farzaneh golfam

Antigen Ki-67 (histone-based nuclear protein) is a static marker of tumor cell proliferation and growth and is commonly measured to indicate the effect of treatment in breast cancer patients. This single-arm trial study aimed to evaluate the effect of short-term endocrine therapy (letrozole) on Ki-67 levels in menopausal women with early hormone-positive breast cancer who were referred to two university hospitals.

Patients with a pre-treatment Ki67 of 5% or less were excluded from the study. Participants (n=25) received oral letrozole (2.5 mg daily) seven days before surgery. Ki-67% on both the biopsy and the surgical specimens were measured and compared.

The mean age of patients was 62±9.4 (48-83 years). Our result indicated that consumption of letrozole before surgery for hormone-positive breast cancer can significantly decrease the level of Ki-67 (23.24±9.74 vs. 16.92±9.55, P=0.001 by paired t-test), with no drug-related adverse events.

Worldwide, breast cancer is the most common cancer-affecting women. The complexity of decision-making in the diagnosis and treatment of patients highlights the necessity for a team approach, mostly multidisciplinary team (MDT). The aim of this study was to compare the opinions of the MDT and the physician on the diagnosis and treatment of women with breast diseases at Motamed Cancer Institute.

This cross-sectional study was performed on 122 women with breast symptoms. Patients were enrolled in the study in diagnostic and therapeutic groups. After introducing patients’ complaints at the MDT meeting, each member expressed their suggestions and at the end of the meeting the final decision which was approved by the majority of members was acknowledged as the opinion of the MDT meeting. Then, the MDT decision was compared with the preliminary decision of the physician.

The final decision of the MDT in the diagnostic group was the same as the physician in 48.9% of the cases, and the MDT changed the diagnosis in 51.1% of patients (P<0.001). In the treatment group, the final decision of the MDT was the same as the physician in 28.6% of cases and in 71.4%, the MDT changed the treatment procedure (P <0.001).

Using an MDT approach in the management of breast diseases reduces the use of aggressive procedures, and helps the physician to make decisions precisely with more confidence in complicated cases.