Breast cancer in Mexican women: an epidemiological study with cervical cancer control

INTRODUCTION: In Mexico, breast cancer (BC) is one of the main causes of cancer deaths in women, with increasing incidence and mortality in recent years. Therefore, the aim of the study is identify possible risk factors related to BC. METHODS: An epidemiological study of hospital cases of BC and controls with cervical uterine cancer (CUCA) was carried out at eight third level concentration hospitals in Mexico City. The total of 353 incident cases of BC and 630 controls with CUCA were identified among women younger than 75 years who had been residents of the metropolitan area of Mexico City for at least one year. Diagnosis was confirmed histologically in both groups. Variables were analyzed according to biological and statistical plausibility criteria. Univariate, bivariate and multivariate analyses were carried out. Cases and controls were stratified according to the menopausal hormonal status (pre and post menopause). RESULTS: The factors associated with BC were: higher socioeconomic level (OR= 2.77; 95%CI = 1.77 - 4.35); early menarche (OR= 1.32; 95%CI= 0.88 - 2.00); old age at first pregnancy (>31 years: OR= 5.49; 95%CI= 2.16 - 13.98) and a family history of BC (OR= 4.76; 95% CI= 2.10 - 10.79). In contrast, an increase in the duration of the breastfeeding period was a protective factor (>25 months: OR= 0.38; 95%CI= 0.20 - 0.70). CONCLUSIONS: This study contributes to the identification of risk factors for BC described in the international literature, in the population of Mexican women. Breastfeeding appears to play an important role in protecting women from BC. Because of changes in women`s lifestyles, lactation is decreasing in Mexico, and young women tend not to breastfeed or to shorten the duration of lactation.

Notes on the feeding habits of Gaidropsarus guttatus (Collett, 1890) from Faial Island, Azores, NE Atlantic, PT

Copyright © 2014 Société Française d’Ichtyologie.

Comparison of different breast planning techniques and algorithms for radiation therapy treatment

This work aims at investigating the impact of treating breast cancer using different radiation therapy (RT) techniques – forwardly-planned intensity-modulated, f-IMRT, inversely-planned IMRT and dynamic conformal arc (DCART) RT – and their effects on the whole-breast irradiation and in the undesirable irradiation of the surrounding healthy tissues. Two algorithms of iPlan BrainLAB treatment planning system were compared: Pencil Beam Convolution (PBC) and commercial Monte Carlo (iMC). Seven left-sided breast patients submitted to breast-conserving surgery were enrolled in the study. For each patient, four RT techniques – f-IMRT, IMRT using 2-fields and 5-fields (IMRT2 and IMRT5, respectively) and DCART – were applied. The dose distributions in the planned target volume (PTV) and the dose to the organs at risk (OAR) were compared analyzing dose–volume histograms; further statistical analysis was performed using IBM SPSS v20 software. For PBC, all techniques provided adequate coverage of the PTV. However, statistically significant dose differences were observed between the techniques, in the PTV, OAR and also in the pattern of dose distribution spreading into normal tissues. IMRT5 and DCART spread low doses into greater volumes of normal tissue, right breast, right lung and heart than tangential techniques. However, IMRT5 plans improved distributions for the PTV, exhibiting better conformity and homogeneity in target and reduced high dose percentages in ipsilateral OAR. DCART did not present advantages over any of the techniques investigated. Differences were also found comparing the calculation algorithms: PBC estimated higher doses for the PTV, ipsilateral lung and heart than the iMC algorithm predicted.

Feeding strategy and trophic ontogeny in Scorpaena maderensis (Scorpaeniformes: Scorpaenidae) from the Azores, NE Atlantic

Copyright © 2014 Société Française d'Ichtyologie.

Differential expression of CDC25 phosphatases splice variants in human breast cancer cells

Background: CDC25 phosphatases control cell cycle progression by activating cyclin dependent kinases. The three CDC25 isoforms encoding genes are submitted to alternative splicing events which generate at least two variants for CDC25A and five for both CDC25B and CDC25C. An over-expression of CDC25 was reported in several types of cancer, including breast cancer, and is often associated with a poor prognosis. Nevertheless, most of the previous studies did not address the expression of CDC25 splice variants. Here, we evaluated CDC25 spliced transcripts expression in anti-cancerous drug-sensitive and resistant breast cancer cell lines in order to identify potential breast cancer biomarkers. Methods: CDC25 splice variants mRNA levels were evaluated by semi-quantitative RT-PCR and by an original real-time RT-PCR assay. Results: CDC25 spliced transcripts are differentially expres-sed in the breast cancer cell lines studied. An up-regulation of CDC25A2 variant and an increase of the CDC25C5/C1 ratio are associated to the multidrug-resistance in VCREMS and DOXOR breast cancer cells, compared to their sensitive counterpart cell line MCF-7. Additionally, CDC25B2 tran-script is exclusively over-expressed in VCREMS resistant cells and could therefore be involved in the development of certain type of drug resistance. Conclusions: CDC25 splice variants could represent interesting potential breast cancer prognostic biomarkers.

eRF3a/GSPT1 12-GGC allele increases the susceptibility for breast cancer development

It is now widely recognized that translation factors are involved in cancer development and that components of the translation machinery that are deregulated in cancer cells may become targets for cancer therapy. The eukaryotic Release Factor 3 (eRF3) is a GTPase that associates with eRF1 in a complex that mediates translation termination. eRF3a/GSPT1 first exon contains a (GGC)n expansion coding for proteins with different N-terminal extremities. Herein we show that the longer allele (12-GGC) is present in 5.1% (7/137) of the breast cancer patients analysed and is absent in the control population (0/135), corresponding to an increased risk for cancer development, as revealed by Odds Ratio analysis. mRNA quantification suggests that patients with the 12-GGC allele overexpress eRF3a/GSPT1 in tumor tissues relative to the normal adjacent tissues. However, using an in vivo assay for translation termination in HEK293 cells, we do not detect any difference in the activity of the eRF3a proteins encoded by the various eRF3a/GSPT1 alleles. Although the connection between the presence of eRF3a/GSPT1 12-GGC allele and tumorigenesis is still unknown, our data suggest that the presence of the 12-GGC allele provides a potential novel risk marker for various types of cancer.

Modulation of translation factor's gene expression by histone deacetylase inhibitors in breast cancer cells

The histone deacetylase inhibitors sodium butyrate (NaBu) and trichostatin A (TSA) exhibit anti-proliferative activity by causing cell cycle arrest and apoptosis. The mechanisms by which NaBu and TSA cause apoptosis and cell cycle arrest are not yet completely clarified, although these agents are known to modulate the expression of several genes including cell-cycle- and apoptosis-related genes. The enzymes involved in the process of translation have important roles in controlling cell growth and apoptosis, and several of these translation factors have been described as having a causal role in the development of cancer. The expression patterns of the translation mechanism, namely of the elongation factors eEF1A1 and eEF1A2, and of the termination factors eRF1 and eRF3, were studied in the breast cancer cell line MCF-7 by real-time quantitative reverse transcription-polymerase chain reaction after a 24-h treatment with NaBu and TSA. NaBu induced inhibition of translation factors' transcription, whereas TSA caused an increase in mRNA levels. Thus, these two agents may modulate the expression of translation factors through different pathways. We propose that the inhibition caused by NaBu may, in part, be responsible for the cell cycle arrest and apoptosis induced by this agent in MCF-7 cells.

Opportunistic feeding behavior of Diplodus argenteus (Perciformes, Sparidae) : human-fish interaction in two rocky reefs from SE and S Brazil

Comportamento alimentar oportunista do marimbá Diplodus argenteus (Perciformes, Sparidae): interação humana-peixe em dois sistemas de costões rochosos do SE e SU do Brasil. Esse artigo aborda dois tipos de comportamentos alimentares do marimbá Diplodus argenteus em dois sistemas de costões rochosos do Atlântico sul no Brasil. Essa espécie alimentou-se sobre o fundo e exibiu comportamentos ocasionais e oportunísticos.

Postdischarge feeding of growing “Preemies”: concerns with limiting fat intake [letter]

The didactic update on requirements, types of feeding and dosages of nutrients by Su is a useful guide for clinicians on optimization of nutrition in preterm infants. We take this opportunity to focus on postdischarge nutrition in very preterm infants, which has not yet reached consensus, because of concerns regarding the potentially negative consequences of rapid catch-up growth on obesity and metabolic programming. Some formula feeding approaches have been proposed when mother’s milk is not available.

STIR, SPIR and SPAIR techniques in magnetic resonance of the breast: a comparative study

The amount of fat is a component that complicates the clinical evaluation and the differential diagnostic between benign and malign lesions in the breast MRI examinations. To overcome this problem, an effective erasing of the fat signal over the images acquisition process, is essentials. This study aims to compare three fat suppression techniques (STIR, SPIR, SPAIR) in the MR images of the breast and to evaluate the best image quality regarding its clinical usefulness. To mimic breast women, a breast phantom was constructed. First the exterior contour and, in second time, its content which was selected based on 7 samples with different components. Finally it was undergone to a MRI breast protocol with the three different fat saturation techniques. The examinations were performed on a 1.5 T MRI system (Philips®). A group of 5 experts evaluated 9 sequences, 3 of each with fat suppression techniques, in which the frequency offset and TI (Inversion Time) were the variables changed. This qualitative image analysis was performed according 4 parameters (saturation uniformity, saturation efficacy, detail of the anatomical structures and differentiation between the fibroglandular and adipose tissue), using a five-point Likert scale. The statistics analysis showed that anyone of the fat suppression techniques demonstrated significant differences compared to the others with (p > 0.05) and regarding each parameter independently. By Fleiss’ kappa coefficient there was a good agreement among observers P(e) = 0.68. When comparing STIR, SPIR and SPAIR techniques it was confirmed that all of them have advantages in the study of the breast MRI. For the studied parameters, the results through the Friedman Test showed that there are similar advantages applying anyone of these techniques.

Learner’s satisfaction within a breast imaging eLearning course for radiographers

Background: An asynchronous eLearning system was developed for radiographers in order to promote a better knowledge about senology and mammography. Objectives: to assess the learners’ satisfaction. Methods: Target population included radiographers and radiogr aphy students, in order to assess eLearning satisfaction according to different experience levels in breast imaging. Satisfaction was measured through a questionnaire developed especially for eLearning systems, using a seven - point Likert scale. Main topics related are content, interface, personalization and learning community. Results: Overall, 85% of learners were satisfied with the course and 87,5% considered that the course is successful. Main areas that were evaluated by most learners in a positive way were interface and content (between six and seven - point); on the other hand, learning community presented a wider distribution of answers . Conclusions: The course provides an overall high degree of learner satisfaction, thus providing more effective knowle dge gain on breast imaging for radiographers.

Comparison of the pencil beam convolution algorithm and the analytical anisotropic algorithm in breast tumors

The calculation of the dose is one of the key steps in radiotherapy planning1-5. This calculation should be as accurate as possible, and over the years it became feasible through the implementation of new algorithms to calculate the dose on the treatment planning systems applied in radiotherapy. When a breast tumour is irradiated, it is fundamental a precise dose distribution to ensure the planning target volume (PTV) coverage and prevent skin complications. Some investigations, using breast cases, showed that the pencil beam convolution algorithm (PBC) overestimates the dose in the PTV and in the proximal region of the ipsilateral lung. However, underestimates the dose in the distal region of the ipsilateral lung, when compared with analytical anisotropic algorithm (AAA). With this study we aim to compare the performance in breast tumors of the PBC and AAA algorithms.

Radiographers practice concerning breast compression in mammography: gradual versus no gradual

Purpose: Evaluate the type of breast compression (gradual or no gradual) that provides less discomfort to the patient. Methods and Materials: The standard projections were simulated [craniocaudal/(CC) and mediolateral-oblique/(MLO)] with the two breast compressions in 90 volunteers women aged between 19 and 86. The women were organised in groups according to the breast density. The intensity of discomfort was evaluated using the scale that have represented several faces (0-10) proposed by Wong Baker in the end of each simulation. It was also applied an interview using focus group to debate the score that were attributed during pain evaluation and to identify the criteria that were considered to do the classification. Results: The women aged between 19-29y (with higher breast density) classified the pain during no gradual compression as 4 and the gradual compression as 2 for both projections. The MLO projection was considered the most uncomfortable. During the focus group interview applied to this group was highlighted that compression did not promoted pain but discomfort. They considered that the high expectations of pain did not correspond to the discomfort that they felt. Similar results were identified for the older women (30-50y; > 50y). Conclusion: The radiographers should considerer the technique for breast compression. The gradual compression was considered for the majority of the women as the most comfortable regardless of breast density. The MLO projection was considered as uncomfortable due to the positioning (axila and inclusion of pectoral muscle) and due to the higher breast compression compared to the CC projection.

Disparities in cervical and breast cancer mortality in Brazil

OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson’s correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment. 

Determinants of using pacifier and bottle feeding

OBJECTIVE To analyze the factors associated with the use of pacifiers and/or bottle feeding in infants aged under one year.METHODS This is a cross-sectional study with 34,366 children and using data from the database of the 2nd Nationwide Survey of Breastfeeding Prevalence performed in the Brazilian capitals and Federal District in 2008. Cluster sampling was used. The questionnaire included questions about the use of artificial nipples in the last 24 hours. The analysis considered three outcomes: exclusive use of pacifier, exclusive use of bottle feeding, and use of artificial nipples (pacifier and bottle feeding). Prevalence ratios were obtained using Poisson regression with robust variance following a hierarchical model.RESULTS The following factors were associated with exclusive use of the pacifier: mother working outside the home, primiparity, child was not breastfed within the first hour, and child had consumed tea on the first day at home. The following factors were associated with exclusive use of bottle feeding: mother working outside the home, primiparity, low birth weight, child not breastfed within the first hour, and child had consumed milk formula and tea on the first day at home. The following factors were associated with use of artificial nipples (pacifier and bottle feeding): mother working outside the home, primiparity, cesarean delivery, the male gender, low birth weight, born in a hospital not accredited as “baby friendly”, required health baby monitoring in the Primary Health Care Unit (PR = 0.91), and child had consumed milk formula, water, or tea on the first day at home.CONCLUSIONS This study identified profiles of exclusive users of pacifiers, bottle feeding, and both. The provided information can guide preventive practices for child health.