High-Dose Toremifene as a Promising Candidate Therapy for Hormone Receptor-Positive Metastatic Breast Cancer with Secondary Resistance to Aromatase InhibitorsRead the full article
International Journal of Breast Cancer provides a forum for scientists, clinicians, and health care professionals working in breast cancer research and management. Research includes molecular pathology, genomics, genetic predisposition etc.
International Journal of Breast Cancer maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
Latest ArticlesMore articles
The Role of Establishing a Multidisciplinary Team for Idiopathic Granulomatous Mastitis in Improving Patient Outcomes and Spreading Awareness about Recent Disease Trends
Background. Iidiopathic granulomatous mastitis (IGM) is stereotypically described as a mysterious entity that mimics breast carcinoma imposing management challenges. In 2002, we established a multidisciplinary team to treat patients with IGM. This study aimed to evaluate the role of this team in improving patient outcomes. Also, a review of literature is provided to highlight recent disease trends. Patients and Methods. Pertinent data for 44 patients treated for IGM from 2002 to 2018 were analyzed and compared to data prior to 2002. Results. Mean age at diagnosis was 37.9 years ± 6.4. The diagnosis of IGM was confirmed by True-cut biopsy (TCB), Frozen section (FS), and surgical biopsy in 70.5%, 25%, and 4.5% of patients, respectively. FS was used to assess the resection margins in three patients. Suspicion for malignancy was raised in one out of 39 ultrasound reports, and one out of 20 mammography reports. Wide local excision was the main treatment modality (95.5%). 19 patients (43.2%) received corticosteroids. Prior to 2002, IGM was only recognized after surgical resection with a 71% initial false impression of carcinoma. After 2002, the initial false clinical impression of carcinoma dropped to 29.5%. Recurrence rate was 31.82%. Younger age at diagnosis was significantly associated with recurrence (χ2 = 5.598; ). Chi-square analysis showed no significant association between BMI and recurrence (χ2 = 0.776; ). Conclusion. The establishment of a multidisciplinary team for IGM was associated with a reduced erroneous impression of breast cancer, and a reduced false positive radiological diagnosis of breast carcinoma. FS was a useful confirmatory procedure. Our series included the first case of a diffuse papular rash as a systemic manifestation of IGM. Recent literature indicates that IGM is changing its face. IGM is being reported in all age groups, and even in males. The clinical manifestations have markedly expanded. Diagnosis by TCB has replaced blind surgical excision. More data regarding predictors of recurrence is accumulating.
Incidence of Breast Cancer in Eritrea: A Retrospective Study from 2011 to 2017
In Africa, breast cancer closely compares with cervical cancer as the most common malignancy affecting women and the incidence rates appear to be rising. Eritrea is experiencing a growing breast cancer problem, but little is presently known on tumor patterns, breast cancer epidemiology, and risk factors. The main objective of this study is to provide baseline data on breast cancer incidence in both sexes in Eritrea. This study was carried out retrospectively and quantitatively by collecting, abstracting, analyzing, coding, and interpreting data recorded in National Health Laboratory (NHL) using CanReg5 ver. 5.00.35. Extracting and classification of the tumor data was done using topography, morphology together with the ICD-10. To generate the incidence rate for the seven years the Eritrean population dataset was used from the population pyramid net for 2014. After we entered all the data from Pathology department in NHL, data was analyzed using the predetermined and developed built-in analysis tools of CanReg5 software and Microsoft Excel 2010. A total number of 9,403 pathology cases were recorded from 2011 to 2017. Out of these 1,497 cases were confirmed as cytology and histology of breast cases. From 1,497 confirmed breast cases in both sexes, the incidence of benign cases was higher than incidence of malignant cases with the case number of 1, 149, and 348, respectively. Out of the 1,497 cases, 1,447 (96.66%) were females; this included a total incidence cases of female benign and malignant breast cases 1,111 (76.78%), and 336 (23.22%), respectively. In both female and male age group the highest positive cases were found in the age greater than 85. The incidence age standard rate per 100,000 in females and male was 3.3 and 0.2, respectively. In sum, the age standardized incidence of breast cancer was relatively low. However, it is our opinion that the low prevalence may be due to low awareness and a highly centralized screening and diagnostic services. This limits access. Altogether, it is our opinion that breast cancer presents a burden to Eritrean ministry of health.
Breast Cancer Survivors’ Perceptions of Prevention versus Control of Future Cancer Recurrence
Background. The Institute of Medicine has established Survivorship Care Planning as a critical component of cancer care to ensure that cancer survivors receive the appropriate follow-up care in a timely manner and support cancer survivors in dealing with the risk of recurrence, yet little is known about how cancer survivors think about preventing or controlling future cancer recurrence. This study sought to assess breast cancer women’s perceived prevention and perceived control of future cancer recurrence. Methods. Women with a history of breast cancer (n=114) were surveyed, and data were analyzed using concurrent mixed methods. Binary logistic regression models examined predictors of perceived prevention and perceived control of cancer recurrence. Results. Most women perceived that they could control cancer recurrence (89%); few (30%) perceived that they could prevent cancer recurrence. Women reported components of the timeline (e.g., early diagnosis), identity (e.g., cancer in body), causes (e.g., hereditary), consequences (e.g., witness success), and cure/control (e.g., exercise) or lack of cure/control. Women who reported lack of control were less likely to perceive that they could control cancer recurrence. Women who reported causes were less likely to perceive that they could prevent or control cancer recurrence. Conclusions. Women’s perceptions about the prevention and control of cancer recurrence are important and different factors in the minds of women with breast cancer. Most women believed they could control cancer recurrence; however, few believed they could prevent cancer recurrence. Interventions to focus on control of cancer recurrence, focusing on evidence-based clinical and lifestyle interventions, are needed.
Knowledge and Health Seeking Behaviour of Breast Cancer Patients in Ghana
Background. Breast cancer is a major contributor to cancer-related deaths among women worldwide, despite the numerous measures employed to prevent and manage the disease. This study explored the knowledge and health seeking behaviour of breast cancer patients at the Komfo Anokye Teaching Hospital. Methods. A descriptive cross-sectional study was conducted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, from June 2014 to July 2014. Thirty-five participants were purposively selected. The responses to questions about their experiences with breast cancer were determined using indepth interviews. Transcripts were coded and analysed using NVIVO version 10.0. Results. Participants’ knowledge about signs and symptoms of breast cancer after their diagnosis was high but low for risk factors. Screening for breast cancer through self-breast examination was infrequently performed prior to their diagnosis. The patients’ first point of care was generally health facilities. Some patients reported late due to misinterpretation of signs and symptoms, cultural influences and fear of losing their breast to surgery, physician delay, health providers’ laxity, and disinterest in breast cancer. Men, for example, husbands, decide on where and when breast cancer patients go for treatment. Conclusion. There is poor knowledge of the risk factors for developing breast cancer. Patients resorted to the hospital as first options for cure but were generally delayed in doing so. There is the need to create awareness about breast cancer among the general population.
The Impact of Breast Clinic on the Mastectomy and Axillary Clearance Rates at a Tertiary Hospital in an Eastern Caribbean Nation: A Comparative Study
Background. Breast cancer is the leading form of cancer in women in Trinidad and Tobago. Traditionally the practice of mastectomy or wide local excision with or without axillary clearance was applied to most of these patients. This is often associated with significant morbidity and a poor cosmetic outcome with both negatively impacting the patients quality of life. The aim of our study was to assess the mastectomy and axillary clearance rate before and after the introduction of a specialty breast clinic in September 2012. Design and Methods. This is a retrospective comparative study of all female patients who underwent breast cancer surgery at our tertiary hospital 3 years prior to and 3 years after starting of breast clinic (between January 2010 and December 2015). Patients were identified from the surgical log books of our hospital. There are 5 surgical units at our hospital and in one of those units the lead surgeon had a special interest in surgical oncoplastic breast surgery. That unit formed the breast clinic in August 2012. Results. There were 532 women (256 before breast clinic and 276 after breast clinic era) with histologically verified breast cancer operated on between January 2010 and December 2015. The overall mastectomy rate was reduced from 62% to 51% (0.7 to 0.4) and the axillary clearance rate from 66.79% versus 37.31% (0.6 to 0.4) after the introduction of the clinic with p values of 0.007 and 0.009, respectively. Conclusions. The introduction of breast clinic has significantly reduced the mastectomy and axillary clearance rate at our teaching hospital.
Extreme Oncoplastic Surgery for Multifocal/Multicentric and Locally Advanced Breast Cancer
Introduction. Breast conserving surgery (BCS) followed by radiation therapy (RT) has become the preferred alternative to mastectomy for patients with early stage breast cancer (BC). Randomized trials have confirmed equivalent locoregional control and overall survival for BCS and mastectomy. Extreme Oncoplasty (EO) extends the indications of BCS for patients who would otherwise require mastectomy, ensuring better aesthetic outcomes and oncological safety. Methods. BC patients with multifocal/multicentric (MF/MC) tumors, extensive DCIS, or large tumor >50mm underwent EO at our breast unit. Therapeutic reduction mammaplasty (TRM) with wise pattern preoperative markings and dual pedicle technique involving parenchymal rearrangement was used for oncoplastic reconstructions in majority of the cases followed by RT. Patient reported outcome measures (PROMs) were assessed using the validated Breast-Q questionnaire. Results. Of the 39 patients in the study, 36 had unilateral and 3 had bilateral BC. Mean age was 47.2 years. Median tumor size was 75mm. 17 (43.6%) patients received NACT; none achieved a complete clinical response. 28 (71.8%) patients were administered to adjuvant chemotherapy. 33(84.6%) patients received RT to the breast with a median dose of 50Gy in 28 fractions and a boost dose of 10Gy in 5 fractions to the tumor bed. No major complications or local recurrences were observed. Excellent Breast-Q scores were observed in patients undergoing EO after 12 months of follow-up. Conclusion. EO followed by RT results in acceptable local-regional control, low rate of complications, and high patient satisfaction. In selected patients, EO could provide a safe alternative for breast conservation surgery instead of mastectomy.