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Query: UMLS:C0006142 (breast cancer)
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The World Cancer Report, a 351 - page global report issued by International Agency for Research on Cancer (IARC) tells us that cancer rates are set to increase at an alarming rate globally (Stewart and Kleiues 2003). Cancer rates could increase by 50 % to 15 million new cases in the year 2020. This will be mainly due to steadily aging populations in both developed and developing countries and also to current trends in smoking prevalence and the growing adoption of unhealthy lifestyles. The report also reveals that cancer has emerged as a major public health problem in developing countries, matching its effect in industrialized nations. Healthy lifestyles and public health action by governments and health practitioners could stem this trend, and prevent as many as one third of cancers worldwide. In a developing country such as India there has been a steady increase in the Crude Incidence Rate (CIR) of all cancers affecting both men and women over the last 15 years. The increase reported by the cancer registries is nearly 12 per cent from 1985 to 2001, representing a 57 per cent rise in India's cancer burden. The total number of new cases, which stood at 5.3 lakhs Care lakh is 100,000 in 1985 has risen to over 8.3 lakhs today. The pattern of cancers has changed over the years, with a disturbing increase in cases that are linked to the use of tobacco. In 2003, there were 3.85 lakhs of cases coming under this category in comparison with 1.94 lakhs cases two decades ago. Lung cancer is now the second most common cancer among men. Earlier, it was in fifth place. Among women in urban areas, cancer of the uterine cervix had the highest incidence 15 years ago, but it has now been overtaken by breast cancer. In rural areas, cervical cancer remains the most common form of the disease (The Hindu 2004).
Asian Pac J Cancer Prev
PMID:Improving cancer care in India: prospects and challenges. 1524 30

Antioxidants play an important role in inhibiting and scavenging radicals, thus providing protection to humans against infections and degenerative diseases. Literature shows that the antioxidant activity is high on herbal and vegetable plants. Realizing the fact, this research was carried out to determine total antioxidant activity and the potential anticancer properties in three types of selected local vegetable shoots such as Diplazium esculentum (paku shoot), Manihot utillissima (tapioca shoot) and Sauropous androgynus (cekur manis). The research was also done to determine the effect of boiling, on total antioxidant activity whereby samples of fresh shoots are compared with samples of boiled shoots. In every case, antioxidant activity is compared to alpha-tocopherol and two methods of extraction used are the organic and the aqueous methods. Besides that, two research methods used were the ferric thiocyanate (FTC) and thiobarbituric acid (TBA) with absorbance of 500nm and 532nm respectively. Oneway ANOVA test at P<0.05 determines significant differences between various samples. In the cytotoxic study, the ethanolic extract and several cell lines i.e. breast cancer (MDA-MB-231 and MCF-7), colon cancer (Caco-2), liver cancer (HepG2) and normal liver (Chang liver) were used. The IC(50)-value was determined by using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. The antioxidant study found that all the samples in both aqueous and organic extraction were significantly different. The total antioxidant activity values of aqueous extract in descending order are as follows: M. utilissima (fresh) >D. esculentum (fresh) >S.androgynus (fresh) > M.utilissima (boiled) > D. esculentum (boiled) > S.androgynus (boiled). It also was found that S.androgynus shoots ethanolic extract was able to inhibit the viability of the breast cancer cell lines, MDA-MB-231 with the IC50 value of 53.33 micrograms/ml. However, S.androgynus shoots and D. esculentum shoots ethanolic extracts did not inhibit the viability of MDA-MB-231 cell line. While, the tapioca shoot ethanolic extract was able to inhibit the viability of MCF-7 cell line with the IC(50) value of 52.49 micrograms/ml. S.androgynus shoots and D.esculentum shoots ethanolic extracts did not give an IC(50) value against the MCF-7 cell line. S.androgynus, tapioca and D.esculentum shoots ethanolic extracts did not show cytotoxic effect against the Caco-2 and HepG2. There was no IC(50)-value from any sample against Chang Liver cell line. In conclusion, the antioxidant activity of both fresh and boiled samples were higher than alpha-tocopherol, although fresh vegetable shoots were found to be higher in antioxidant activity compared to boiled shoots. This study also suggested that S.androgynus shoots and tapioca shoots have potential as an anticancer agent against certain breast tumours.
Asia Pac J Clin Nutr 2004
PMID:Determination of total antioxidant activity in three types of local vegetables shoots and the cytotoxic effect of their ethanolic extracts against different cancer cell lines. 1533 45

Although controversial, the belief that developing breast cancer may be associated with psychological distress is not uncommon. The present study examined the role of psychological variables in the development of breast cancer in women attending a breast clinic for medical examination in Tehran, Iran. During a three-year period (1997-1999) a trained female nurse interviewed all women attending the Iranian Center for Breast Cancer (ICBC) before a confirmed diagnosis was made (N = 3000). Data were collected on demographic variables (age, education and marital status), known risk factors (age at menarche, age at first time full term pregnancy, family history of breast cancer, menopausal status, and oral contraceptive use), psychological variables, including history of psychiatric medications, depression (depressed mood, hopelessness, and loss of interests and pleasures), anxiety (mental and somatic signs) and two single measures of overall health and quality of life. In all, 243 patients were diagnosed as having breast cancer. A total of 486 patients with benign disease were randomly selected from the original cohort as controls. Univariate and multivariate logistic regression analyses were performed to determine the predictive effect of each factor on the risk of breast cancer. There were no significant differences between cases and controls except for age at menarche (P = 0.007) and family history of breast cancer (P<0.001). With regard to psychological variables studied, the results showed that there were significant differences between cases and controls regarding depression (depressed mood P<0.0001, hopelessness P = 0.001, and loss of interest and pleasures P = 0.001), and anxiety (mental signs P = 0.006). Finally, after performing multiple logistic regression analysis in addition to family history and age at menarche, depressed mood and hopelessness showed significant results (odds ratios of 1.90, and 1.63 respectively). The findings of the present study suggest that in addition to the known risk factors, psychological determinants such as depressed mood may play an important role in etiology of breast cancer and deserve further investigation, especially in different populations.
Asian Pac J Cancer Prev
PMID:The role of depression in the development of breast cancer: analysis of registry data from a single institute. 1537 13

Women of all ages have been found to overestimate both the incidence and the mortality rate from breast cancer and the reasons for this are unclear. A qualitative study asked eighty three women (mean age = 44 years) how likely they thought they were to get breast cancer and to explain the reasoning behind their choice. Based on their responses, women's perceptions were categorised as: no risk (5%); reasonably accurate (30%); overestimated (22%); and greatly overestimated (43%). Four main themes emerged from the reasons given: 'Don't know/guess', 'family history' of breast cancer,'age' related reasoning, and making their decision from the information sheet read prior to answering the questions. The information currently available to women may be creating falsely high estimates of their risk of developing breast cancer as the risk factors of age and family history appear to be poorly understood. Meaningful communication of health risk in need of further improvement if it is to be useful in changing health related knowledge and behaviours.
Asian Pac J Cancer Prev
PMID:"I don't really know, so it's a guess": women's reasons for breast cancer risk estimation. 1554 50

The objective of this study was to determine the anti cancer effects of red spinach (Amaranthus gangeticus Linn) in vitro and in vivo. For in vitro study, microtitration cytotoxic assay was done using 3-(4,5-dimethylthiazol-2-il)-2,5-diphenil tetrazolium bromide (MTT) kit assay. Results showed that aqueous extract of A gangeticus inhibited the proliferation of liver cancer cell line (HepG2) and breast cancer cell line (MCF-7). The IC(50) values were 93.8 mu g/ml and 98.8 mu g/ml for HepG2 and MCF-7, respectively. The inhibitory effect was also observed in colon cancer cell line (Caco-2), but a lower percentage compared to HepG2 and MCF-7. For normal cell line (Chang Liver), there was no inhibitory effect. In the in vivo study, hepatocarcinogenesis was monitored in rats according to Solt and Farber (1976) without partial hepatectomy. Assay of tumour marker enzymes such as glutathione S-transferase (GST), gamma-glutamyl transpeptidase (GGT), uridyl diphosphoglucuronyl transferase (UDPGT) and alkaline phosphatase (ALP) were carried out to determine the severity of hepatocarcinogenesis. The result found that supplementation of 5%, 7.5% and 10% of A. gangeticus aqueous extract to normal rats did not show any significant difference towards normal control (P <0.05). The exposure of the rats to chemical carcinogens diethylnitrosamine (DEN) and 2-acetylaminofluorene (AAF) showed a significant increase in specific enzyme activity of GGT, GST, UDPGT and ALP compared to normal control (P <0.05). However, it was found that the supplementation of A. gangeticus aqueous extract in 5%, 7.5% and 10% to cancer-induced rats could inhibit the activity of all tumour marker enzymes especially at 10% (P <0.05). Supplementation of anti cancer drug glycyrrhizin at suggested dose (0.005%) did not show any suppressive effect towards cancer control (P <0.05). In conclusion, A. gangeticus showed anticancer potential in in vitro and in vivo studies.
Asia Pac J Clin Nutr 2004
PMID:Potential anticancer effect of red spinach (Amaranthus gangeticus) extract. 1556 47

Not only the incidence but also the mortality of female breast cancer has been steadily increasing in Korea since the 1980s. Epidemiologic evidence on changes in lifestyle and risk factors related with breast cancer, and data from migrant studies strongly suggest that breast cancer might further increase. In order to estimate the long-term trend in mortality of breast cancer in Korean women, we analyzed age-specific mortality rates for breast cancer over the past 20 years, and made a projection up to 2020 using a linear regression model with the Poisson distribution. The age-adjusted mortality rates for breast cancer per 100,000 persons were 2.84 in 1983, 4.91 in 1993, and 6.26 in 2003. The predicted expected age-adjusted mortality rates for breast cancer are 6.51 for 2005, 7.37 for 2010, 8.22 for 2015, and 9.07 for 2020, with an estimated annual increment of breast cancer mortality of 0.1704. Accordingly, 1,564 women in 2005 and 3,087 in 2020 will be expected to die of breast cancer in Korea. Compared with the rate in 1983, this indicates a more than 3-fold increase by 2020. On the basis of our results, female breast cancer in Korea will linearly increase for the forseeable future if the trend over the past 20 years continues.
Asian Pac J Cancer Prev
PMID:Long-term prediction of female breast cancer mortality in Korea. 1578 25

The goal of this research was to study breast cancer morbidity in females of reproductive age in Kyrgyzstan. Information on patients was obtained from the National Center of Oncology under the Ministry of Health and the National Statistics Committee of the Kyrgyz Republic. The research was retrospective and covered the period from 1995-2002. Cancer morbidity ratios were calculated for reproductive age according to standard methods of medico-biological statistics. The breast cancer morbidity in the country's female population was determined as 12.3+/- 0.2/100,000. The research revealed ethnic specificity: in Russians (crude rate, 32.9+/- 2.1) was higher (p<0.001), than in Kyrgyz and Uzbek females, who demonstrated equal crude incidence rates of -8.0 +/- 0.6. The dynamics over time showed increase in Kyrgyz and Uzbek females but decrease in Russians. Age ratios analysis showed higher morbidity in later reproductive age (40-49 years), with a statistically significant difference (p<0.001) between ethnic Europeans and Asians.
Asian Pac J Cancer Prev
PMID:Epidemiology of breast cancer in females of reproductive age in Kyrgyzstan. 1578 30

From a cohort of female breast cancer patients registered at the Shaukat Khanum Memorial Cancer Hospital and Research Center, in Lahore, Pakistan, during the time period extending from December 1994 to December 2002, 700 subjects who were followed up in time, were selected. Those who presented with benign tumors, carcinoma in situ, or metastases were excluded from the analyses. Age, tumor size, nodal status, menopause, estrogen receptor (ER), and progesterone receptor (PR) status, at the time of presentation, were determined. Tumors were classified according to the TNM classification (American Joint Commission on Cancer (AJCC)-sixth edition), and subsequently, grouped into T1/T2 and T3/T4. Lymph nodes were categorized as N0 (node-negative) and N1, N2, and N3 combined (node-positive). The odds ratio (OR) for developing recurrence in T3/T4 versus T1/T2 was determined to be 2.06 (95% confidence interval (CI) 1.39-3.05, p < 0.001); the OR for node-positive relative to node-negative was found to be 2.54 (95 % CI 1.61-4.0, p < 0.001). Furthermore, the association between the odds of developing recurrence in ER-positive compared to ER-negative was represented by an OR of 0.61, (95 % CI 0.40-0.94 (p= 0.02)). These findings are consistent with the observations that ER-positive, node-negative, and T1/T2 lesions have a decreased risk of recurrence. Also, ER-positive patients may have a better response to hormonal treatment than those who are ER-negative.
Asian Pac J Cancer Prev
PMID:Variables associated with recurrence in breast cancer patients-the Shaukat Khanum Memorial experience. 1578 33

Breast cancer is the most frequent tumor among Saudi women, accounting to 19.8% of female cancers. The present study was conducted to determine 5-year survival for all cases of invasive breast cancer that occurred during 1994-96 in the province of Riyadh (n=316). The overall observed survival probability of the study population at 1, 3 and 5 years was 93.9%, 79.2% and 59.6%, respectively. The 5 year survivals for the younger (< 40 years), older (50 + years) and 40-49 years patients were 60.6%, 51.6% and 69.2% respectively, the differences not reaching statistical significance. While there was not a great deal of variation in the 5-year survival between cases with regional (55.6%), distant metastasis (57.6%) and extent of disease unknown (56.7%) cases, localized (67.5%) cases had a clearly better prognosis. An increased but not significant hazard was seen for the cases with regional and distant metastasis disease, 1.40 and 1.11 respectively, compared to localized cases. The 5-year survival for duct carcinomas (62.8%) was greater than for adenocarcinomas (55.6%) and lobular carcinomas (50.0%).
Asian Pac J Cancer Prev
PMID:Population based survival of female breast cancer cases in Riyadh Region, Saudi Arabia. 1578 37

Given the continuing increase in mammary cancer incidence and in many cases also mortality across the world, as well as the difficulty with primary prevention, the question of whether screening for early detection is effective is of prime importance. If there is a real benefit in terms of reduced mortality then attention should clearly be focused on the modality which should be recommended in different resource settings. In the developed world where mammography is generally available the results are less than conclusive. It seems possible that there is a segment of breast cancer benefited both by screening and by treatment, and that far from these effects being additive, they affect the same spectrum of cases, so that as treatment improves, the benefit we can expect to see from screening falls. In the Asian Pacific setting, randomized trials on the basis of the cost and benefit should be a high priority. However, the lesson from all programmes of breast screening, is that for success, attention has to be paid to all aspects of the programme, compliance with screening, high quality screening tests, quality in the referral, diagnosis and treatment process, as well as adequate follow-up.
Asian Pac J Cancer Prev
PMID:Screening for breast cancer -is there an alternative to mammography? 1578 39


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