Archives of Breast Cancer
Volume:4 Issue: 1, Feb 2017

The impact of positive intramammary lymph node (IM LN) on the prognosis of patients with breast cancer has been debated for years; likewise, the standard management of patients with positive IM LN remains unclear, especially when it is identified by preoperative imaging or by sentinel lymph node biopsy. The present study aims at reviewing the level of concurrent involvement of IM LN and axillary nodes to clarify the management of patients with breast cancer with positive IM LN and clinically negative axilla or negative axillary sentinel lymph nodes.
We reviewed all published studies on IM LN metastasis in breast cancer from 1980 to 2016 in 4 major databases. Twenty-five studies containing data on pathologic examination of IM LN were included, in twenty- two of which, pathologic status of IM LN and axillary lymph nodes were exactly available.
The incidence of positive IM LN is highly variable (0%-100%). Positive IM LNs were associated with positive axillary lymph nodes in more than half of patients, but isolated involvement of IM LN were documented in significant number of patients in various studies.
Although metastatic IM LN could often be associated with axillary nodal involvement, it could be the only site of breast cancer spread; hence, the concept stating that positive IM LN mandate further axillary dissection needs to be debated.

About 83% of patients with breast cancer (BC) undergo radiation therapy. These patients show various degrees of mild to acute reactions during and after the completion of treatment.The aim of this study was to compare inherent radiosensitivity of gamma-irradiated G0-lymphocytes between BC patients and normal individuals using cytokinesis blocked micronucleous assay.
Three to 4 mL blood was drawn in heparinized syringes from patients and normal individuals. A portion of the sample was irradiated with gamma rays at a dose of 300 cGy. Irradiated and non-irradiated samples were cultured in complete RPMI-1640 culture medium. A standard cytokinesis-blocked micronucleus assay protocol was followed for the preparation of binucleate lymphocytes. Slides were prepared and stained in Giemsa. Thousand binucleate cells were scored for the presence of micronucleus (MN). Data were statistically analyzed using SPSS software.
The results showed that the background frequency of micronuclei in both groups of control and Luminal A (LA) patients was nearly similar and relatively low but was significantly higher in triple negative BC (TNBC) patients Significantly different (P The results indicated radio-sensitivity of LA patients but radio-resistance in TNBC patients. This different reaction of lymphocytes of patients with BC might be due to different status of genome instability in these patients.

Breast cancer is a completely heterogeneous disease caused by interaction of factors, such as genetic and environmental risks leading to a progressive accumulation of genetic and epigenetic changes in breast cancer cells. Moreover, it deeply affects patient's mental and social health. The present study aimed at examining the effect of group commitment-acceptance treatment on perceived stress, symptoms of depression, and marital satisfaction in women with breast cancer.
The present research was a Randomized Controlled Trial (RCT), the study population of which consisted of women with breast cancer referred to Avicenna Research Institute in Tehran, Iran. The participants were selected randomly using random sampling method and Morgan table, and they were assigned to 2 groups of trial (20 individuals) and control (20 individuals). The trial group underwent 8 sessions (each taking 2 hours) for 1 month and received therapy in mind empowerment clinic based on acceptance and commitment, but the control group received no therapy except the routine management. Both groups were examined in terms of psychology using standardized questionnaires. Afterwards, the collected data were analyzed using mean and standard deviation, t-test, univariate analysis of covariance, and multivariate analysis of covariance by employment of SPSS software.
The results of analysis of covariance indicated that the performed therapy improved the level of perceived stress, symptoms of depression, and marital satisfaction in the trial group. The calculated eta-squared (0.40) indicated that 40% of individual differences in post test scores of perceived stress, marital satisfaction, and symptoms of depression is related to ACT. In addition, the results of univariate analysis of covariance indicated that 48% of individual differences in scores of perceived stress, 63% of individual differences in scores of marital satisfaction, and 58% of individual differences in scores of symptoms of depression were related to ACT.
The results of the present study show that acceptance-commitment group therapy is effective and productive in reduction of psychological problems of women with breast cancer. The findings of this study, in general, provide an experimental support for ACT in terms of reduction of psychological problems of patients with cancer.

Genetic factors associated with cancer have been widely investigated and several polymorphisms have been connected with breast cancer. Breast cancer (BC) can be considered one of the most popular reasons of death among women. BC, likewise, is the second cause of death in Iran. The present research aims at determining the frequency of the fibroblast growth factor receptor (FGFR) gene polymorphism in patients with breast cancer.
The FGFR family is one of the tyrosine kinase receptors containing 4 members, whose pathway is activated in many tumors. We assessed, for the first time, these polymorphisms and their consequences on the breast cancer risk association in an Iranian sporadic population-based case-control study including 126 patients with breast cancer and 160 controls using a PCR-RFLP-based assay.
The analyses of the experimental and control groups indicated that homozygote genotype FGFR4 Gly/Gly has the highest frequency in experimental and control groups (30.4% and 18.9%). The main genotype FGFR4 Gly/Gly risk factors in our population were: ArgGly /GlyGly, OR = 2.359, 95% CI = 0.208 - 4.621, P = 0.001; ArgArg /ArgGly, OR = 0.412, 95% CI = 0.082 - 0.547, P = 0.078, ArgArg /GlyGly, OR = 0.076, 95% CI = 0.030 - 0.189, P = 0.26.
A significant association was observed between breast cancer risk and FGFR4 GlyGly and ArgGly polymorphism.

Cylindroma of the breast is a rarely described tumor that closely resembles its dermal counterpart.
We report a case of a 55-year-old woman with an incidental finding of a left breast mass on screening mammography. On histologic examination, the tumor was found to be consistent with cylindroma of the breast.
Generally considered to be a benign lesion, cylindroma of the breast may be challenging to differentiate from morphologically similar tumors, such as solid type adenoid cystic carcinoma, and this uncertainty may lead to a dilemma in treatment options. These patients should be followed closely, as long-term outcome data is not available given the uncommon occurrence of these lesions within the breast.

Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease, which can mimic breast cancer. As the managements of IGM and breast cancer are entirely different and the initial clinical manifestations are similar in several cases, it is very important to differentiate them.
We reported a 48-year-old female patient with IGM and breast cancer. She was referred to the outpatient clinic with bilateral large masses and clinical impression of bilateral breast cancer with inflammatory features in the right side. Through pathology, the diagnoses of invasive ductal carcinoma (IDC) for the left breast lesion and IGM for the right breast lesion were confirmed, respectively. Incisional biopsy was performed for the right breast lesion to rule out breast cancer and to make sure of the diagnosis of IGM.
To the best of our knowledge, breast cancer and IGM were reported only in two studies. Although IGM is not the underlying cause of breast malignancy, the diagnosis of breast cancer should always be kept in mind. Any other lesions in these patients should be assessed well to rule out breast cancer.