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1
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Coronary artery disease associated with radiation therapy

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Celık T., Yuksel C., Demırkol S., Iyısoy A., Ulutın C.
Open Medicine
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2010
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vol. 5
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issue 2
180-183
EN
Recent advancements in curative-intent therapies have led to dramatic improvements in breast cancer-specific mortality but at the direct expense of increased risk of cardiovascular-related mortality. The use of radiation therapy has led to significant improvements in survival for patients treated for breast cancer. However, as patients live longer, the potentially serious adverse effects of radiation on the heart have raised concerns. Coronary artery disease following irradiation is encountered rarely but is one of the most devastating treatable complications.In this article we review the cardiac complications associated with radiation therapy.
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Mastoscopic sentinel lymph node biopsy in breast cancer

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Ding B., Zhang H., Li X., Qian L., Chen X., Wu W., Wen Y., Zhao Y.
Open Medicine
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2014
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vol. 10
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issue 1
EN
Background: Previous studies have demonstrated that mastoscopic sentinel lymph node biopsy (MSLNB) has good identification rate (IR) and low false negative rate (FNR). However, few studies have directly compared the surgical performance and peri- and post-operative factors of MSLNB with conventional sentinel lymph node biopsy (SLNB). Methodology: Sixty patients diagnosed with breast cancer were recruited and randomly assigned to one of the three groups: MSLNB, SLNB and SLNB with lipolysis injection. Peri- and post-operative parameters were compared using general linear models. To examine the effect of age on these parameters, we performed separate analysis stratified by age (≤50 years old vs. >50 years old). Results: Patients in the MSLNB group experienced longer surgery and suffered higher surgical cost than patients who underwent conventional SLNB or SLNB with lipolysis injection (p<0.0001). Despite this, they had significantly less blood loss than those who underwent conventional SLNB (22.0±7.0 ml vs.73.5±39.6 ml; p<0.0001). Analysis by age group indicates a similar pattern of difference among the three groups. MSLNB and conventional SLNB have similar IR and FNR. Conclusion: As a minimally invasive technique, MSLNB can significantly reduce blood loss while providing similar IR and FNR, indicating that it can be a promising alternative to conventional SLNB. Conclusion: Variations in popliteal artery terminal branching pattern occurred in 7.4% to 17.6% of patients. Pre-surgical detection of these variations with MD CTA may help to reduce the risk of iatrogenic arterial injury by enabling a better surgical treatment plan.
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Rare types of breast carcinoma

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Gudaviciene D., Steponaviciene L., Meskauskas R., Smailyte G., Aleknavicius E.
Open Medicine
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2014
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vol. 10
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issue 1
EN
Breast cancer (BC) is a heterogeneous disease that encompasses several distinct entities with remarkably different characteristics. Histological type is one of important BC characteristics. Histological type is associated with differences in epidemiology, diagnostic issues, clinical course, prognosis. When we talk about BC, ductal and lobular carcinoma is usually what we have in mind. However, the other types that comprise less than 10% of BC are also very important. The rarity of many of these neoplasms does not allow large or randomized studies to define the optimal treatment. Many of the descriptions are from case reports and small series. The aim of this retrospective study was to analyze the data on rare breast cancers, to describe their main characteristics, and to calculate survival rates. We believe that the experience of our institution will contribute to the available data about these rare breast cancers and help in better understanding of this subgroup.
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Familial and inherited breast cancers in Lower Silesia (Poland)

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Bębenek M., Rutkowska A., Błaszczyk J.
Open Medicine
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2006
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vol. 1
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issue 3
261-269
EN
The purpose of this study was to determine the frequencies of hereditary and familial breast cancers among Lower Silesian women. The questionnaires, dealing with cancer episodes in first-and second-degree relatives, were sent to 5,000 females, who were diagnosed with breast cancer between 1984 and 2005. Twenty-five percent of the questionnaires were completed and returned. Their analysis and further counseling revealed that 24.9% of the responders met the criteria for familial breast cancer (FBC), including 10.5% definitive cases. Mutations in BRCA1 were detected in 32.5% and 1.9% of patients with definitive and suspected FBC, respectively. They all represented three of the abnormalities of the BRCA1 gene: 300T/G, 4153delA and 5382insC. No mutations of BRCA2 were found in material studied. Although a fraction of FBCs identified in our study was similar to those described in other European countries and in the United States, the percentages of genetic mutations seen on routine tests were relatively low. Consequently, the standardized analysis of oncological pedigree seems to be a more valuable diagnostic tool if patients with familial aggregations of breast cancer are targeted in a prophylactic context only.
5
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FDG-PET-CT in the early response evaluation for primary systemic therapy of breast cancer

88%
Tőkés T., Torgyík L., Kulka J., Borka K., Szász A., Tóth A., Harsányi L., Lengyel Z., Györke T., Dank M.
Open Medicine
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2014
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vol. 9
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issue 2
306-312
EN
Primary systemic therapy (PST) is a standard treatment for patients with locally advanced breast cancer. We report one of our patients to demonstrate the optimal use of FDG-PET-CT in the routine clinical workup during PST, especially when clinicians face contradictory clinical and pathological findings, and to show the advantages of this imaging modality in the decision-making process about the initial treatment choice. By reviewing the literature we would also like to confirm that FDG-PET-CT is highly sensitive in the measurement of the early therapeutic response and the prediction of the complete pathological remission, as early as after the first cycle of chemotherapy is administered.
6
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Cardiac troponin T for early detection of cardiotoxicity in breast cancer patients treated with epirubicin

88%
Erdim R., Celiker A., Gemici G., Tokay S., Ülfer G., Dede F., Turhal S., Oktay A.
Open Medicine
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2009
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vol. 4
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issue 3
327-330
EN
The aim of the study was to investigate the role of cTnT for the prediction of long term cardiac dysfunction after epirubicin-containing adjuvant chemotherapy for breast cancer. The study group comprised of 45 patients (all female; mean age 48 ±8 years), treated with epirubicin-containing adjuvant chemotherapy for stage 2 and stage 3 breast cancer. Patients received either 4 cycles of cyclophosphamide plus epirubicin (90 mg/m2) (n=23; stage 2 breast cancer) or 6 cycles of cyclophosphamide plus epirubicin (75 mg/m2) plus fluorouracil (n=18; stage 3 breast cancer). Venous blood samples were drawn, before and 72 hours after, every cycle of chemotherapy for the measurement of cTnT. Cardiac assessment was carried out at baseline and 1 year after chemotherapy by clinical evaluation, electrocardiography, radio-nuclide ventriculography (RNV) and transthoracic echocardiography. All patients remained free of clinical heart failure during the study period. In 26 patients (63%), cTnT was elevated after chemotherapy. Mean left ventricular ejection fraction, assessed by RNV at baseline and one year after chemotherapy, were 61±8% and 56±7% (p<0.0001). The sensitivity and specifity of cTnT for the detection of left ventricular systolic dysfunction at one year were 69% and 39% respectively. Echocardiographic examinations at baseline and one year after chemotherapy revealed a significant decrease in E/A ratio from 1.15±0.3 to 0.9±0.2 in cTnT positive patients, suggesting diastolic dysfunction. In conclusion, elevated serum cTnT levels after epirubicin-containing adjuvant chemotherapy for stage 2 and stage 3 breast cancer, predict future cardiac dysfunction with moderate sensitivity and poor specificity.
7
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Breast cancer incidence and mortality in Lower Silesia (Poland) between 1984 and 2003 - trends and perspectives

88%
Bębenek M., Pudełko M., Błaszczyk J.
Open Medicine
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2007
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vol. 2
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issue 2
208-215
EN
The purpose of the study was to determine the epidemiological characteristics of breast cancers diagnosed among Lower Silesian women between 1984 and 2003. Data from the Lower Silesian Cancer Registry on the incidence and mortality of breast neoplasms in the Lower Silesian province were analyzed. The annual number of breast cancers and cancer-related deaths increased markedly between 1984 and 2003. The non-standardized coefficients of incidence in the large cities of Wroclaw, Legnica, and Walbrzych were markedly higher than in the other counties of the province. The number of tumors detected with diameters ≤5 cm increased from 57% in 1984 to 81% in 2003. The increasing incidence of breast cancer seemed to be mostly related to the socioeconomic characteristics of Lower Silesian women. Although a down-staging due to better care reflects some positive trends, the outlook for breast cancer in Lower Silesia remains unfavorable.
8
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Erysipelas in breast cancer patients after the radical mastectomy

75%
Matijasevic M., Dekic N., Kolarevic D., Milosevic S., Tomasevic Z., Jurisic V.
Open Medicine
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2012
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vol. 7
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issue 2
149-153
EN
Erysipelas is a bacterial cellulitis usually associated with Streptococcal infection. It may appear as a complication following mastectomy and radiotherapy for breast cancer. The study involved 17 cases of erysipelas of the upper limbs with a median age of 62 years. Here we described the clinical, therapeutic and evolutionary aspects of erysipelas. Our results indicated that the erysipelas appeared with an average of 9 years after mastectomy and was recurrent in three patients (17.64%). It is associated with obesity in 42% and arterial hypertension in 52.9% of patients with breast cancer after radical mastectomy. Breast cancer patients in advance stages of disease at presentation (T2+ T3) are significantly more subject to erysipelas in comparison to those patients with locoregional stage of disease at presentation (T1), Mann Whitney U-test, (p<0.05). All patients had complete response to antibiotics. The recurrence occurred in 2 patients (11.76%) who underwent radiotherapy with adjuvant tamoxifen and in one patient who underwent chemotherapy and radiotherapy combined. Based on these results it is possible to suggest that patients who received radiotherapy may have an additional risk factor for developing lymphedema and erysipelas
9
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The effects of tamoxifen on homocysteine levels in breast cancer patients

75%
Eroğlu A., Eğin Y., Akar N.
Open Medicine
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2009
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vol. 4
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issue 4
450-453
EN
Tamoxifen is widely used in the treatment of breast cancer and associated with an increased risk of thromboembolism (TE). An elevated homocysteine is one of the risk factors for TE. The aim of the study was to assess the effect of tamoxifen on serum homocysteine levels in breast cancer patients. We performed a case-control study in 20 female subjects to evaluate the relationship between homocysteine levels, and 5,10-methylenetetrahyrofolate reductase (MTHFR) C677T and dihydrofolate reductase (DHFR) 19-bp intron-1 deletion polymorphisms in breast cancer patients and in control subjects. It was observed that homocysteine levels were decreased during tamoxifen therapy, but this finding was not statistically significant. There was also no statistically significant difference in homocysteine levels between the two groups (p> 0.05). MTHFR C677T and DHFR 19-bp deletion polymorphisms were not associated with serum homocysteine value in either group.
10
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N-cadherin in cancer dormancy

63%
Sinha G., Rameshwar P.
Cell death in therapy
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2014
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vol. 1
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issue 1
EN
N-cadherin is an adhesion protein, which is important for intercellular interaction. It is involved in cell migration and motility during embryonic development, neuronal synapsis and cancer metastasis. There are several signaling cascades affected by N-cadherin including TGF-β, Rho family. N-cadherin is associated at the cytoplasmic domain with catenins (α, β, γ and p120) to facilitate metastasis. An increase in N-cadherin with down regulation of E-cadherin occurs during epithelial mesenchymal transition. Overexpression of N-cadherin is associated with cell cycle arrest, which correlates with a similar property of cancer stem cells (CSC). Connexin expression, which is important in CSC dormancy, is regulated by N-cadherin. This review discusses the potential of N-cadherin to be involved in maintaining CSCs, and to investigate pathways in N-cadherin expression. A better understanding of the role of N-Cadherin in CSC biology may identify new targets for the treatment of cancer.
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