Archives of Breast Cancer
Volume:10 Issue: 4, Nov 2023

Since Omega-3 (n-3) polyunsaturated fatty acid (PUFA) supplementation plays a significant role in the treatment of cancer, decreases the adverse effects of medications, and helps in preserving lean mass and weight control, there is a good correlation between it and the prognosis for patients with breast cancer (BC). The objective of this study was to examine the effects of n-3 PUFA supplementation as an adjuvant therapy in the treatment of patients with BC.

The following databases were searched electronically: Embase, PubMed, Web of Science, and Google Scholar. The selection criteria were based on relevance of the topic, which was mentioned as a certain stage of BC and the usage of n- 3 PUFA. The first search yielded 62 papers in total; afterwards, 55 publications that did not meet our eligibility requirements were removed, and eight articles were selected.

n- 3 PUFA supplementation ranged from 1 to 4.3 g/day in the studies. When n-3 PUFA was added to the BC treatment regimen, tumor growth was inhibited and vascular endothelial growth factor and Ki-67 levels decreased, leading to an improvement in longevity. Many side effects of BC therapies have been studied, and it may be feasible to reduce these negative effects by taking n-3 PUFA supplements.

In addition to being an antioxidant, n-3 PUFA supplements have been shown to help patients with BC in other ways, such as by increasing their chance of survival, lowering side effects (like xerostomia and bone reabsorption), improving their lipid profile, and increasing breast density.

Patients who achieve a pathological complete response (pCR) after neoadjuvant therapy have better outcomes than patients with residual disease. Despite the excellent prognosis associated with achieving a pCR, recurrence still occurs. The study was conducted to evaluate factors associated with tumor recurrence and survival among patients achieving pCR after neoadjuvant therapy.

We evaluated the medical records of patients with breast cancer who received neoadjuvant therapy and achieved pCR in our academic institute. The survival curve was estimated with the Kaplan-Meier method in patients who developed recurrence.

In our retrospective study 2,360 received neoadjuvant therapy out of which 315 (13.3%) who achieved pCR were included in this study. The mean age was 45.85 (range 21-92 years) and the mean duration of follow-up was 41.2 months. The clinical tumor stage T1-T2 represented 55%, T3-T4 was 44.1%, and node-positive was 54%. The primary endpoint was the correlation between pCR achieved after neoadjuvant therapy and disease-free survival or overall survival. Predictors of pCR were clinical T-stage which received appropriate chemotherapy.We observed that patients who had an increased risk of recurrence after achieving pCR were those with clinical stage III-IV, patients with mastectomy, and those with triple-negative tumor subtype.

Achieving pCR after neoadjuvant therapy is distinctly related to the improvement of survival; however, patients who achieved a pCR, women younger than 50 years of age and those with stage III/IV disease have a higher risk of developing distant metastasis

Post-radiation angiosarcoma (AS) of the breast is a rare complication after breast radiotherapy. The diagnosis and management of post-radiation AS is challenging because of its non-specific but aggressive presentation. This study aims to examine the experience of a local health district with post-radiation AS to improve awareness of this condition.

A retrospective case series was performed on patients diagnosed with post-radiation AS within Western Sydney Local Health District between 2000-2021. Eligibility criteria included patients with histologically proven breast angiosarcoma and a history of past breast radiotherapy.

In the study,11 patients had post-radiation AS of the breast. The annual incidence was 1 in 18,000 of the breast radiotherapy-treated population. Descriptive analysis was performed on six patients. The median age was 67 years, with a median latency period of 5.5 years. All patients presented with non-specific skin changes. Core/punch biopsy was inconclusive in five patients. Mastectomy was the mainstay of treatment. Three patients had disease recurrence. The five-year survival rate was 68%.

Post-radiation AS of the breast is a rare disease associated with a poor prognosis due to its aggressive nature and high recurrence rate. Diagnosis is challenging with high false-negative rates associated with imaging and biopsy. It is important to maintain a high index of suspicion in patients treated with past breast radiotherapy.

Breast cancer (BC) screening and awareness programs are conductedannually for Iranian women by the collaboration of several governmental and non-governmental organizations (NGOs). We designed a study to assess the effect of the campaign on women's awareness, education, and the outcome of previously unnoticed breast lesions detected during the campaign screening program.

Through online social media announcements, women were invited to participate in this campaign runin five locations in the capital of Iran, Tehran. Participants filled out a questionnaire about personal data, previous breast problems, BC awareness,and screening attitudes. BCscreening was only performed via breast examination by surgeons for all women. We called all participants who required further investigation after two years.

In this campaign, 418 women with a mean age of 43.19±49.11 were examined. About 42% had some information about BC, mainly acquired from the media. Among women over 50, 30.2% had no previous screenings, and 15.9% had not been referred despite having symptoms. Among the women who needed further investigations,according to the campaign evaluation, 71.8% complied with the recommendation to follow-up their case, and two women were diagnosed with BC.

Women need more education in the field of BC awareness, and on the need for screening,especially after the age of 50. To achieve these goals, using mass media is highly recommended,and the experience of the successful campaigns runby charity organizationsand academic centersmight be a good guide for preparing a comprehensive protocol.

Pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) is a marker for important clinical outcomes in the management of breast cancer. In Nigeria where the majorityof patients are candidates for NAC, there is limited data on pCR following NAC. This study evaluated the pCR rate in a cohort of Nigerian patients.

A retrospective review of patients who had NAC and mastectomy for breast cancer between 2017 and 2022. Relevant baseline clinicopathological and treatment data were obtained.pCR was defined as the absence of invasive cancer with or without in situ disease in the breast. The relationship between receptor status, type of chemotherapy and pCR was evaluated.

One hundred and sixty six of the 250 patients who had mastectomy during the period had NAC and were eligible for analysis. The mean age was 50.1±11.1, and the majority had stage 3 disease. The overall (pCR) rate was 19.9%,with the latter part of the study corresponding to the period with increased use of taxanes, having higher pCR (35.9% in 2022 vs 7.4% in 2017, p=0.024). Patients with HER 2 positive/Hormone receptor negative (HER 2+/HR-), HER 2+/HR+ and triple-negativedisease hadsignificantly higher pCR than those with HR+/HER 2 negative disease (38.9%, 30.8%, 24.5% and 6.5% respectively, p=0.03).

NAC resulted in pCR in about one-fifth of the entire cohort, particularly those with potentially aggressive HER 2+ and triple-negativedisease. The use of taxanes was associated with higher pCR rates.

Women diagnosed with breast cancer experience high levels of psychological disorders ranging from depression, anxiety, maladjustment to the disease, and decreased self-confidence to different emotional disturbances and fears of recurrence and mortality. The present study aimed to investigate the mediating role of cancer self-efficacy in the association between health literacy and social support with health-promoting behaviors in women with breast cancer.

In this descriptive-correlational study, the purposive sampling method was employed to select 282 women diagnosed with breast cancer in Ahvaz, Khuzestan Province (Iran) in 2021.The participants were asked to answer the Health-Promoting Lifestyle Profile II (HPLP-II), Iranian Health Literacy Questionnaire, Social Support Survey, and Cancer Behavior Inventory.Descriptive statistics and structural equation modellingwere used to analyze the data in SPSS v27.0 and AMOS v25.0 software.

The results revealed that there was a significant association between perceived social support with health-promoting behaviors (β=0.17, P=0.004) and cancer self-efficacy (β=0.37, P=0.001) in women with breast cancer. There was a significant association between health literacy and cancer self-efficacy in women (β=0.31, P=0.004). According to the results, the mediating role of cancer self-efficacy in the association between perceived social support and health literacy with health-promoting behaviors was found to be significant in women with breast cancer (P=0.001). In the final model, CFI and RMSEA were found to be0.97 and 0.061, respectively.

Accordingly, the research model had a desirable fit. The findings of this research showed the effective role of cancer self-efficacy in the outcome of social support and health literacy to increase health-promoting behaviors in women with breast cancer.Therapists and counselors are also recommended to use a variety of methods for improving patients' self-efficacy and social support.

HIV and breast cancer are a major global burden of disease for women.There were 35 million people infected with HIV in 2013,over 70% of whom lived in sub-Saharan Africa.Breast cancer is the leading form of cancer affecting South African women.Themain aim of this study was to better understand the profile and features of breast cancer in HIV-positive and negative patients in the Limpopo province, South Africa.

This isa retrospective cross-sectional descriptive quantitative study designed to analyse the profile of patients with breast cancer who attended Mankweng Breast Oncology Clinic from July 2020 to December 2021.

From a total of 205 patients,the HIV-positive group consisted of 43 patients and the HIV-negative group of 162 patients. The age rangewas20-90 years, the mean age was 51, the mean age of HIV-positive group was 46.6(30-79) years and HIV-negative 52.4 (20-90) years. Early-stage cases (0, I & II) included 46 patients and late stage cases (III & IV) included 159 patients. In the HIV-negative group (162),36patients (22%) presented with early stages and 126(78%) in the late stages. The HIV-positive group (43) consisted of10(23%) patients in the early stage and 33(77%) in the late stage.

In this study,the mean age of HIV-positive patients was lower than the mean age of HIV-negative patients (46.6 vs 52.4). Triple negative molecular subtype breast cancer was more frequently present in HIV-positive patients than in HIV-negative patients (24.2% vs14.4%).HIV-positive patients demonstrated a higher grade 3(47%),while HIV-negative patients had a higher grade 2(62%).

Although response-adjusted surgery is a highly recommended strategy following neoadjuvant systemic treatment (NAST), consensus on axillary management in cN+/ycN0 breast cancer patients is still lacking. In this setting, clinical significance of the higherfalse negative rate of sentinel lymph node biopsy (SLNB) procedure is unknown. The present analysis aims to evaluate the long-term safety of the SLNB in ycN0 patients.

In this study, 60 patients with the operable breast cancer, undergoingsurgeryafter NAST in Clinical Hospital Centre Rijeka, Croatia, from May 2016 to May 2018, were included in the analysis. Following a preliminary retrospective analysis in 2019, follow-up (FU) was extended, and all outcomes were re-evaluated in December 2022.

The median FU time was 65 months and 98% of patients hadcomplete FU data. In the ypN0 group, ALND was performed for 15 and SLNB for 20 patients. The median number of LN retrieved in ALND and SLNB was 15 and 3, respectively. The method of surgical axillary staging had no impact on oncological outcomes; Regional Recurrence Free Survival Chi-square=0.5789, P=0.4467; Distant Recurrence Free Survival Chi-square=1.3658, p=0.2425; Breast Cancer Specific Survival Chi-square=0.9755, P=0.3233.

Irrespective of a higher FNR following NAST, as compared to the upfront surgery setting, SLNB is a safe procedure and should be considered for all ycN0 patients, regardless of pre-treatment cN status.

Four-dimensional computed tomography (4D-CT) acquires multiple CT images over time, allowing to visualize the respiratory motion of organs and tumors. In patients undergoing 4D-CT for stereotactic radiotherapy of intra-thoracic tumors, 4D-CT provides the opportunity to study the incidental movements of the breast during normal breathing. A study protocol to investigate breast respiratory motion is presented herein.

Patients with any primary cancer who underwent 4D-CT will be retrospectively selected from a radiotherapy treatment planning database. Study inclusion requires full lungs and breasts coverage in the 4D-CT images. Patients with advanced tumors are excluded. The protocol details breast locations of interest (upper, lower, inner, outer, central), specifies virtual breast tumor beds, and details how breast motion will be measured. Data will be analyzed to quantify the range of movements, to evaluate breast motion according to laterality and location, and to evaluate the correlation between movements of the breast and the intra-thoracic organs.

Results should provide quantitative information on the extent of breast movements during free breathing, which could be valuable to plan for respiratory control during breast radiotherapy.

Thisstudy presents a protocol to investigate breast movements during normal breathing using 4D-CT. The findings will aid in planning respiratory control for breast radiotherapy.

Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition that forms tumefactive lesions in various organs, presenting with diverse clinical manifestations. Diagnosis of IgG4-RD could be challenging and relies on characteristic histopathological findings and elevated IgG4+ plasma cell counts.

The patientwas a48-year-old woman with diabetes mellitus initially presented with a painless breast mass. Imaging indicated irregular opacities and lymph nodes in the breast. Biopsy results revealed lymphoplasmacytic infiltration with IgG and IgG4 positivity, overall compatible with IG4-related disease. A mass resection was performed, and intraoperative assessment ruled out malignancy. Then,with a 5-month interval of no symptoms, the patient developed a cheek mass, initially misdiagnosed as low-grade spindle cell sarcoma. Subsequently, she underwent partial maxillectomy, further examination,and histology confirmed IgG4-RD, meeting all diagnostic criteria.

This case underscores the diagnostic challenges posed by IgG4-RD, often mistaken for malignancies due to its invasive behavior and emphasizes the importance of considering IgG4-RD in differential diagnoses for tumor-like lesions, particularly when affecting multiple organs, to enable timely treatment decisions and prevent unnecessary interventions.

Axillary Web Syndrome (AWS) manifests after breast cancer surgery as 1mm wide, singular, or multiple cords that can extend from the ipsilateral axilla to the antecubital fossa and further into the forearm and wrist. These cords can be painful and cause diminished range of motion. Even though there is no current standard treatment for AWS, physical therapy is recommended as the first approach in management. In refractory cases, no management has been proposed.

We present a case of a 59-year-old female with right-sided breast pain and a palpable cord, refractory to one year of physical therapy, whichbegan at the inframammary fold up towards the lumpectomy scar and further towards the axilla. Cord developed post-lumpectomy and post-radiation for a right-sided stage I invasive ductal carcinoma with negative sentinel lymph node biopsy. Based on the refractory nature of the cord, the patient underwent three treatments of steroid injections which made the cord less palpable and improved the pain. Due to persistent diminished range of motion and tenderness, the patient underwent a percutaneous needle cord disruption procedure with a last round of corticosteroid injection to prevent adherence of the cord pieces. At a 7-month follow up post-procedure, the breast cord was no longer present, and range of motion had been restored.

We found that percutaneous cord disruption with concurrent steroid injections can be an effective treatment for AWS refractory to physical therapy.