فصلنامه بیماری های پستان ایران
سال چهاردهم شماره 2 (پیاپی 53، تابستان 1400)

Breast cancer is one of the inflammatory diseases, and physical inactivity is one of the risk factors. It has been suggested that exercise training can improve breast cancer outcomes by modulating inflammation. The aim of this study was to determine the effect of 12 weeks of high-intensity interval training and moderate- intensity continuous training on serum levels of IL-17 and IL-10 in breast cancer survivors.

In this quasi-experimental study, 45 postmenopausal women (age:57.25± 3.91)  who after the termination of breast cancer treatments, were randomly divided into three groups of 15 individuals each: (1) a high-intensity interval training (HIIT) group, (2) a moderate-intensity continuous training (MOD) group, and (3) a control group. HIIT and MOD were performed for 12 weeks, three days a week, using a cycle ergometer. Body composition and biochemical indices were evaluated 48 hours before and after the interventions. Data were analyzed using  one- way ANOVA and the Tukey post hoc test at a significance level of 0.05.

The results showed that 12 weeks of HIIT and MOD significantly decreased IL-17 (P< 0.001 and P= 0.004, respectively) and significantly increased IL-10 (P= 0.005, P= 0.027, respectively). However, a significant difference (P= 0.004) was observed between the training group and the control group only in the levels of IL-17. In addition, no significant difference was observed between the two training groups in IL-17 or IL-10 (P> 0.05).

It seems that HIIT and MOD can be incorporated in breast cancer treatment plans as effective strategies for modulating inflammatory and anti-inflammatory factors.

Breast cancer is the most common type of cancer in Iranian women, detected in 70% of cases when the disease has reached an advanced stage. The discovery of new diagnostic biomarkers is essential for the early detection of the disease. Cystatin C is a member of the cystatin family and a non-glycosylated, cysteine ​​protease inhibitor that is also used as a functional marker of the kidney.
To evaluate the serum cystatin C level in women with breast cancer compared with a control group and to verify this in the pathophysiological data of the patients.

This study was carried out on 88 women (44 patients with breast cancer and 44 healthy controls) referred to Reza radiotherapy and oncology center, Mashhad, Iran, in 2020. After recording demographic information and clinical studies, the serum cystatin C level was measured using an ELISA kit, and the data were analyzed with SPSS version 22.

The mean age of healthy controls was 48.48 years and patients 52.32 years. The patients had a mean BMI of 29.52 m2/kg, while the mean BMI for the controls was 24.37 m2/kg. Our results showed that the mean serum cystatin C level (ng/ml) in breast cancer patients was 0.555±0.413 versus 0.258±0.291 in the control group (P<0.001). Serum cystatin C levels was correlated with cancer stage (P = 0.029), tumor size (P = 0.002), tumor grade (P = 0.001). In the analysis by BMI, serum cystatin C level was significantly higher for both BMI>25 (P < 0.001) and BMI≤25 (P = 0.017) in breast cancer patients compared with the controls. Cystatin C also increases significantly in patients over 50 years (P < 0.001). No significant association was found between serum cystatin C level and lymph node involvement, estrogen receptor, progesterone receptor, or HER2. In the study of the ROC curve, sensitivity was equal to 65.9%, specificity 86.4%, positive predictive value 82.8% and negative predictive value 71.6%.

Cystatin C plays an important role in the pathophysiology of breast cancer and can be used as a diagnostic biomarker.

Breast cancer is the most common female cancer in the world and Iran and the leading cause of cancer death among Iranian women. One way to control this cancer is to get screened and diagnosed early. Given that screening in the general population is not possible, early detection of this cancer in high-risk women is one way to control it. Mammography is one way to diagnose breast cancer, but unfortunately, most people do not want to have a mammogram. This is an important issue for women with a family history of breast cancer, which constitutes one of the most high-risk groups for the disease. Therefore, the present study aimed to identify the views of relatives of patients with breast cancer about the reasons for unwillingness to perform mammography.

The present study was a qualitative study performed on 160 first-degree relatives and 118 second-degree relatives of breast cancer patients who were selected by purposive sampling to discover the reasons for not performing mammography. In-depth semi-structured interviews were used to collect data. All data were recorded and handwritten and analyzed using structural methods.

In the content analysis of the interviews, 5 themes, 14 main categories, and 73 subcategories were extracted. Preoccupation with daily life matters and lack of knowledge were the most common barriers to participation in screening among 1st-degree relatives, while wrong beliefs and attitudes constituted the most common barriers contributing to the unwillingness to getting mammography screening among 2nd-degree relatives.

Relatives of women with breast cancer are neglected despite facing a high probability of developing this cancer. It is suggested that the country’s health system provide comprehensive and effective education for relatives of women with breast cancer to raise awareness and eliminate misconceptions.

Breast cancer is the most common cancer in women. The present study aimed to assess the incidence, family histories, and symptoms of breast cancer among the 30–70-year-old women under the coverage of the health centers of Arak city, as well as evaluating the rate of participation in breast cancer screening.

The present cross-sectional study was conducted during 2016-2019 among all the 30- to 70-year-old women who were under the coverage of health centers in Arak and attended rural, urban, or suburban health centers for breast cancer screening and whose data were recorded in the Sib system. Family histories, signs and symptoms reported, rate of participation in the screening program, and incidence of breast cancer were calculated.

The population of women aged 30 to 70 years who were under the coverage of health centers in Arak was 145,743 persons, 56,168 (38.5%) of which participated in the breast cancer screening program. The participation rate was greater in villagers (71.3%) than in the city (33.9%) and the suburb (35.1%). Family history of breast cancer and breast mass were the most frequently reported issues. The mean (SD) age of the breast cancer diagnosis was 49.49 (9.53) years, and breast cancer incidence rates in 2016, 2017, 2018, and 2019 were 7.85, 8.61, 10.26, and 10.70 (per 10,000 people), respectively, which made an increasing trend. Also, the highest incidence was observed in the age group of 46-59 years.

The rates of participation in the breast cancer screening program in the city and suburb were low, and the trend of the cancer incidence was increasing. Finally, awareness-raising about breast cancer risk factors and symptoms, as well as regular participation in screening, is considered essential.

Psycho-spiritual therapy (mind-body spirituality) is a multidimensional, transpersonal, and integrative intervention for breast cancer survivors. This study aimed to determine the effectiveness of counseling based on transpersonal psychotherapy (spirituality therapy, mind and body) in reducing the fear of recurrence in breast cancer survivors.

This was a randomized controlled clinical trial with a pretest-posttest design conducted in Motamed cancer clinic, Tehran. Iran. Thirty breast cancer patients who had finished their treatment were randomly allocated to either an experimental or a control group, 15 patients each. Both groups completed the Persian version Fear of Cancer Recurrence Inventory. Then, the experimental group participated in transpersonal therapy for 14 sessions, a 2-hour session every week. Both groups completed the aforementioned questionnaire again immediately and two months after the intervention. The data were analyzed with an independent t test and the analysis of variance for repeated measures.

  In the experimental group, the mean fear of recurrence was significantly lower immediately (58.87± 17.86) and at the 2-month follow-up (54.07± 11.88) compared with the baseline (106.80± 15.32) (P< 0.001). However, no difference was observed in the control group.  Also, there were significant differences between the two groups in the mean scores for all components of fear of recurrence, including triggers, severity, psychological distress, coping strategies, functioning impairments, and insight (P< 0.001), except for reassurance.

Based on the findings of the present study, counseling based on transpersonal psychotherapy can reduce the fear of recurrence and stress and increase adaptation and insight in cancer patients. This method increases relaxation, reduces stress, contributing to improved quality of life.

The most appropriate and effective method of breast cancer screening is breast self-examination. The aim of this study was to determine the effect of group counseling based on reality therapy on women’s self-efficacy of breast self-examination.

This was an educational trial with a pretest-posttest design that was conducted in Shazand city in 2020. The study sample consisted of 30 women who were recruited from five health centers via available sampling. Participants were randomized into two groups of intervention (14 people) and control (16 people). Both groups completed personal, demographic, and self-efficacy of breast self-examination questionnaires. The intervention group received 8 sessions (two 90-min sessions per week) of group counseling based on reality therapy. One month after the intervention, both groups completed the self-efficacy of breast self-examination questionnaire again, and changes in the mean scores were examined.

There was no statistically significant difference between the groups in terms of demographic characteristics such as age, level of education, marital status, menstrual age, age at marriage, and gestational age. The mean score of female self-efficacy of breast self-examination before intervention was 58.9 ± 19.8 in the control group and 58.4 ± 21.2 in the intervention group (no difference). After the intervention, the mean score of female self-efficacy in breast self-examination was 59.9 ± 18.8 in the control group and 85.7 ± 9.7 in the intervention group (P < 0.05). Using analysis of covariance (ANCOVA), the effect size of counseling was calculated at 46%.

The results of the study indicate that group counseling based on reality therapy can improve women’s self-efficacy of breast self-examination. Since this approach can be achieved in a shorter time than other types of counseling, the use of this method in important health behaviors such as breast self-examination is recommended.