Materials and Methods
Patients
In this retrospective study, performed across 4 oncology centers in Saudi Arabia and Egypt, we evaluated
280 women who were diagnosed with unilateral early breast cancer from between March 2010 and October 2013.
Patients received standard neoadjuvant chemotherapy
(6-8 cycles of an anthracycline and Ttaxane-containingregimen) with or without trastuzumab according to the human epidermal growth factor receptor 2 (HER2) status. After excluding patients who underwent breast conservative surgery because of a possible high incidence of recurrence, the included patients underwent modified radical mastectomy with axillary clearance followed by local radiotherapy with/without hormonal treatment for
Candide patients,
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Fluorescence in situ hybridization (FISH) was used to establish the HER2 status when IHC yielded equivocal results. The interpretation of HER2 FISH results (HER2- to-CEP 17 ratio and gene copy number) was as follows: positive HER2 amplification, FISH ratio > 2.2 or HER2 gene > 6.0; equivocal HER2 amplification, FISH ratio of
1.8-2.2 or HER2 gene copy of 4.0-6.0; and negative HER2 amplification, FISH ratio <1.8 or HER2 gene copy < 4.0.
Statistical Analysis
SPSS version 17.0 was used for data analysis.
Quantitative data are presented as the mean and standard deviation (SD). Parametric and non-parametric t-tests were used for comparison of two independent groups.
The Kaplan-Meier method was used to estimate overall survival. Overall survival was measured from the first day of treatment until death, while disease- free survival was defined as the period from the date of diagnosis until the date of first recurrence, either loco-regional or systemic.
The log rank test was used to compare survival between the groups. The χ2 and Fisher exact tested were used to determine the proportion of independents. The logrank test was used to calculate P- values for the differences between groups. For all the above- mentioned statistical tests, the threshold of significance was fixed at the 5% level. The P value of >0.05: indicates non-significant
It is estimated that 40,030 deaths from breast cancer (39,620 women, 410 men) are will occur in 2013. Breast cancer is second only to lung cancer as the leading cause of cancer deaths in women. Breast cancer death rates have been decreasing steadily since 1989, rates decreased by 3.0% per year in women younger than 50 and by 2.0% per year in women 50 and older between 2005 and 2009. This decline is attributed to prevention, early detection, improved healthcare services and reduced use of MHT.
This paper aims to provide the gaps in our understanding of breast cancer by examining the functions and to enhance our ability to distinguish the anatomy of female human breast. The author also attempts a better understanding of some of the different types of human breast cancer namely: ductal carcinoma in situ, lobular carcinoma in situ, invasive ductal carcinoma and invasive lobular carcinoma. It is hoped that this paper will inform those who do not have the understanding and knowledge about the risk factors, diagnosis, treatments and preventions of the breast cancer.
There are many different diseases that terrorize the human race every day. Of all of these sicknesses, one of the most devastating is breast cancer. Breast cancer touches all types of people all over the world each day. It is actually the second most common cancer amongst women in the United States. One in every eight women in the United States has some form of breast cancer and currently, the death rates are higher than any other cancer with the exception of lung cancer. Cancer is defined by the Merriam-Webster Online dictionary as “a malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis.” Therefore, breast cancer is a disease of
Working as a nurse on a busy inpatient oncology unit can be rewarding. It is busy. It can be crazy. I see things that I would have never thought possible. Around Thanksgiving of 2012 I had a lady that came into the hospital with a host of problems. Before I could assess her and see what was happening, I had to peel off a very worn, purple, faux fur coat that was caked with blood. Removing her coat, I could see that her clothes were in similar shape. After going through a few layers of clothing, I removed her shirt and found the source of the blood: She had a gaping wound on her right breast. When I asked how long she had this wound, she answered that it had only been a few months. This was my first experience after being a nurse for nearly a decade of seeing a patient with inflammatory breast cancer.
Around 25-30% of the total breast cancer patients are diagnosed with HER2 gene amplification (Vogel, Charles L., et al, 2002). Patients with HER2 gene overexpression also produces a higher level of protein therefore, the patients with this condition are susceptible to decreased disease free and shorter overall survival rate(Vogel, Charles L., et al, 2002). The non-targeted cytotoxic chemotherapy has been used as a standard treatment of this condition. However, there are several side effects for these non-targeted therapies; such as vomiting, nausea, headache, fatigue, diarrhea, dizziness, anemia, thrombocytopenia, leukemia, anxiety, depression, anorexia and so on(O 'Shaughnessy, Joyce, et al, 2011). Therefore, a lot of patients are unable to use cytotoxic chemotherapy as a standard treatment. It is necessary to have a safe treatment that can serve the unmet purpose of these patients.
Cancers are a large family of disease that involve abnormal cell growth which can then spread to other parts of the body.This year about 564,800 Americans are expected to die of cancer, more than 1,500 people a day. Cancer may be identified with many kind of symptoms depending on where in the body is the cancer located, how big is the cancerous tumor and how much is affects the surrounding organs and tissues.
Breast cancer is one of the most common forms of cancer only surpassed by lung cancer. It involves a cancerous tumour located inside the breast but spreads if treatment is not administered. (Evert et al 2011) Breast cancer can be treated if diagnosed in its early stages but becomes progressively more difficult upon reaching more advancing malignant stages. Breast cancer can be confused with being a female only disease however both sexes suffer. According to statistics in 2011 which measured the abundance of breast cancer in the UK, 50,285 new cases of breast cancer were confirmed with 98% being female and 2% male, these statistics show that the disease is more problematic in females which may result from differences in breast formation or hormonal and genetic differences.
Breast cancer is the most common cause of cancer-related death among females in the world. It is known for “have both a genetic and non-genetic etiology” (Milne et al., 2010). It involves a combination of several factors- such as “genetic, environmental and behavioral risk factors”- that are unique to each individual (Nickels et al., 2013). This type of cancer is represented by a malignant tumor manifested in breast cells such as the line duct and line lobules cells, just to name a few. Because there are different types of breast cancer, it is harder to create an effective treatment or therapy that would lower or prevent its death rates. Despite advances in technology but lack of monetary support, there is a higher prevalence in African countries (U.S. breast cancer statistics, 2013). It has been found that “two thirds of breast tumors express estrogen receptors” (Lopez-Tarruella & Schiff, 2007). Because of this, growth factor receptor signaling and hormone therapies have been shown as promising treatments to prevent and/or to find a cure for this cancer.
Inflammatory breast carcinoma is a type of cancer affecting the epithelial tissues of the breast, it is often said to be characterized by the rapid onset of tenderness, swelling, pain and redness of the breast as well as the discolouration of the overlying breast tissue. IBC accounts for 2.5% of all cases of cancer and is usually termed to be an aggressive and rare cancer that is usually misdiagnosed for mastitis. This type of cancer progresses rapidly and is seen to affect the population of young women. IBC has a survival rates of less than 5 years. The diagnosis of IBC is very complex and if tests are not preformed correctly, read correctly or done as soon as possible it can result in the death of the patient. In this paper dealing with the rapid killer disease known as IBC we will be examining the disease, its signs and symptoms, and its diagnosis.
The studied group was divided into three groups: group A included 92 breast cancer patients with age ranged from (23-70 years). Group B included 25 patients with benign breast and their age ranged from (21-43 years) and group C (the control group) included 16 subjects with age ranged from (20-65 years).
Cancer is one of the main threats to health as the second cause of death after heart disease[1]. Approximately 7.6 million people per year worldwide die from cancer and there tends to be an increase in the number of cancer patients each year[2]. One type of cancer is breast cancer that occurs due to disruption of the system of cell growth in breast tissue[3]. This type of cancer most commonly suffered by women worldwide. In Indonesia, there are 48 thousand cases of breast cancer with 21.4% of deaths in women[4]. Cancer treatment method widely used today are surgery, radiation, hormone therapy, chemotherapy, and targeted protein therapies aimed to remove the cancerous tissue or make cancer cell death, but the method induces side effects on normal
All patients were females with a Mean age of 52.8 years. The correlation showed 85.71% concordance between the two grading systems with a 93.33% agreement and an observed weighted Kappa value of 0.916 implying a substantial strength of agreement. Chi-square statistical test performed for lymph node metastasis with grade of the tumor was statistically significant with a p-value of 0.0189 (p= 5 times size of RBC
It is expected that in the coming decades, these countries would account for majority of new breast cancer patients diagnosed globally. Breast cancer cases are expected to increase by 26% by 2020 and most of these will be seen in developing countries (Anonymous, 2009). It is estimated that by 2030 the global burden of breast cancer will increase to over 2 million new cases per year (IARC, 2011) (GLOBOCAN, 2008).Such alarming statistics of occurrence and mortality rates make it one of the most important health hazards.
According to the American Cancer Society, Each year, more than 200,000 women are diagnosed with breast cancer; furthermore Twelve percent of all women will contract the disease, and 3.5% of them will die from breast cancer (American Cancer Society, 2005). There are risk factors that may lead to breast cancer. There are 4 stages of breast cancer and several treatments, although treatments vary from types and stages of breast cancer. Breast cancer is the leading cause of death among women who are 40 to 55 years old (Breast Cancer, 2009).Cancer occurs when cells divide uncontrollably. It changes from a normal cell to cancerous cells that require gene alterations. Therefore the altered genes and the uncontrolled growth may lead to tumors.
Another issue that was reported in Saudi Arabia was that the majority of breast cancer cases were presented in the advanced stages as 39.6% and16.9% were in regional (III) and distant (IV) stages respectively (Kingdom of Saudi Arabia Ministry of Health Saudi Cancer Registry, 2012). That was supported by a Saudi retrospective study carried out by Rudat, Brune-Erbe et al. (2012) who compared data of breast cancer patients in one of the tertiary hospitals in Saudi Arabia with American publications derived from the Surveillance Epidemiology and End Results (SEER) database between 2004 and 2011.The study revealed that Saudi Arabian breast cancer patients who were diagnosed with advanced stage breast cancer composed of 61.2% versus 28.6% of localized stage cancer in the US.