فصلنامه بیماری های پستان ایران
سال هفدهم شماره 1 (پیاپی 64، بهار 1403)

exercise is regarded as an adjuvant treatment for people with breast cancer (BC), reducing their fatigue,  aiding their rehabilitation, and improving their quality of life (QOL) both during and after treatment. The significance of exercise in reducing fatigue and enhancing QOL in women with BC is undeniable; nonetheless, there is a dearth of studies on the impact of exercise intervention on metastatic breast cancer (MBC) patients. To investigate the effects of resistance training (RT) on fatigue, QOL, and body composition in MBC patients, we adopted an almost novel approach by selecting subjects from this population and completing an eight-week RT program.

This clinical trial study was conducted on 27 MBC patients who were referred to Tehran Naft Hospital from 2022-2023. All subjects participated in the research with informed consent. People were randomly assigned to two control and resistance training groups. Primary endpoint fatigue was assessed using the chronic fatigue syndrome (CFS)  questionnaire. Moreover,  QOL was measured using the two EORTC questionnaires (C30 and BR23). Patients' adherence to exercise was high (98.07%).  

After data analysis, there was a significant difference between the two groups of total fatigue and all fatigue subscales (P<0/001). The QOL (P<0/001) improved significantly; moreover, body image (P<0/001) and future perspective (P<0/012) increased significantly in the RT group. In addition, body composition (P<0/001) indices improved significantly in favor of the RT group.

As evidenced by the obtained results, for MBC patients, eight weeks of RT can decrease fatigue and improve QOL. Comparing the results demonstrated that, for MBC patients, a combination of physical activity and clinical therapy is more beneficial than clinical treatment alone. The RT is as appropriate and practical for MBC patients as healthy people. For these patients, RT can be a standard protocol. It is recommended that research on larger sample sizes be carried out over a longer period of time.

Breast cancer is the most common cancer. Therapeutic strategies reduce neurogenesis in treated patients. The present study aimed to assess the effect of endurance training along with the combination of gallic acid and Kaempferol on neurogenesis in the hippocampus caused by the side effects of paclitaxel in mice with breast cancer.

The mice were randomly assigned to six groups (n=6), including control group, the group with breast cancer injected with 4T1 cell line, the cancer group that received paclitaxel (10 mg/kg), cancer group treated with paclitaxel and gavage supplemented with Kaempferol and gallic acid, cancer group treated with paclitaxel and endurance exercise, the cancer group treated with paclitaxel and endurance training and supplements. Gene expression was measured by the Real Time-Polymerase Chain Reaction (PCR) method. Genes were selected using bioinformatics software. In this study, statistical analysis was performed using GraphPad Prism software (version 9). Data were calculated using one-way analysis of variance (ANOVA) with Tukey's post hoc test. Results were presented as mean±standard deviation. A p-value less than 0.05 was considered statistically significant.

The expression of VEGFα/ARC/CREB increased significantly (P<0.05) due to the consumption of gallic acid, kaempferol, and endurance training in mice treated with paclitaxel. Moreover, the expression level of VEGFα/ARC/CREB genes increased in the endurance training group and the supplement (P<0.05). On the other hand, breast cancer has increased the expression of HIF1α gene (P<0.05). Endurance training and supplement consumption significantly reduced the expression of the HIF1α gene (P<0.05).

Endurance training, along with gallic acid and Kaempferol, regulated the expression of ARC, VEGFα, HIF1α, and CREB1 genes in the brain tissue of mice with breast cancer treated with paclitaxel.

Anxiety about cancer recurrence is identified as the most common psychological burden experienced by cancer patients and survivors. The present study aimed to assess the mediating role of fatigue in the effect of anxiety on posttraumatic stress disorder (PTSD) symptoms and fear of recurrence in breast cancer patients.

The cross-sectional study was conducted at Kasra Hospital and Cancer Research Center at Shahid Beheshti University of Medical Sciences in Tehran, Iran, from September to November 2022. A total of 220 female breast cancer patients completed questionnaires, including the Penn State Anxiety Questionnaire, PTSD Checklist for DSM-5, Fear of Cancer Recurrence Inventory), and Cancer Fatigue Scale. The data were analyzed in SPSS (version 27) and SmartPLS (version 4) software packages using the advanced statistical method of structural equation modeling.

The model fit indices were good (SRMR=0.6 and NFI=94). The results obtained from structural equation modeling pointed to the direct and significant effect of anxiety on PTSD (β=0.287; T=3.62; P<0.001), anxiety on fatigue (β=0.310; T=3.89; P<.001), fatigue on PTSD (β=0.390; T=5.31; P<.001), and fatigue on fear of cancer recurrence (β=0.274; T=3.73; P<.001). The non-significant impact of anxiety on fear of cancer recurrence (β=0.052; T=0.757; P=0.449) was in the framework of the conceptual model of the present study. It is worth noting that fatigue had a partial mediating role in the effect of anxiety on PTSD.

These findings suggest that fatigue can increase cancer-related PTSD and fear of cancer recurrence in breast cancer patients. Since early fatigue can increase the impact of cancer diagnosis and treatment on the performance and quality of life of these patients, the findings of the present study are effective for healthcare providers and breast cancer survivors. Future research should focus on the use of psychological interventions to reduce the psychological consequences of cancer for this growing population in Iran.

In recent years, with the advancement of nanotechnology, new methods have been invented to treat cancer. The Moringa plant (Moringa oleifera) is rich in flavonoid compounds, especially quercetin, which has anticancer and antioxidant properties. In this research, the characteristics of metal nanoparticles of Iron, Copper, Zinc, and Silver biosynthesized from the aqueous extract of the M. oleifera plant were studied, and then the effect of the essential oil and aqueous extract obtained from the aerial parts of this plant and the synthesized metal nanoparticles on the growth and survival of cancer cell lines MCF-7 and BT-549 were investigated.

In this research, after the biosynthesis of metal nanoparticles such as iron, copper, zinc, and silver from the aqueous extract of the plant M. oleifera and checking their properties in terms of size with the help of Dynamic Light Scattering (DLS) and verifying the structure with the help of Fourier Transform Infrared Spectrometer (FTIR), the number of secondary compounds of the essential oil (using Gas chromatography-Mass spectrophotometry (GC-Mass)) and the aqueous extract of Moringa plant (with the help of HPLC) were investigated. , the anticancer properties of the essential oil and aqueous extract of the plant M. oleifera and its biosynthesized metal nanoparticles were evaluated on two cell lines, MCF-7 and BT-549. The experiment was conducted in a completely randomized design with three replications. GraphPad Prism8 and FlowJ softwares were used to check cell viability and flow cytometry results, respectively.

According to the results obtained from DLS, the sizes of iron, copper, zinc, and silver nanoparticles were 35, 32, 33, and 34 nm, respectively. According to the results obtained in this research, the IC50 value of MCF-7 and BT-549 cell lines was significantly affected by the type of treatment used at the probability level of 1%. The highest amount of IC50 (35.9 μL/mL) corresponds to the MCF-7 cell line treated with the essential oil obtained from the aerial parts of the Moringa plant. Furthermore, in this research, it was found that the percentage of necrotic cells, and the percentage of cells in the pre-apoptotic and post-apoptotic stage of the MCF-7 and BT-549 cell lines were significantly affected by the type of treatment used at the probability level of 1%. In the case of the MCF-7 cell line, the highest percentage of necrotic cells, cells located in the pre-and post-apoptotic stage (2.03, 3.42, and 22.5 percent), respectively, related to the control treatment, aqueous extract obtained from aerial parts, and synthesized copper nanoparticles from aqueous extract were obtained. Meanwhile, the highest percentage of necrotic cells, cells located in the pre-and post-apoptotic stage of the BT-549 cell line (6.33, 4.32, and 17.56 percent) were related to the control treatment, biosynthesized copper nanoparticles from the aqueous extract.

According to the results obtained in this research, the copper nanoparticle biosynthesized from the Moringa plant aqueous extract had the highest anticancer effect on MCF-7 and BT-549 cell lines.

Breast cancer patients experience high levels of distress due to fear of recurrence, worry about mortality and outcomes, anxiety related to treatment, as well as experiencing physical and financial problems. One of the intervention methods used for psychological support of cancer patients is mindfulness-based treatments. Therefore, the present study aimed to assess the effect of mindfulness training on emotional regulation and distress tolerance in women with breast cancer.

The present interventional study t was conducted on breast cancer patients in Birjand in 2023. this study recruited 30 subjects in two control and intervention groups (15 people in each group) using the convenience sampling method. Mindfulness training took place in the intervention group for eight weeks (one session per week and one to one and a half hours per session). The Gross and John (2003) emotion regulation questionnaire and the Simmons and Gaher (2005) emotional distress tolerance questionnaire were used to collect information. Data were analyzed in SPSS software (version 26) using independent t-tests and paired t-tests at a significance level of 0.05.

The mean age scores of patients in the control and intervention groups were 46.9±12.0 and 45.8±11.7 years, respectively, and no significant difference was observed between the two groups (P=0.795). The results of the present study demonstrated that after the mindfulness-based interventions, subjects in the intervention group obtained higher scores than the control group, which was statistically significant (58.1±6.2 vs. 50.1±7.3; p=0.003). Nonetheless, these interventions did not display a significant effect on distress tolerance scores in both control and intervention groups (6.4±33.8 vs. 6.6±31.5; P=0.334).

As evidenced by the results of the present study, the intervention based on mindfulness has significant effects on the regulation of emotions in patients with breast cancer; therefore, the implementation of educational programs based on mindfulness can be of great help in reducing the emotions of patients with breast cancer.

Investigating the effective factors on the quality of life in breast cancer patients is of utmost importance in reducing the complications of the disease. The present study aimed to investigate health-related quality of life and its related factors in nonmetastatic breast cancer patients.

In this cross-section-descriptive-analytical study, 267 patients with nonmetastatic breast cancer were included by simple random sampling method. Pre-diagnostic, diagnostic, and post-treatment information were recorded, and the EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) was administered to study participants.

The results of the X2 statistical analysis also demonstrated that the correlation coefficient between quality of life and age is 0.281, which is statistically significant (P<0.001). Furthermore, the results indicated that the difference in mean quality of life scores among different levels of education, different occupational groups, and marital status was not statistically significant (P=0.605, P=0.096, and P=0.442, respectively). Nonetheless, the difference in mean quality of life scores among individuals in the study across five stage T groups and a history of illness in relatives was statistically significant (P=0.007 and P=0.006, respectively).

The highest quality of life score was related to emotional function; nonetheless,  cognitive function and role play obtained lower scores. Also, age and severity of fatigue affect patients' quality of life. The results of this study emphasize the importance of considering these factors in the management of breast cancer patients in order to improve their quality of life.

Breast cancer is one of the most common malignancies in women. Cytotoxic chemotherapy or drugs exert a negative effect on fertility potential. Techniques,such as ovarian suppression, oocyte and embryo freezing, InVitro Maturation, and ovarian tissue freezing, are necessary to preserve fertility.

To conduct this study, a query was conducted on Persian and English sources databases as Scoupus, Google Scholar, Pub Med, and Science Direct during the last 24 years using the following keywords: breast cancer, infertility, fertility preservation, oocyte freezing, and embryo freezing.

Based on the result15% to 25% of patients are young premenopausal women. Chemotherapy or radiation therapy can lead to infertility or early menopause. As suggested by evidence, the success rate of embryo freezing is much higher than oocyte freezing and In Vitro Maturation. Among the fertility preservation methods, ovarian tissue freezing and 3D bioprinting are in the laboratory research stage and have received much attention. Correct counseling and providing accurate information to patients and their timely referral have have a marked impact on improving their mental and physical condition and treating their underlying disease.

As evidence by the result of this study, early diagnosis of breast cancer and timely referral to a fertility specialist  enable , breast cancer patients to maintain their fertility and experience their biological child after aggressive cancer treatments.