Insulin-Like Growth Factor-I (IGF-1), IGF-Binding Protein-3 (IGFBP-3) and mammographic features

Introduction. The IGF system has recently been shown to play an important role in the regulation of breast tumor cell proliferation. However, also breast density is currently considered as the strongest breast cancer risk factor. It is not yet clear whether these factors are interrelated and if and how they are influenced by menopausal status. The purpose of this study was to examine the possible effects of IGF-1 and IGFBP-3 and IGF-1/IGFBP-3 molar ratio on mammographic density stratified by menopausal status. Patients and methods. A group of 341 Italian women were interviewed to collect the following data: family history of breast cancer, reproductive and menstrual factors, breast biopsies, previous administration of hormonal contraceptive therapy, hormone replacement therapy (HRT) in menopause and lifestyle information. A blood sample was drawn for determination of IGF-1, IGFBP-3 levels. IGF-1/ IGFBP-3 molar ratio was then calculated. On the basis of recent mammograms the women were divided into two groups: dense breast (DB) and non-dense breast (NDB). Student’s t-test was employed to assess the association between breast density and plasma level of IGF-1, IGFBP-3 and molar ratio. To assess if this relationship was similar in subgroups of pre- and postmenopausal women, the study population was stratified by menopausal status and Student’s t-test was performed. Finally, multivariate analysis was employed to evaluate if there were confounding factors that might influence the relationship between growth factors and breast density. Results. The analysis of the relationship between mammographic density and plasma level of IGF-1, IGFBP-3 and IGF-1/ IGFBP-3 molar ratio showed that IGF-1 levels and molar ratio varied in the two groups resulting in higher mean values in the DB group (IGF-1: 109.6 versus 96.6 ng/ml; p= 0.001 and molar ratio 29.4 versus 25.5 ng/ml; p= 0.001) whereas IGFBP-3 showed similar values in both groups (DB and NDB). Analysis of plasma level of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 molar ratio compared to breast density after stratification of the study population by menopausal status (premenopausal and postmenopausal) showed that there was no association between the plasma of growth factors and breast density, neither in premenopausal nor in postmenopausal patients. Multivariate analysis showed that only nulliparity, premenopausal status and body mass index (BMI) are determinants of breast density. Conclusions. Our study provides a strong evidence of a crude association between breast density and plasma levels of IGF-1 and molar ratio. On the basis of our results, it is reasonable to assume that the role of IGF-1 and molar ratio in the pathogenesis of breast cancer might be mediated through mammographic density. IGF-1 and molar ratio might thus increase the risk of cancer by increasing mammographic density.

La normativa sammarinese in materia di prevenzione e repressione della violenza di genere

Con legge 20 giugno 2008, n. 97 «Prevenzione e repressione della violenza contro le donne e di genere» la Repubblica di San Marino si è dotata di un impianto normativo teso al contenimento del fenomeno della violenza domestica, sessuale e di genere, il cui tratto saliente è dato dal coinvolgimento della compagine sociale nel contrasto delle condotte delittuose (Santolini & Venturini, 2013/2014. La progressiva sensibilizzazione della collettività (Authority Pari Opportunità, 2010)rispetto a fenomeni tollerati in ragione di stereotipi culturali radicati nel contesto sociale tende a favorire l’emersione di episodi altrimenti destinati a rimanere ignoti agli organi giudiziari. Essa appare, pertanto, espressiva della «(…) acquisita consapevolezza del legislatore del fallimento, in materia di violenza di genere, delle modalità tradizionali di formazione e trasmissione della notitia criminis», conseguenti alle «difficoltà oggettive della vittima (…) di reagire alla violenza subita con i tradizionali strumenti della querela o della denuncia» (Santolini&Venturini, 2013/2014, 27), posta l’esistenza di fattori di vulnerabilità specifica del soggetto passivo (ragioni di carattere culturale, sociale o religioso, dipendenza economica e/o psicologica) che lo relegano in posizione subalterna rispetto al perpetrator.