowledge about the presentations of breast cancer while the level of awareness was “good” in 19.2% of them in field of risk factors (statistically significant difference). As only about 16% of them knew that women should perform breast self-examination once a month and about 15% of them were aware of the screening role of the annual clinician performed breast examination.Conclusion: Most of our participants had statistically significant lower level of knowledge about the risk factors and screening rules and tools of breast cancer than its clinical presentation.
Gynecology Oncology
Maryam Rahimi; Elahe Keyhani; Farkhondeh Behjati
Volume 5, Issue 4 , December 2020, , Pages 137-148
Abstract
Background & Objective: As the most common cancer type, breast cancer has been recognized as the second mortality cause among women. The KIT proto-oncogene is one of the important factors involved in tumor development. The previous findings have demonstrated an increased copy number and overexpression ...
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Background & Objective: As the most common cancer type, breast cancer has been recognized as the second mortality cause among women. The KIT proto-oncogene is one of the important factors involved in tumor development. The previous findings have demonstrated an increased copy number and overexpression of this gene under the influence of breast cancer development.Materials & Methods: This study aimed to investigate the relationship between the copy number variation (CNV) of all exons of KIT gene and estrogen receptor (ER), progesterone receptor (PR), HER2, P53, stage, tumor size, Ki67, Annexin V, histological type, age, molecular subtype, and node status by surveying breast cancer tissues collected from 64 patients. The CNV exons and clinicopathological variables were assessed by multiplex ligation-dependent probe amplification (MLPA), hematoxylin and eosin (H&E) staining, and immunohistochemistry techniques.Results: Sixty percent of cases in exon 17, 60% in exon 18, and nearly 67% in exon 19 with increased CNVs had a tumor size of 2-5 cm; these results were significant. Also, patients with an increased exon 7 CNV were significantly in stage 3. Other exons did not exhibit significant relation to other clinicopathological variables (P < /em>>0.05).Conclusion: Exons 7, 17, 18, and 19 are the key coding domains of tyrosine kinase, involving the activation of various upstream transcription factors that regulate apoptosis, cell differentiation, proliferation, and angiogenesis. Variation in exons can influence drug resistance. The results of this study can contribute to the diagnosis and treatment of breast cancer, although their confirmation requires further examinations.
Freshteh Osmani; Ebrahim Hajizadeh; Ali Akbar Rasekhi
Volume 3, Issue 2 , May and June 2018, , Pages 53-58
Abstract
Aims: Breast cancer is one of the most prevalent recurrent cancers among women. Several factors affecting multiple recurrences of this disease have been studied and recognized in various studies. One of the various types of models used to analyze recurrent events considering the lack of homogeneity among ...
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Aims: Breast cancer is one of the most prevalent recurrent cancers among women. Several factors affecting multiple recurrences of this disease have been studied and recognized in various studies. One of the various types of models used to analyze recurrent events considering the lack of homogeneity among patients is a frailty model. The aim of the present study was to investigate joint frailty modeling for multiple recurrent events and its application in patients with breast cancer.
Materials and Methods: In this survival and retrospective analysis, 342 patients with breast cancer whose records were registered for follow-up in a Cancer Research Center at Shohadaye Tajrish Hospital, Tehran, Iran, from 2006 to 2015, were selected. The sampling method was purposive. These patients were monitored for at least 6 months after diagnosis and their latest statuses. For data analysis, the joint frailty survival model was used. Running the model and conducting the data analysis were performed by codes in Frailtypack using R 3.4.1 statistical software.
Findings: Three-year and five-year survival rates for the patients were 0.79 and 0.68, respectively. The risk of multiple recurrences (Local and metastases) increased for the patients with tumor grades greater than I. It was found that when neglecting the relationship between multiple recurrences in the patients with breast cancer, a significant correlation was missed.
Conclusion: With regard to the significant variance of the frailty component of the metastases event, the patients with the same predictive variables are prone to different levels of metastases risk.
Azadeh Joulaee; Nasibeh Khaleghnejad-Tabari
Volume 2, Issue 4 , November and December 2017, , Pages 1-3
Abstract
The majority of cases are very young, less than 40 years old, which means they are out of the screening age range. For older pregnant women, screening is not done both due to possible radiation exposure of fetus and low accuracy of mammographyin pregnancy-induced highly dense breasts. Therefore, all ...
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The majority of cases are very young, less than 40 years old, which means they are out of the screening age range. For older pregnant women, screening is not done both due to possible radiation exposure of fetus and low accuracy of mammographyin pregnancy-induced highly dense breasts. Therefore, all the patients are symptomatic at presentation. Mass or ulcer in the breast, nipple or axilla; skin or nipple retraction, nipple scaling, unilateral uniduct spontaneous nipple discharge with any color, unilateral breast edema without or with redness (Peaud’orange) are the symptoms that bring the patient to her obstetrician. Thus, all pregnant women must be informed by their obstetricians about the possibility of breast cancer occurrence during pregnancy as well as all signs and symptoms of breast cancer. It should be noted that, stage by stage, the prognosis is the same as that of non-pregnant patients. Among the three breast imaging modalities, sonography is the first imaging procedure used for symptomatic pregnant women. It can safely be done during all trimesters of pregnancy. As always, sonography can differentiate solid tumors from cysts. Simple cysts are always benign, although they may present as large masses. Since there is no possibility for malignancy in these simple cysts, there would be no need for further follow-up because during the follow-up, their size and number can change or they may disappear spontaneously. These findings do not change our approach. In the case of large painful cysts, they can be aspirated using a needle either by surgeons or under the guide of sonography by a radiologist. On the other hand, if any solid mass is seen in the wall of a cyst, it is no longer a simple cyst and is considered as suspicious, thus classified as at least breast imaging reporting and data system (BIRADS) 4 needing immediate tissue diagnosis. Sonography, also, gives important information about solid tumors. By the evaluation of margins, vascularity, and elasticity, it can differentiate possibly benign tumor defined as BIRADS 3 from suspicious ones defined as BIRADS 4 or 5 that, again, need immediate tissue diagnosis. Well defined round or oval masses with fine margins without vascularity by Doppler evaluation and elastic, not rigid in elastography, are considered as possibly benign tumors or BIRADS 3 and can be followed by sonography instead of tissue diagnosis because the possibility of malignancy though not zero, is less than 2%. Sonography can, also, evaluate the lymp nodes in the breast and axilla; and diagnose the suspicious ones (thick cortex, round rather than kidney shape). If an LN is suspicious, tissue diagnosis is needed by needle biopsy which is usually done at the same time as the breast biopsy.
