fatemeh homaei-shandiz

Despite suggesting many genetic risk markers as the outcome of Genome-wide association studies (GWAS) for breast cancer, replicating the results in different populations has remained the main issue. In this regard, this study assessed the association of two variations in Zinc Finger 365 (ZNF365) in an Iranian population.  In a case-control study conducted at Mashhad University of Medical Sciences, Mashhad, Iran, between 2017 and 2020, ZNF365-rs10822013 and rs10995190 were genotyped using Allele-Specific PCR (AS-PCR). Breast density was assessed using mammography images. PHASE software module version 2 and SPSS version 16.0 were used for haplotype and statistical analyses. Quantitative and qualitative variables were compared between groups using independent t tests and Chi square tests, respectively. Binary logistic regression analysis was performed to calculate odds ratios. Multivariate analysis was then undertaken for the baseline variables, with a P<0.05 in the univariate analysis. The survival analysis was performed using the Kaplan-Meier method and the log-rank test. In this survey, 732 females, including 342 breast cancer patients and 390 healthy subjects, were enrolled. rs10822013-T allele (P=0.014), rs10995190-G allele (P=0.003), and TG haplotype (P=0.002) were significantly associated with the increased risk of breast cancer. Moreover, rs10995190-GG genotype (P=0.042) and C-G haplotype (P=0.019) revealed a significant association with better overall survival. However, considered polymorphisms and their haplotypes indicated no association with breast density and clinical features of breast cancer. ZNF365 variants might be a potential risk marker of breast cancer in the Iranian population. The interaction between alleles in haplotypes may modulate the amount of the risk conferred by these variants. Further studies on different ethnic groups can validate these results.

Survival after breast conserving surgery (BCS) vs. modified radical mastectomy (MRM) is a controversial issue. In this study, we want to compare the disease-free survival (DFS) of women who underwent BCS with those treated by MRM. In this historical cohort study, a total of 1097 women who were diagnosed with breast cancer between 2001 and 2007 and received modified MRM or BCS were entered into the study and followed up to March 2017. Kaplan-Meier estimator and extended cox model, and Cox proportional hazards model with propensity score weighting were implemented to compare overall survival between two groups. A total of 283 women with a maximum follow-up of 11.1 years and age 47.17 ± 11.278 were met the inclusion criteria. The results of the extended cox model did not show any difference between the survival of two groups (P = 0.35). After implementing the Cox model with propensity score weighting, the inferences remained unchanged (P = 0.67). The patients treated with BCS tend to have the same DFS rate as those who underwent a mastectomy in a randomized controlled trial-like setting using propensity score weighting.

Breast cancer (BC) is the most frequent cancer in Iranian females. Due to the changes in lifestyle and reproductive risk factors, the BC incidence rate has been rapidly increasing. Knowing risk factors of BC could significantly contribute to improve preventive behaviors. To investigate the relationship between menstrual and reproductive factors and BC in Iranian female population.

Web of Science, PubMed, Scopus, and SID as well as references of included studies were searched. Among relevant published observational studies, 27 studies met the inclusion criteria. Pooled risk estimates for the risk factors were determined using random‑effects models due to the presence of substantial heterogeneity (P < 0.05).

All of the selected studies had case– control design. There was a positive relationship between maternal age at first pregnancy and risk of BC (OR = 1.79 95% CI: 1.36–2.35). Also, menopausal status was associated with higher risk of BC (OR = 1.60 95% CI: 1.18–2.17), whereas, there was no association between menarche age and increased risk of BC (OR = 0.55 95% CI: 0.29–1.03). History of abortion (OR = 1.21 95% CI: 0.97–1.5), nulliparity (OR = 1.43 95% CI: 0.89–2.31), and breastfeeding history (OR = 0.68 95% CI: 0.42–1.09) were not associated with BC risk.

Our findings suggest that age at the first pregnancy and menopausal status were significantly associated with BC risk among Iranian women, whereas menarche age, nulliparity, and history of breastfeeding were not. In regard to the history of abortion, our findings revealed no association with BC, but in high‑quality studies, this relationship was significant.

Gynecological cancer is an unfortunate event for women. Due to cultural and social constraints, there is not enough information about the problems of these women. So, the aim of this study is explaining the experience of the challenges in women with gynecological cancer.

This qualitative content analysis approach study, with a content analysis approach and with using purposive sampling, was done on 16 women with gynecological cancer who referred to three medical centers in Mashhad city. Data were analyzed by conventional content analysis method. Guba and Lincoln criteria were used to confirm the accuracy of the data.

The age range for participants in this study was 35-62 years of age. By analyzing the data, three categories were obtained :1) Concerns about losing their position in marital life (forcing to stop sexual intercourse, increasing the burden of life on the spouse and reducing the patient's presence in marital life) 2) Effect of the disease on sexual relations (deterioration of intimacy, unpleasant experiences during sexual intercourse and the occurrence of gradual sexual frigidity) and 3) Concerns about the possibility of divorce and separation (being out of favor with husband and marital conflicts).

Women with gynecological cancer face many challenges. It is necessary to inform nurses and physicians about this issue, in order to increasing their understanding of these women's problems. Also, conducting educational classes and counseling sessions along with medical treatment for patients, can play an important role in promoting the health of these women in various dimensions.

The impact of initiation time of radiotherapy after breast surgery on disease-free status of patient is a controversial issue. We assessed the relationship between the delay in adjuvant radiotherapy and surgery and relapse or metastasisfree survival in women with breast cancer taking heavy censoring into account.

This was a historical cohort study on 284 patients with breast cancer, who underwent surgery between 2001 and 2007 and followed up until March 2017. The association of the duration between radiotherapy and surgery, as well as other demographic and clinical factors with occurrence of local relapse or metastasis of breast cancer was examined through penalized Cox regression modeling. The obtained data were analyzed using R 3.6.3.

A total of 284 women with the mean age of 47.2 ± 11.3 years met the inclusion criteria. The maximum follow-up time was 11.1 years and the time between surgery and radiotherapy was 168 ± 84.3 days. About 10% of the patients experienced local relapse and 19% had metastasis. In multiple analysis of factors related to diseasefree survival, the stage of disease was significant, while surgery to radiotherapy interval (≤180 days vs >180 days) did not have any significant impact on hazard of failure. Analysis of 3, 4, or 5 months of delay in radiation therapy did not imply any significant affects.

In the studied patients, the delay in radiotherapy initiation after surgery did not lead into outcomes of local relapse or metastasis.

Gynecological cancer is an unfortunate event. Due to cultural and social constraints, there is insufficient information as to the challenges of Iranian women with this cancer.

The aim of this study was explaining the marital life challenges of patients with gynecological cancer.

A qualitative study was performed through semi-structured and face-to-face interviews, and the data was analyzed through conventional content analysis. The participants included 16 women with gynecological cancer referred to three medical centers in Mashhad, Iran.

By analyzing the data, three categories were obtained :1) concerns about losing their position in marital life (forcing to stop sexual intercourse, increasing the burden of life on the spouse and reducing the patient’s presence in marital life), 2) effect of the disease on sexual relations (deterioration of intimacy, unpleasant experiences during sexual intercourse and the occurrence of gradual sexual frigidity), and 3) concerns about the possibility of divorce and separation (being out of favor with husband and marital conflicts).

Women with gynecological cancer face numerous challenges. It is necessary to inform nurses and physicians about this issue to increase their understanding of these women’s problems. Also, holding educational classes and counseling sessions along with medical treatment for patients can play an essential role in promoting the health of these women in various dimensions

In various radiotherapy techniques for breast cancer, the inclusion of internal mammary nodes (IMNs) in the target volume is important for selecting the most appropriate technique. This study aimed to compare three radiotherapy techniques with the inclusion of IMNs regarding the dose homogeneity index (DHI) of regional lymph nodes and the chest wall, besides the dose received by the heart and the left lung.

Three radiotherapy techniques were planned for CT imaging of the RANDO phantom, including the wide tangent (WT); oblique parasternal photon (OPP); and oblique parasternal electron (OPE) techniques. The doses reaching the contoured organs were compared between the three techniques, using the data gathered from the thermoluminescent dosimetry and treatment planning system.

The OPE technique produced a lower absorbed dose for the left IMNs, compared to the other two techniques. In the OPP technique, the dose received by the left lung was higher than its tolerance, while the lung dose in the OPE technique was slightly lower than the WT technique. The absorbed dose by the heart was the lowest in the WT technique; also, the DHI value was better for this technique than the other two techniques.

The WT technique showed better results regarding the dose homogeneity distribution of IMNs and the chest wall, as well as protection of organs at risk.

There are believed to be several risk factors affecting the prognosis of breast cancer through their effect on the growth rate of tumour. In the present study, we investigated estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and tumor protein P53 (TP53) as well-known biomarkers, particularly in breast cancer prognosis, associated with age.

In a case-control study, 406 breast cancer patients were considered retrospectively. In order to extract the clinical and pathologic data, we employed the patients’ records. The extracted information was compared between two groups: for patients under 40 (group I) and above 40 years of age (group II). Herein, the researchers performed statistical analysis using SPSS Ver16.

The most prevalent type of cancer in both groups was found to be invasive ductal carcinoma. The major method of treatment was modified radical mastectomy. According to our observations, grade 3 breast cancer was more common in group I. Lymph node involvement significantly increased in group I, while oestrogen and progesterone receptor expressions were less in this group. HER2, TP53, and Ki-67 oncogenes were overexpressed in group I compared with group II.

Expression of HER2, TP53, and Ki-67 biomarkers and a reduction in the number of hormonal receptors in younger patients (<40YO) indicated that breast cancer might be more invasive in younger women with breast cancer and therefore, they might have poorer prognosis and less favourable outcomes.

Anaplastic variant of juvenile granulosa cell tumor is one of the rarest ovarian malignancies. The aim of this study is to describe a case of anaplastic variant ovarian granulosa cell tumor in a 14-year-old girl with presentation of abnormal uterine bleeding and gradual abdominal enlargement.

The patient at the time of diagnosis with an inhibin A and B more than 500 Pg/ml and ovarian mass of about 30×20×15 cm underwent unilateral salpingo-oophorectomy and juvenile granulosa cell tumor was diagnosed with no follow-up. She has referred with ascites, recurrent mass and distance metastasis of liver after 10 months. The patient underwent four courses of BEP (Bleomycin, Etoposide, Cisplatin)and five courses of paclitaxel and carboplatin. Then, she underwent laparotomy for metastasectomy, which was not successful due to the extent of involvement. Eventually, she died six months after the second surgery.

This case report confirms the need for accurate follow-up of patients with juvenile granulosa cell tumor and appropriate justification for the patient and their caregiver to prescribe needed adjuvant therapies to prevent recurrence.

CC chemokine receptor 5 (CCR5) is introduced as an immune response modulator. The activity of CCR5 influences breast tumour development in a p53-dependent manner. This study aimed to investigate the frequency of CCR5delta32 and its association with the risk of breast cancer in 1038 blood samples in North East of Iran.

In this case-control study, we genotyped 570 control samples and 468 breast cancer patients by a gel electrophoresis-based gap-polymerase chain reaction (gap-PCR) method Mashhad, Iran. The data were analyzed using the SPSS software.

Of 570 controls included, 542 (95.09%) had CCR5delta32 wild/wild (W/W) genotype, 28 samples (4.91%) had CCR5delta32 wild/deletion (W/D) genotype and none of them were CCR5delta32 deletion/deletion (D/D) genotype (0%). While 428 samples of patients (91.45%) had CCR5delta32 W/W genotype, 40 samples (8.55%) had CCR5delta32 W/D and CCR5delta32 D/D homozygous was nil (0%) amongst cases. All samples were in the Hardy–Weinberg equilibrium (P>0.05). According to the allele frequency, D allele, as a risky allele, in the cases was more than the control samples (0.0427 vs 0.0245, respectively) (P=0.0206). Hence, W/D genotype may confer a risk effect (OR=1.77, CI: 1.09-2.90; P=0.0206) compared with WW genotype between case and control groups.

There is a statistically significant association between CCR5W/D and breast cancer risk. CCR5 may be regarded as a target for the prevention of breast cancer in certain conditions such as interaction with p53 variants, which remains to be further investigated.

Cervical cancer is known to be a preventable cancer in which various risk factors play role in increasing the risk of the disease. In this study, we have assessed different risk factors involved in invasive cervical cancer in Northeast of Iran.

In a case control study, 100 patients with advanced cervical cancer were compared to 100 healthy, normal women. In addition, 100 cases of prisoner women who had a high risk profile for cervical cancer were also investigated. Cervical risk factors for these groups were documented using a questionnaire and available medical notes. Univariate analysis was done for each risk factor followed by a multivariate regression analysis to evaluate the most powerful risk factors after adjustment.

Age of first intercourse ≤16 (P<0.001)[OR= 4.18, 95% CI (2.32-7.54)], sexually transmitted diseases (STD) (P<0.001) [OR=8.59,95% CI (4.25-17.37)], passive smoking (P<0.01) [OR= 2.35, 95% CI (1.17-4.72)], smoking (P<0.01) [OR=10.33, 95% CI (2.32-46.17)], age of first pregnancy ≤17 years (P<0.001) [OR= 3.37, 95% CI (1.79-6.33)] were strongly related to the occurrence of cervical cancer. However, STD remained statistically significant (P<0.01) after adjustment.

PI3K/Akt/mTOR pathway is important in inducing resistance to hormone therapy in patients with hormone positive breast cancer. One regulator of this pathway is the PTEN gene. This study was performed with aim to compare the expression of PTEN gene in hormone receptor positive breast cancer patients between patients with sensitive and resistant to tamoxifen.

This cross-sectional and retrospective study was performed on 80 hormone receptor positive breast cancer patients who had referred to oncology clinics of Mashhad University of Medical Sciences from 2006 to 2016. Tissue samples of tamoxifen-sensitive and -resistant patients (recurrence/metastasis occurring during the first 5 years of adjuvant hormone therapy) were immunohistochemically evaluated for PTEN expression. Data were analyzed by SPSS software (version 16) and Independent t-test, U Mann-Whitney and chi-square tests. P<0.05 was considered statistically significant.

In this study, 80 patients were evaluated in two groups of tamoxifen sensitive and resistant. The expression of PTEN in tamoxifen-sensitive and resistant patients was 97.5% and 27.5%, respectively (p=0.001). However, in patients with more advanced lymph node involvement, the expression of PTEN was significantly reduced (p=0.001), there was no significant relationship between PTEN expression and tumor size (p=0.19), tumor grade (p=0.14) and Her2/neu expression (p=0.85).

There is association between PTEN gene expression and tamoxifen resistance.

Prediction of response to neoadjuvant treatment is an important part of treatment of patients with breast cancer. This study aimed to assess changes in serum levels of Cytokeratin 18 during neoadjuvant chemotherapy in patients with locally advanced breast cancer and its association with neoadjuvant treatments.

This research was performed on newly diagnosed breast cancer patients referred to Omid Radiotherapy Center and radiotherapy and oncology departments of Emam Reza and Ghaem hospitals, in Mashhad, Iran. Serum levels of M30 and M65 fragments of Cytokeratin 18 were measured before and 24 hours after the first course of neoadjuvant chemotherapy. Changes in serum levels of Cytokeratin 18 and its fragments and their correlation with pathologic response were analyzed.

Pre- and post-chemotherapy levels of M30 were respectively 223.9±18.94 and 250.7±23.92 U/L (P=0.24). For M65, these levels were respectively 301.5±313.9 and 330.2±352.2 U/L (P=0.1). Changes in M30 level during chemotherapy in patients with and without pathologic complete response were -20±92.69 and 43.1±106.5, respectively (P=0.1). For M65, these changes were respectively -247±55 and 76±240 (P=0.1). Baseline levels of M30 and M65 had no relation with menopausal status, tumor grade, hormone receptor status, Ki67 expression, molecular subtype, and stage.

Our findings showed statistically insignificant changes in the level of Caspase-cleaved- (M30) and uncleaved- (M65) cytokeratin 18 fragments (apoptotic and necrotic indicators, respectively) during neoadjuvant chemotherapy in patients with breast cancer. There was no notable relationship between tumor-related factors and either baseline levels or serum changes of CK18 fragments. Also, there was no correlation between M30/M65 level and pathologic response to neoadjuvant chemotherapy.

Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, is a life-threatening disease worldwide. The aim of this study was to investigate the epidemiology and clinical features of HCC patients who referred to Omid hospital in Mashhad, northeast of Iran.

In this cross sectional retrospective study, we reviewed the medical records of patients who referred to Omid hospital – a cancer research center– in Mashhad during 1991 to 2012. Medical records of 29 patients with primary liver cancer proven with biopsy, CT scan or MRI were analyzed in this study.

Of 25 eligible cases, 68% were men and the rest were women. The majority of HCC patients were in the 60-69 age group. Also, 44% of patients were found to be hepatitis B virus surface antigen (HBsAg) positive.

The age distribution and male preponderance of HCC patients observed in the present study in line with other conducted studies in Iran and other countries. Since this is a retrospective study, a comprehensive study with a larger sample size in a case-control study is needed to establish other HCC-related factors in our province.

Cervical cancer is the second most common cancer in less developed countries. Chemoradiation is the standard treatment for advanced cervical cancer, but there is a lack of radiotherapy equipment in developing country. Therefore, this study was performed with aim to evaluate the pathologic response, treatment complication and survival rate of patients with locally advanced squamous cell carcinoma (SCC) of cervix who were not candidate for chemoradiation with use of chemotherapy before surgery.

In this single group, before-after randomized clinical trial, 24 patients with FIGO stages IB2, IIA2, and IIB squamous cell carcinoma (SCC), who were not candidate for standard chemoradiation due to different causes, received 3 courses of neoadjuvant paclitaxel (135mg/m2)+ Cisplatin (75mg/m2) chemotherapy regimen. Then, surgery was performed. Clinical response to neoadjuvant chemotherapy and treatment side effects were assessed after each course. Wertheim hysterectomy was done 4 to 6 weeks later in those with favorable response. In the absence of major risk factors in the surgical pathology, patients received 3 additional cycles of adjuvant chemotherapy. In high risk patients, adjuvant chemoradiotherapy was performed. Data was analyzed by SPSS software (version 21) and Chi-square, and Kaplan Mayer tests. P

Among 24 patients, 13 cases (54.2%) and 17 (73.9%) had FIGO stageIIB and gradeII tumors, respectively. Parametrial involvement was presented in 13 patients (54.2%). Seven patients were excluded. 17 patients underwent surgical resection. Four high risk patients and were candidate for chemoradiation. Clinical and complete pathological response rate were 17 cases (70.8%) and 8 cases (47.1%), respectively. With a median follow up of 18.5 months, mean of overall survival and disease free survival of patients treated with the study protocol were 24.51 and 25.71 month, respectively. The mean of overall survival of whole patients (24 cases) was 30.8 month (CI: 95%, 29/38-32/26).  

Neoadjuvant chemotherapy in patients with locally advanced cervical cancer despite acceptable pathologic response is not associated with survival advantage.

Various treatments are used to prolong survival and improve quality of life (QOL). The purpose of this study was to assess the change in QOL scores in patients with Oesophagogastric (OG) cancer undergoing curative intent and palliative therapy.

This was a mix-designed cohort study with a consecutive sampling of patients with OG cancer who underwent curative or palliative treatment regimens. The QOL, as a determinant of efficacy and impact of cancer care, was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires. QOL data were collected from the eligible subjects at three points of time. The repeated measurement test was used to compare the significance of change in scores.

Overall, 149 patients (54.4% male, 61.1% curative intent, 52.3% esophageal, 37.6 % gastric, 10.1% OG junction cancer; with mean age 62 year) with OG cancer were eligible for inclusion in the study. Compared to the palliative group, the curative group was more likely to have an esophageal tumor site, Squamous Cell Carcinoma, and stage 2 (versus stomach, Adenocarcinoma, and stage 4 in the palliative group). In comparing the patient's functional, global health status, and cancer symptom, considering time, group of treatment, and their mutual effect the result indicated significant difference between the intervention groups.

Most patients with Oesophagogastric cancer are diagnosed with an incurable form of the disease. Hence in absence of curative treatment, palliative therapy is the most effective therapy to maintain patient independency and relieve pain and symptom in order to improve their QOL. The present study has shown that palliative similar to curative intervention can improve the QOL in cancer patient especially in short term.

The First apoptosis signal (FAS) and First apoptosis signal ligand (FASL) genes initiate the apoptosis pathway, playing a central role in the tumor growth and metastasis. Gene polymorphisms including -1377 G/A in the promoter region of FAS and -844 C/T in the promoter region of FASL have shown to change the transcription activities of these genes.
In this study we evaluated association of these polymorphisms with risk of metastasis of breast cancer, in a population selected from Mashhad, Iran. A total of 115 patients with breast cancer and 115 controls were recruited in this case-control study. Polymerase Chain Reaction-based Restriction Fragment Length Polymorphism (PCR-RFLP) was applied for genotyping on extracted DNA from participant’s blood. Unconditional logistic regression was used to estimate cancer risk by calculating odds ratios (OR) and their 95% confidence intervals (95% CIs).
There was no significant association between these genetic polymorphisms and breast cancer risk. Additionally, our results showed no significant influence from the above mentioned gene polymorphisms on metastasis of breast cancer.
These results suggest that the FAS-1377G/A and FASL-844 C/T gene polymorphism don’t have much influence on the susceptibility to metastasis of breast cancer in northeastern Iranian population. Therefore, we suggest to investigate impact of other candidate gene polymorphisms on metastasis of breast cancer for future research.

Muslim cancer patients and healthcare professionals face several challenges about the necessity of fasting and its possible side effects during the holy month of Ramadan. We aimed to study the prevalence of fasting among cancer patients during Ramadan and opinions of health care professionals about fasting among cancer patients in Iran.
We conducted a cross-sectional survey during the Ramadan (July-August) in 2013. Participants were 620 cancer patients and, 187 healthcare professionals in several cancer clinics from different provinces of Iran. We used self-administered questionnaires and collected data from patients, and healthcare professionals to collect data. We performed descriptive analysis by using Stata statistical software.
Out of 620 patients who participated in this study, 428 (69%) were women. 76 (13%) of patients had fasted for at least a day during Ramadan and, from which 41 (7%) had fasted whole months because of their religious belief. Among patients who had refrained from fasting, the reasons were lack of sufficient physical strength (403, 65%), excessive thirst (141, 23%). 275 (44%) of participants had consulted with their physician about fasting. We found that more than 50% of physicians advised against fasting for patients following surgery, pre-operation, recent hospitalization, and consumption of oral or intravenous chemotherapy. Most of the healthcare professionals (68%) believed that cancer survivors could not fast even if they have no signs or symptoms or side-effects after the treatment.
Although most of the cancer patients refrain from fasting, some cancer patients practice fasting and face challenges during the holy month of Ramadan in Iran. Most patients consult about fasting in Ramadan with their doctor who has variable opinions about this issue. Development of guidelines for healthcare professional and cancer patients regarding Ramadan fasting is needed.

Air pollution consists of chemicals resulting from many human activities and natural resources, which can cause gene mutations. Almost, it is proven that air pollution contributes to lung cancer and its relationship with other cancers including bladder, cervical cancer, ovary, prostate, brain and breast cancer is suspected. Breast cancer is the most frequent cancer in women and the prominent cause of death among them all around the world. Poor prediction of risk factor leads to discovery of more reliable factors. Mammary tumors in animals that are generated by chemicals compounds, give possible mechanisms for effects of environmental pollutants. Therefore, the purpose of our study is to review the available literature for investigating the relation of ambient air pollution and breast cancer. Findings of our study highlight the possibility of increasing in occurrence of breast cancer, developing to invasive cancer and mortality in both premenopausal and postmenopausal women exposed to air pollution.

Breast cancer is one of the most common cancers among women worldwide. Tumor protein 53 (TP53) and its regulator the mouse double murine 2 (MDM2) have important roles in tumorigenesis by playing key roles in cell division and response to DNA damage. MDM2 SNP309 T>G (rs2279744) polymorphism in the promoter region of MDM2 gene can cause dysfunction and inactivation of TP53 which promote tumor progression as a result. The aim of this study was to investigate the association between this polymorphism and risk of breast cancer in northeastern Iranian population. A case-control study with 128 breast cancer patients and 143 healthy women was conducted. PCR-ARMS was performed to assess the MDM2 SNP309 T>G (rs2279744) polymorphism. The GG Genotype frequency between patients and controls showed no significant association between this polymorphism with breast cancer risk (p=0.116, OR [95% CI]: 1.267 [0.616, 2.603]). Also, G allele frequency was not associated with breast cancer risk in studied population (p=0.143, OR [95% CI]: 1.326 [0.908, 1.935]). For this polymorphism, a significant difference of 8.0 years in the average age of cancer diagnosis was observed between TT and TG carriers (40.57 versus 48.15 years, p = 0.029). The results of this study suggest that the SNP309 T>G polymorphism in the MDM2 gene may not be associated with the risk of breast cancer in an Iranian population

Breast cancer remains the most common and second lethal cancer in females. HER-2/neu is one of the most important amplified oncogene in breast cancer. The amplification of HER-2 is correlated with decreased survival, metastasis, and early recurrence. The amplification of HER-2/neu gene and synthesis of the protein are reported in 10%-34% of breast cancer cases associated with tumor size, advanced tumor stage, high-grade tumor, young age at diagnosis, absence of steroid hormone receptor, and lymph node involvement.
Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) methods are options to evaluate HER-2 expression. The current study aimed at identifying the correlation between FISH and real-time polymerase chain reaction (PCR) in measuring HER-2 expression.
The study investigated the performance of the real-time PCR as measured against FISH method in IHC borderline cases. In a total of 120 IHC 2 samples, 58.3% were negative and 41.6% positive for HER-2 gene, confirmed by FISH as a gold standard method. The real-time PCR ratio was Despite the fact that real-time PCR is a promising method to evaluate HER-2 over expression and a supplementary array to FISH, according to the results of the present study it cannot be utilized instead of gold standard techniques; therefore, additional studies should be carried out to appraise the value of this method to evaluate HER-2 over expression.

Breast cancer is the most common type of cancer among women worldwide and affects Iranian women at least one decade earlier than their counterparts in the developed countries. The aim of this study was to determine whether northeastern Iranian breast cancer patients, who were either pre- or postmenopausal, had differences pertaining to their body mass index (BMI) and obesity incidence in comparison with controls. A case-controlled, crosssectional study was performed to assess the BMI of 214 patients, who were either pre- or postmenopausal and had been diagnosed with breast cancer via excisional biopsy. Patients were compared to 463 healthy women. Regardless of their menstrual status, patients and controls exhibited a significant difference in the mean BMI (P-value = 0.04). When the menstrual status and BMI were analyzed, the obesity rate was higher among both premenopausal (P-value = 0.03) and postmenopausal women. Our results showed that there was an increased risk of breast cancer among obese, premenopausal women in northeastern Iran.

The etiology of breast cancer and our understanding on the carcinogenicity of different risk factors is impotant for control programms.
We investigated the expression of estrogen and progesterone receptors (ER, PR), and human epithelial receptor 2 (HER2) overexpression and its associations, with environmental risk factors among breast cancer patients.
We classified the patients into four groups including; triple negative (ER–/PR–/HER2-), HER2-overexpression (ER–/PR–/HER2), luminal A (ER and/or PRﱱ) and luminal B (ER and/or PRﱱᇛ). We used a case-only design and multinomial logistic regression analyses.
In premenopausal patients, those with high BMI had lower prevalence of luminal B tumors compared to luminal A groups (OR= 0.42, 95% CI= 0.23 to 0.74). However, in the postmenopausal groups, prevalence of the luminal B tumors was less than luminal A tumors oral contraceptive pill (OCP) users (OR= 0.64, 95% CI= 0.42 to 0.98). In addition, among those who had an older age at menarche had a higher risk of ER2-overexpression tumors compared to luminal A tumors (OR= 2.82, 95% CI= 1.29-6.19).
Expression of HER2, ER, and PR, among breast cancer patients seems to be associated with OCP use, BMI, age at menarche and age at first pregnancy.

Most women are diagnosed with breast cancer (BC) when they are still at the appropriate age for employment. The increasing survival rates of patients with BC call for more attention to their ability to return to work.. The aim of this study was to identify factors related to the return to work in Iranian women underwent BC treatment..Patients and A total of 175 women with BC, who met the inclusion criteria, were enrolled in this cross-sectional study. The subjects were recruited from four hospitals affiliated to Mashhad university of medical sciences. These hospitals are oncology referral centers in eastern Iran. All records of employed women with BC were studied in four hospitals of Mashhad city, Iran, during 2000 - 2010. The researchers designed a questionnaire, which consisted of questions regarding social/demographic, health/disease, and work characteristics. The questionnaires were completed through interviews. Data were analyzed using SPSS software, version 11.5.. The mean age of the patients at the time of interview was 44.3 ± 6.72 years. Mean age of “Return- to-work” group was 42.71 and “No return-to-work” group was 51.06. Most women (80%) were married. At the time of the interview, 80% had returned to work after a BC diagnosis. Older patients (OR = 0.796; 95% CI, 0.625 - 0.907, P = 0.002), and those with a great deal of work experience (OR = 0.861; 95% CI, 0.752 - 0.986, P = 0.030) were less likely to return to work. Also, women who had no pain or surgery scar (OR = 23.03; 95% CI, 4.53 - 117.02, P < 0.001) as well as those who had no lymphedema after the BC treatment were more likely to return to work (OR = 22.373; 95% CI, 4.04 - 23.892, P < 0.001).. The results of this study show the factors related to the return-to-work after BC treatment in working women in Mashhad city, Iran. These predictors should be taken into account in order to improve the patient’s life quality..

Cancer represents the second cause of mortality in the world. Saffron as a medicinal plant is known for its anti-cancer and anti-depressant properties. In this randomized double blind clinical trial, the effects of saffron on response to treatment in patients suffering from liver metastasis were evaluated. Thirteen patients suffering from liver metastases who referred to Ghaem and Imam Reza hospital, Mashhad, Iran were included in this study and then divided into two different groups. Both groups received chemotherapy regimen. Patients in group one were treated with saffron capsule (50 mg, twice daily) during chemotherapy periods whereas patients in group two received placebo. A sum of the longest diameter were calculated and compared for all lesions in IV contrast CT scan before and after the treatment. from 13 patients included in this study, six patients quit and seven continued until the end. In saffron-treated group, two patients showed partial and complete response (50%) whereas in placebo group, no response was seen. Also, two deaths in placebo and one in saffron group occurred. This research suggests that saffron might be useful in patients suffering from liver metastasis. However, further investigations with larger sample size are required.