Breast cancer : the embodied transfer of uncertainty and risk

The thesis highlights how women reconstruct themselves after mammography, following a positive diagnosis of cancer, and post mastectomy. It juxtaposes women's experiences of breast cancer with doctors' perceptions of their role in treating patients, allowing an understanding of how risk and uncertainty are transferred between the private and public spheres.

Risk perception, risk communication and message framing : breast cancer and family history

Examines the relationships between risk perception, risk communication, and health protective behaviour in relation to breast cancer and family history. Qualitative research was conducted to develop a printed community resource. Theoretical and practical implications for health behaviour theory and risk communication are identified.

Early breast cancer identification : Which way to go? Microarray or image based computer aided diagnosis!

The goal of this research is to develop a computer aided diagnostic (CAD) system that can detect breast cancer in the early stage by using microarray and image data. We verified the performance of six well known classification algorithms with various performance matrices. Although we do not suggest a unique classifier algorithm for a CAD system, we do identify a number of algorithms whose performance is very promising. The algorithms performance was validated by 3 images dataset; two have been used for the first time in this experiment. Multidimensional image filtering is adopted for the final data extraction. The image data classification performance is compared with microarray data. Results suggest the most effective means of breast cancer identification in the early stage is a hybrid approach.

Does multidisciplinary care enhance the management of advanced breast cancer? : evaluation of advanced breast cancer multidisciplinary team meetings

Purpose: To assess the contribution of the advanced breast cancer (ABC) multidisciplinary team meetings (MDMs) to patient care and clinical outcomes.

Methods: Members of ABC MDMs at two health services completed questionnaires in November 2007. The questionnaire asked about the performance of the MDMs and their contribution to improvement in patient care in five domains: medical management, psychosocial care, palliative care, care in the community, and benefits for team members. A final section covered the perceived value and importance of the MDM in patient management. Descriptive statistics (frequencies, mean, and standard deviation) were used to summarize the performance, improvement, and importance scores.

Results: A total of 27 multidisciplinary team members (73%) completed the questionnaire. The MDM performed best in medical management (mean performance score out of 5 [M] = 3.78) and palliative care (M = 3.77). These were also the areas that were most improved through the MDM. Benefits to team members and care in the community (both M = 3.05) ranked lowest by both measures. The MDM provided the most benefit for patient management in the areas of "awareness of services available" (M = 4.32), "efficiency of referrals" (M = 4.27) and "supportive care for patients" (M=4.27). "Awareness of services available," "psychological care for patients," and "continuity of care" were considered the most important (M = 4.64).

Conclusion: The study provides evidence that MDMs make an important contribution to the logistical and medical management of patients with advanced breast cancer.

Therapeutic effects of matrine on primary and metastatic breast cancer

Matrine, one of the main components extracted from a traditional Chinese herb, Sophora flavescens Ait, has displayed anti-cancer activity in several types of cancer cells. This study aims to evaluate the therapeutic benefits of matrine on primary and metastatic breast cancer. Matrine inhibited the viability of and induced apoptosis in human MCF-7 and mouse 4T1 breast cancer cells in a dose-dependent manner in vitro as shown by MTT assay, flow cytometry and laser scanning confocal microscopy. Administration of matrine inhibited the growth of primary tumors and their metastases to lungs and livers, in a dose-dependent manner, in a highly metastatic model of 4T1 breast cancer established in syngeneic Balb/c mice. Tumors from matrine-treated mice had a smaller proliferation index, shown by immunostaining with an anti-Ki-67 antibody, a greater apoptosis index, shown by TUNEL-staining, and a less microvessel density, shown by immunostaining with an anti-CD31 A antibody, compared to the controls. Western blot analysis of tumoral homogenates indicated that matrine therapy reduced the ratio of Bcl-2/Bax, downregulated the expressions of VEGF and VEGFR-2, and increased the activation of caspase-3 and caspase-9. This study suggests matrine may be a potent agent, from a natural resource, for treating metastatic breast cancer because of its anti-apoptotic, anti-proliferative and anti-angiogenic activities.

Two-photon endomicroscopy for 3D imaging of cancer cells labelled with gold nanorods

Biofunctional nanorods are developed to specifically target cancer cells. The cervical cancer cells, HeLa cells, are labeled by these biofunctional gold nanorods. Those cancer cells can be detected by a multi-photon-excited photoluminescence endomicroscope, which proves that the cancers can be in vivo diagnosed by using biofunctional gold nanorods with nonlinear endomicroscopy.

Fabrication and biofunctionalization of selenium-polypyrrole core-shell nanoparticles for targeting and imaging of cancer cells

Selenium-polypyrrole core-shell nanoparticles are fabricated by an in-situ polymerization process and functionalized with transferrin for targeting and imaging of human cervical cancer cells. The shell thickness and chemical composition of the as-synthesized particles can be manipulated by controlling the precursor concentration. The presence of the polymer layer can greatly increase the thermal stability of the selenium nanoparticles. The presence of transferrin molecules on the surface of the core-shell nanoparticles can significantly enhance their cellular uptake. The tranferrin-conjugated core-shell nanoparticles can be potentially used for the targeting and imaging of cancer cells.

Malware variant detection using similarity search over sets of control flow graphs

Static detection of polymorphic malware variants plays an important role to improve system security. Control flow has shown to be an effective characteristic that represents polymorphic malware instances. In our research, we propose a similarity search of malware using novel distance metrics of malware signatures. We describe a malware signature by the set of control flow graphs the malware contains. We propose two approaches and use the first to perform pre-filtering. Firstly, we use a distance metric based on the distance between feature vectors. The feature vector is a decomposition of the set of graphs into either fixed size k-sub graphs, or q-gram strings of the high-level source after decompilation. We also propose a more effective but less computationally efficient distance metric based on the minimum matching distance. The minimum matching distance uses the string edit distances between programs' decompiled flow graphs, and the linear sum assignment problem to construct a minimum sum weight matching between two sets of graphs. We implement the distance metrics in a complete malware variant detection system. The evaluation shows that our approach is highly effective in terms of a limited false positive rate and our system detects more malware variants when compared to the detection rates of other algorithms.

The need to examine metastatic tissue at the time of progression of breast cancer : is re-biopsy a necessity or a luxury?

Knowledge of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2) status is necessary for determining the optimal treatment of breast cancer patients. At the same time, the discordance between marker profiles (ER/PR and HER2) of primary and metastatic breast cancer is well documented. Whether discordant cases are secondary to “clonal selection” in the face of targeted anti-estrogen or anti-HER2 therapy or whether they are a laboratory artifact is still debated; both scenarios are likely. This article outlines current modalities for ER, PR, and HER2 testing in primary breast carcinoma and its metastases and reviews prospective and retrospective studies that have addressed these issues, as well as recent advances in the field.

Immune thrombocytopenic purpura (ITP) and breast cancer. Does adjuvant therapy for breast cancer improve platelet counts in ITP?

Although both breast cancer and immune thrombocytopenic purpura (ITP) are common conditions, the simultaneous coexistence of these two diseases is rare. ITP is an autoimmune disease in which the presence of autoantibodies against platelets results in splenic sequestration and thrombocytopenia that may be associated with lymphoid neoplasms [1]. Except for an observational case series of 10 patients [2], only a few individual case reports of ITP coinciding with breast cancer have been reported [3–8]. We are reporting two cases with simultaneous confirmed ITP and breast cancer. The platelet counts in both women have improved during adjuvant breast cancer chemotherapy.

Primary systemic therapy in HER2-amplified breast cancer : a clinical review

Primary systemic therapy (PST) in early breast cancer is utilized in locally advanced breast tumors and when breast-conserving surgery is desirable. In addition, the PST setting provides an opportunity to monitor response including histopathological and biomarker examination of the tumor and host tissues before and after systemic therapy. Trastuzumab is a monoclonal antibody targeting the hEGF receptor that is overexpressed in 15–20% of breast tumors. Trastuzumab is effective in prolonging survival when used to treat women with hEGF receptor overexpressed tumors, both in adjuvant and metastatic disease settings. Trastuzumab has also shown promising activity in PST/neoadjuvant studies by achieving high rates of complete pathologic response. This is a review of clinical studies that incorporated trastuzumab in PST and/or neoadjuvant chemotherapy, including the results of recently reported studies using trastuzumab in combination with other novel therapies such as lapatinib or pertuzumab.