Search Results (219)

Background: The identification of pathogenic variants in the Breast Cancer Genes 1 and 2 (BRCA1/2) is a critical predictive biomarker for poly (ADP-ribose) polymerase inhibitor (PARPi) therapy in epithelial ovarian cancer (EOC). The aim of this study is to define real-world rates and determinants of germline and somatic BRCA1/2 testing and subsequent PARPi utilisation in Australia using a national clinical quality registry. Methods: This multi-centre cohort study analysed data from 1503 women with non-mucinous EOC diagnosed between May 2017 and July 2022, captured by the Australian National Gynae-Oncology Registry (NGOR). We evaluated rates of germline and somatic testing and PARPi use, using multivariate logistic regression to identify associated clinical and demographic factors. Results: Overall germline and somatic testing rates were 68% and 32%, respectively. For the high-grade serous ovarian cancer (HGSOC) cohort, rates were higher, at 78% and 39%, respectively. Germline testing was significantly less likely for women aged >80 years (OR 0.49), those in regional areas (OR 0.61), and those receiving single-modality treatment. Somatic testing uptake increased significantly following public reimbursement for PARPi (p = 0.004). Among eligible women with a newly diagnosed BRCA pathogenic variant and advanced disease (n = 110), 52% commenced first-line maintenance PARPi. Conclusions: This national study offers valuable insights into Australian ovarian cancer care, highlighting opportunities to enhance testing equity for older women (aged >80) and regional patients. Furthermore, it identifies the translation of a positive test into PARPi therapy as a complex area that warrants further collaborative investigation to optimise patient outcomes. Full article

Background: The prevalence of BARD1 mutations in breast and ovarian cancers varies across different ethnic groups. Evaluating the cancer risk and clinical significance of BARD1 mutations in the local Chinese patients with breast cancer, ovarian cancer, or both is clinically important for designing an appropriate surveillance scheme. Methods: This study used a 30 gene panel to identify BARD1 germline mutations in 2658 breast and ovarian cancer patients. Results: Among this cohort, the BARD1 mutation prevalence was 0.45% for breast cancer and 0.29% for ovarian cancer. In our 12 mutation carriers, we identified eight types of mutation variants, including three novel mutations. BARD1 mutation carriers were more likely to have a family history of liver, prostate, and cervical cancers (p-values = 0.004, 0.018, and 0.037, respectively) than patients who tested negative for mutations. Among the BARD1 mutants, the majority of the breast tumors were invasive ductal carcinoma (NOS type) (10/11, 90.9%) of high-grade disease (9/9, 100%) and half of them were triple-negative breast cancer (5/10, 50%). Conclusions: Although the prevalence of BARD1 mutations is low and the penetrance is incomplete, we recommend including BARD1 in the test panel for breast cancer patients. Our data suggest that more comprehensive surveillance management may be considered in mutation carriers due to the familial aggregation of a relatively wide spectrum of cancers. Full article

Background/Objectives: Since breast cancer (BC) survival rates have increased to 91% at 5 years and 80% at 15 years postdiagnosis, there is a growing awareness of the importance of addressing the long-term well-being of patients. Consequently, integrative oncology, which combines standard therapies with complementary approaches (nutrition, mind–body practices, and lifestyle modifications), has emerged as a patient-centred model aimed at improving symptom management, treatment adherence, and overall quality of life (QoL). This study aims to demonstrate how integrative therapies can benefit body composition, phase angle, and fluid and electrolyte balance through bioelectrical impedance analysis (BIA). Methods: This study considers a patient who underwent BC surgery and was enrolled in the AMICO clinic for anamnesis, as well as their oncological pathology data, assessment of QoL, and BIA. The breast surgeon specialising in integrative oncology therapies prescribed the patient curcumin and polydatin, moderate physical activity, a balanced diet, and Qigong sessions. The patient underwent monitoring through haematochemical analysis, BIA, and a QoL questionnaire, with follow-up every four months. Results: Between 4 and 12 months, fat mass (FM) and body mass index (BMI) markedly decreased, whereas fat-free mass (FFM), total body water (TBW), and skeletal muscle mass (SMM) increased progressively. Moreover, the improvements in the Na/K ratio and phase angle (PhA) suggest a shift toward better electrolyte and fluid balance and enhanced cellular integrity and membrane function. Equally outstanding were her psychological benefits in terms of mood, sleep, anxiety, and melancholy. Conclusions: Patient progress in body composition, metabolic function, pain management, and psychological status measured during the 12-month follow-up demonstrates the potential benefits of an integrative approach to supportive cancer care. Full article

Background: Breast cancer is one of the most prevalent neoplasms among women, often requiring mastectomy, a procedure with a significant impact on functionality, self-esteem, and quality of life. Objective: This study aimed to map the main interventions performed by the Rehabilitation Nursing Specialist in the follow-up care of mastectomised women. Methods: A review was conducted according to the Joanna Briggs Institute methodology. The search included 11 articles published between 2019 and 2024 in Portuguese, English, and Spanish, available on the EBSCO platform (MEDLINE with Full TEXT, CINAHL). The descriptors used were (Mastectomy OR Breast Removal) AND (Rehabilitation Nursing OR Nursing Intervention). Results: The Rehabilitation Nursing Specialist interventions focused on education regarding upper limb mobilisation, medication administration, lymphedema prevention, strategies for performing Daily Life Activities with less effort and pain, implementation of rehabilitation plans with physical exercises, and emotional support in accepting body image changes. Hospital discharge planning and caregiver education also emerged as key elements to ensure continuity of care. Most studies (six) identify performing exercises to strengthen muscles and prevent lymphoedema as a very important intervention for nurses, followed by education on care for upper limb mobilisation and lymphoedema prevention (five) and emotional and social support (four), among other interventions. Conclusions: The Rehabilitation Nursing Specialist interventions are fundamental for promoting functionality, emotional well-being, and quality of life in mastectomised women, reinforcing the importance of a multidisciplinary, person-centred approach supported by scientific evidence. Full article

Background/Objectives: In many cases, the detection of a single lesion could revolutionise patient clinical management; not all localisations, especially those with a low uptake and, consequently, a low Tumour-to-Background Ratio (TBR), are readily detectable using [¹⁸F]F-FDG PET/CT. LAFOV-PET offers a potential enhancement in lesion detection, but the proportion of patients who would benefit from its use has yet to be determined. With the present analysis, we aimed to assess which clinical contexts the enhancement in lesion detection could affect the most. Methods: This retrospective study included 764 patients who underwent [¹⁸F]F-FDG PET/CT between January and April 2024. Data were obtained through a review of PET/CT reports. Inclusion criteria comprised patients who attended our centre for cancer pathologies or masses of undetermined nature (MUNs) in a staging setting, excluding patients who had undergone a prior [¹⁸F]F-FDG PET/CT scan or who had received therapy for any cancer pathology. This analysis focused on the total number of lesions identified, as well as the SUVmax of the lesion with the highest uptake. We analysed the proportion of patients who were within the range of number of lesions between 1 and 2, as well as who had an SUVmax of the lesion with the highest uptake between 2 and 5, either in the whole patient population or in the pathologies with a larger numerosity in the present study. Results: Among the 862 scans analysed, 289 (34%) were found to be negative, while 573 (66%) presented at least one localisation. In total, 4.5% of patients presented both a lesion number of between 1 and 2 and an SUVmax of the lesion with the highest uptake between 2 and 5. Among the malignancies that were the most common in the analysed population, a higher-than-average proportion of patients meeting these criteria were found in melanoma (6.2%), breast cancer (5.9%), and multiple myeloma (4.8%) patients. Conversely, the conditions that presented a lower proportion of patients in this range were suffering from MUNs (4.0%), lung cancer (2.1%), head–neck cancer (2.1%), suspected lymphoma (2.0%), and colon cancer (0.0%). Conclusions: Our analysis shows that almost 1 in 20 patients evaluated at oncological staging with [¹⁸F]F-FDG PET/CT could benefit from the increased diagnostic sensitivity offered by LAFOV-PET scanners. These data, although preliminary, support the need for future prospective controlled studies to confirm the actual clinical impact of implementing LAFOV-PET in current practice. Full article

Introduction: Breast cancer affects over 25,000 women annually in Canada and has seen improved survival rates due to advances in screening and treatment. However, cardiotoxic therapies including anthracyclines and trastuzumab have made cardiovascular disease a leading cause of death among survivors. Baseline left ventricular ejection fraction is a reliable predictor of heart failure, and various guidelines recommend pretreatment cardiac imaging; however, its utility is largely based on expert opinion. Methods: This retrospective cohort study analyzed 93 breast cancer patients treated at a single cancer centre in Northwestern Ontario between 2012 and 2017 to determine the yield (defined as imaging leading to clinically actionable changes in care) of imaging. Results: Patients were grouped by treatment regimen: trastuzumab-only (cohort A, n = 3, mean age = 73.55 ± 9.90), anthracycline-only (cohort B, n = 60, mean age = 58.83 ± 9.83), and combination therapy with both trastuzumab and anthracyclines (cohort C, n = 30, mean age = 59.37 ± 10.91). Due to the very small sample size in cohort A, findings are presented for qualitative insight only. Cohort B had the highest imaging yield (13.33%), while cohorts A and C showed lower yields (7.14% and 4.17%) with more frequent imaging. Predictors of higher yield varied, with cohort B identifying the most, including diabetes and coronary artery disease. Conclusions: These findings underscore the need for targeted cardiac imaging to optimize resource allocation and patient outcomes, particularly in resource-limited settings such as Northwestern Ontario. Subsequent investigations should seek to stratify proactive versus reactive interventions, evaluate outcomes, refine imaging guidelines, and gather more data on patients receiving trastuzumab. Full article

The aim of this study was to evaluate selected reproductive traits and estimate selected meat traits of male and female ducks of strains P-11 and P-22 during the rearing period, in order to analyse the differences between the two duck populations in terms of these traits in three consecutive generations, i.e., in the years 2020–2022. The birds were kept at the Duck Breeding Centre in Lińsk, Kuyavian-Pomeranian Voivodeship. This study was conducted using all individually tagged individuals of both sexes of known origin and lineage. The birds were kept under standard conditions, and incubation and hatching were carried out in accordance with applicable technology. Reproductive traits were evaluated in three generations of ducks, and meat traits were evaluated during rearing. Ducks of strain P-11 were shown to have a higher laying rate than P-22 ducks, a higher egg fertilization rate, and higher hatching rates of healthy ducklings from set eggs and fertilized eggs, which confirms the differences between the two populations. Average egg fertilization rates during the three-year study period ranged from 92.38% to 94.71% in strain P-11 and from 91.37% to 92.80% in strain P-22. The rates of healthy ducklings hatched from set eggs ranged from 72.24% to 78.15% in strain P-11 and were 2.89% to 4.73% higher than for strain P-22. Egg weight at peak laying (above 80%) ranged from 91.9 to 92.3 g in strain P-22 and from 89.2 to 89 g in strain P-11, and the heritability coefficients for both strains were within the range for moderately heritable traits. Statistically significant differences were shown between the two populations for all meat traits evaluated during the rearing period, i.e., body weight at 3 and 7 weeks of age, keel length, and breast muscle thickness, in each of the three years of this study (three successive generations of birds). Male ducks had higher body weight, better musculature, and higher fat content than females. In addition, the males and females of strain P-22 had higher values for these traits than the birds of strain P-11. Minor changes were observed in successive generations in the values for these traits, as well as in the heritability coefficients estimated from variance for fathers (h²_S), mothers (h²_D), and fathers and mothers (h²_SD). For most meat traits, the heritability coefficients estimated from the variance for fathers (h²_S), mothers (h²_D), and fathers and mothers (h²_SD) took on values from low to high in both strains. Full article

Background: In the era of precision medicine, Next-Generation Sequencing (NGS) has emerged as an important tool for identifying targetable mutations and tailoring treatment options. Yet the Middle East and North Africa (MENA) lags behind in adopting this technology. This study aims to demonstrate the transformative potential of molecular profiling in the region. Methods: This retrospective study reviewed cancer patients at the American University of Beirut Medical Centre, comparing outcomes between those who received NGS-based treatment adjustments (NBTAs) and those who did not. Results: The study enrolled 180 patients, including those with non-small-cell lung cancer (21.2%), sarcomas (20%), gastrointestinal malignancies (23.3%), breast cancer (10.6%), and other cancers (24.9%); 58.3% had stage 4 cancer at diagnosis. Before molecular profiling, 20.6% had stable disease, 21.7% showed partial response, and 57.8% had progressive disease. Most (96%) had received treatment, mainly systemic (90%), with chemotherapy (89%) being the most common. Forty patients (22.2%) underwent NGS-based treatment adjustments (NBTAs). Post-NGS, targeted therapies increased from 35% to 43% and immunotherapies from 14% to 18%. Mutations were detected in 98% of patients, with a median of four mutations per patient. NBTA patients had a median overall survival of 59 months, compared to 23 months for non-NBTA patients (p = 0.096), and significantly improved progression-free survival (5.32 vs. 3.28 months, p = 0.023). Conclusions: The use of large-scale molecular profiling to guide treatment adjustments promises advancements in patient care. Integrating NGS into clinical practice correlates with improved PFS, calling for a broader adoption of its use in the MENA region. Full article

Background: Sentinel lymph node biopsy (SLNB) is the primary procedure for nodal assessment in breast cancer patients. Radioisotopes (RIs) are considered the gold-standard tool. The ferromagnetic technique (superparamagnetic iron oxide—SPIO) is a non-isotope alternative SLNB method. This study compares the efficacy of SPIO and RI SLNB across two independent breast cancer centres. Methods: A total of 406 breast cancer patients, who underwent SLNB between January 2021 and December 2022, were analysed (SPIO—223 patients, RI—183 patients). Statistical tests, including Mann–Whitney U and chi-squared analyses, compared the SLN identification rates, the number of SLNs retrieved, and the positive node detection rates. Results: The identification rates were similar for SPIO and RI (two-tailed Fisher’s exact test, p = 1.0). The SPIO method retrieved significantly more SLNs than RI (3.26 vs. 2.15; p < 0.001). A larger proportion of patients in the SPIO group had ≥ 5 SLNs removed (20.2% vs. 8.7%; p = 0.001). A statistically significant difference was observed in the proportion of metastatic SLNs to harvested SLNs between the techniques, with a larger proportion detected in the RI group (1/7.88) compared to the SPIO group (1/14.81) (chi-squared test, p < 0.03). Conclusions: In our study, the SPIO and RI methods effectively collected SLNs. The gold-standard RI method offers distinct advantages, including its precise and consistent dosing unaffected by patient-specific factors and a highly targeted approach to node identification. These features minimise the risk of over-dissection and ensure that only the most clinically relevant nodes are removed. We note that the SPIO technique in SLNB in breast cancer patients requires further standardisation. Full article

Background: This study compared the change in pre- and postoperative health-related quality of life (HRQoL) among breast cancer patients undergoing breast-conserving surgery (BCS), total mastectomy no reconstruction (TMNR), and total mastectomy immediate breast reconstruction (MIBR). Patient factors associated with postoperative anxiety and depression were also identified. Methods: This prospective cohort study enrolled breast cancer patients between September 2017 and August 2020. HRQoL changes from preoperative to six months postoperative were compared using patient-reported outcome tools assessing anxiety, depression, pain, perceived health, breast satisfaction, psychosocial, physical, and sexual well-being and analyzed with ANOVA and linear regression. Results: A total of 471 patients completed preoperative and postoperative surveys (BCS: 313, TMNR: 60, MIBR: 98). Postoperative anxiety decreased across all modalities, with MIBR showing the greatest reduction (p = 0.03), though still exhibiting the highest postoperative anxiety (p = 0.05). Depression and perceived health scores showed no significant difference in change across modalities (p = 0.15, p = 0.48). MIBR patients showed the greatest increase in pain (p = 0.05) and the highest postoperative pain scores (p = 0.04). All three modalities showed a clinically significant decline in physical and sexual well-being. TMNR and MIBR had additional reductions in breast satisfaction, with TMNR also showing a decline in psychosocial well-being. Absolute postoperative scores for breast satisfaction, psychosocial, physical, and sexual well-being remained highest in BCS compared to TMNR and MIBR (p < 0.01, for each domain). In multivariable regression analysis, postoperative depression and anxiety scores did not differ between surgical modalities, but younger age was significantly associated with higher postoperative depression, pain and anxiety (p < 0.01), and adjuvant chemotherapy with higher postoperative depression (p < 0.01). Conclusions: BCS may have better overall HRQoL outcomes, specifically in breast satisfaction, psychosocial, physical, and sexual well-being, compared to TMNR and MIBR. Additionally, younger age, rather than surgical modality, was found to be associated with higher postoperative depression, pain, and anxiety scores. Full article

Current breast cancer therapies are unable to positively impact the lives of a significant proportion of diagnosed patients (24% based on 10-year survival rate). Breast cancer relapse and metastasis, the leading cause of breast cancer-associated deaths, is linked to the existence of breast cancer stem cells (CSCs). Redox-modulating metal complexes have been used to perturb the redox balance in breast CSCs and effect cell death. Here, we sought to expand this promising class of anti-breast CSC agents. Specifically, we report the synthesis, and anti-breast CSC properties of a series of copper(II) complexes bearing regioisomeric vanillin Schiff base ligands (1–4). X-ray crystallography studies show that the copper(II) complexes 1–4 adopt square planar geometries with the copper(II) centre coordinated to two vanillin Schiff base ligands. The most effective copper(II) complex within the series 4 displays low micromolar potency towards breast CSCs, up to 4.6-fold higher than salinomycin and cisplatin. Mechanistic studies indicate that copper(II) complex 4 elevates reactive oxygen species levels in breast CSCs, leading to activation of the JNK/p38 pathway and caspase-dependent apoptosis. Overall, this work expands the library of anti-breast CSC copper(II) complexes and provides insight into their mode of action. Full article

Chest wall perforator flaps (CWPFs) are a promising option for partial breast reconstruction but are underutilized, particularly in resource-limited settings. This retrospective observational study explores the feasibility and impact of CWPFs in breast-conserving surgery at our single-surgeon center, where 203 procedures were performed between 2018 and 2023. We evaluate 200 cases treated after multidisciplinary tumor board discussions and shared decision-making, assessing clinicopathological data, surgical outcomes, oncological results, cosmetic outcomes, and patient-reported outcome measures (PROMs). The median age of patients was 52.5 years. Single CWPFs were used in 75.9% and dual flaps in 24.1%. Sentinel node biopsy was performed in 76.9% of malignant cases, with no positive margins. Minor complications occurred in 11%, and no major complications were reported. At a 27-month median follow-up, the overall survival rate was 97.5%, with a disease-free survival of 92.1%. Cosmetic outcomes were good-to-excellent, and PROMs indicated high satisfaction. This largest single-surgeon study from Asia demonstrates the transformative role of CWPFs in breast conservation surgery for Indian women with sizable, locally advanced tumors. The technique offers excellent oncological and cosmetic outcomes, reduced costs, and a shorter operative time, highlighting the need for oncoplastic algorithms in resource-limited settings to improve breast conservation accessibility. Full article

Background: Breast reconstruction (BR) following mastectomy plays a critical role in restoring breast contour and improving patients’ quality of life. Acellular dermal matrices (ADMs) have emerged as valuable adjuncts in BR, providing structural support and enhancing soft tissue integration. However, their radiological characteristics remain underexplored, leading to potential misinterpretation and diagnostic challenges. This study aims to evaluate the imaging features of ADM in post-mastectomy patients using conventional imaging modalities, identifying its temporal evolution and clinical implications for radiologists and surgeons. Materials and Methods: This single-centre retrospective study included breast cancer patients who underwent mastectomy followed by ADM-assisted BR. Patients were monitored using standardised radiological follow-up protocols, including digital mammography (DM) and ultrasound (US), at 6 (T0), 12 (T1), and 18 months (T2) postoperatively. The primary outcomes assessed were the presence and evolution of ADM-related imaging findings, differentiation between normal ADM integration and pathological changes, and the role of different imaging modalities in ADM evaluation. Results: Sixty-three patients met the inclusion criteria and underwent radiological follow-up. At T0, ADM was identified in 16% of cases, primarily as a peri-capsular hypoechoic thickening on US and a linear peri-implant density on DM. At T1, these findings were partially resolved, with 11% of cases still displaying peri-capsular changes. By T2, imaging signs of ADM were further reduced, with only 7% of cases showing residual peri-capsular thickening or pseudonodular formations. No ADM-related complications, graft rejection, or implant loss were detected. These findings suggest a progressive integration of ADM into the host tissue over time, with characteristic imaging changes that must be recognised to avoid misdiagnosis or unnecessary interventions. Conclusions: ADM exhibits a dynamic radiological evolution in post-mastectomy BR, with its imaging characteristics gradually fading. Recognising these features is critical for radiologists and surgeons to ensure accurate interpretation and optimised patient management. A structured imaging follow-up protocol, incorporating US as the primary modality and MRI in cases of inconclusive findings, is recommended to improve diagnostic accuracy. Future multicentre studies with extended follow-up and advanced imaging techniques are necessary to refine radiological criteria and further explore ADM integration patterns. A multidisciplinary approach is essential to enhance clinical decision-making, reduce unnecessary interventions, and optimise patient outcomes in ADM-assisted BR. Full article

Background: Male breast cancer (MaBC) is a rare disease and due to its rarity and the lack of specific protocols for its management, treatment algorithms are extrapolated from female breast cancer (FBC). To optimize MaBC treatment, we conceived an umbrella review with the aim of supplying an evidence-based summary of systematic reviews published about this topic in the last twenty years. Methods: This umbrella review was performed according to a predefined protocol (PROSPERO number CRD42024574299). We performed a literature search of the PubMed and Cochrane Libraries databases and we considered systematic reviews on MaBC treatment published from 2004 to 2024. We evaluated relevant treatments in the management of MaBC, including surgery, radiotherapy, and systemic treatments. We conducted the quality assessment according to A MeaSurement Tool to Assess systematic Reviews version 2 (AMSTAR-2), and the description of the main findings of eligible articles. Results: Seven systematic reviews were selected and the main findings were compiled. Breast-conserving surgery is a reasonable treatment approach and, in selected cases, equivalent in terms of safety and survival outcomes compared to mastectomy. Sentinel lymph node biopsy represents a successful surgical practice with similar accuracy compared to female cases. Adjuvant radiotherapy improves overall survival in MaBC patients following partial mastectomy and after radical mastectomy, in case of involved nodes. Finally, Tamoxifen is associated with an improvement of survival outcomes; aromatase inhibitor and gonadotrophin-releasing hormone should be used only in case of contraindications to tamoxifen. Conclusions: Further research and improved guidelines for MaBC treatment should consider these evidence-based data. Full article

Background: Breast cancer (BC) is the most common malignancy affecting women globally, significantly impacting their quality of life (QoL). This study aimed to assess the prevalence and severity of symptoms in newly diagnosed BC patients undergoing chemotherapy in Oman using the Edmonton Symptom Assessment System (ESAS-A); Materials and Methods: A cross-sectional study was conducted between December 2022 and February 2024 at the Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Oman. The study included 105 Omani women, aged 18 to 60, diagnosed with stage I to III BC and undergoing chemotherapy. Symptom evaluation was performed using ESAS-A. Descriptive statistics were employed to summarize socio-demographic characteristics and clinical outcomes, while the Mann–Whitney U test and multiple linear regression analysis were used to examine associations between independent variables and symptom scores; Results: Out of 127 invited participants, 105 (82.6%) agreed to participate. The average age was 43.6 years (SD = 7.2). Fatigue (37.1%), poor well-being (30.5%), and drowsiness (27.6%) were the most commonly reported symptoms. Anxiety and depression affected 21.9% and 17.1% of participants, respectively. Linear regression analysis showed that having children was linked to higher fatigue and shortness of breath, while inversely associated with pain. A family history of chronic disease was significantly correlated with higher depression scores; Conclusions: This study is the first in Oman to utilize ESAS-A for assessing symptom burden in newly diagnosed BC patients undergoing chemotherapy. The findings highlight the importance of personalized symptom management and enhanced supportive care to improve patient well-being. Full article