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 ASSESSMENT OF DISEASE ORIENTED DEPRESSION IN BREAST CANCER PATIENT

 ASSESSMENT OF DISEASE ORIENTED DEPRESSION IN BREAST CANCER PATIENT

A samples consisted of Ninety four patients and they all are agreed to participate and were asked to complete the HAD scale questionnaire straight forward which was easy to complete. The following information was retrieved from each patient’s medical record i.e. Cancer type, data of cancer diagnosis, extension of the disease, sites of metastasis, estimated lifetime and Demographic data. The following inclusion criteria has followed in our study like age between 18-65 years, estimated survival time should be more than six months, patient should be able to speak, patient should be managed at home with their family and also the health care professionals those who have known, Patients excluded from our study those who have known mental disorder and metastasis in brain. Levels of anxiety and depression were self rated by HADS and it is a reliable method for early assessment of a patient’s psychological state.
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Modern treatment of symptomatic apical periodontitis after chemotherapy in a breast cancer patient. Case report

Modern treatment of symptomatic apical periodontitis after chemotherapy in a breast cancer patient. Case report

The problem of providing dental care to patients with cancer has been and remains very relevant. According to the National Cancer Institute, in Ukraine there are more than a million people suffering from cancer. Every 3-4 men and every fifth woman are at risk of developing cancer. Studies of the state of the oral cavity in this category of patients have established a high prevalence of dental diseases and, as a result, a significant need for dental care (1, 2). There is a direct correlation between the state of oral hygiene and the severity of cancer (3, 4).
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Autoantibodies to aberrantly glycosylated MUC1 in early stage breast cancer are associated with a better prognosis

Autoantibodies to aberrantly glycosylated MUC1 in early stage breast cancer are associated with a better prognosis

to each well and the slides incubated at room tempera- ture for one hour with gentle agitation. Slides were washed with PBS wash buffer (PBS containing 0.05% Tween-20) and then with PBS, and then probed with Cy3 labelled anti-human IgG secondary antibody (1:1,000 dilution, C2571 Sigma, Gillingham, Dorset, UK) at room temperature, for one hour, with gentle agita- tion. Slides were then washed again and scanned with a single laser power and detector gain setting. The images were quantified with ProScanArray Express software program (PerkinElmer). Spots were identified using automated spot finding or manual adjustments for occa- sional irregularities. The spot intensities were deter- mined by subtracting the median compound for each sample. The operator was blinded as to which samples were from breast cancer patients or controls and all samples were screened in duplicate with the same posi- tive control serum from a breast cancer patient being run on every slide. The reproducibility of the assay was assessed by screening a subset of samples at two sites (KCL and University of Copenhagen). A total of 57 sam- ples from cancer patients were assessed as positive in Copenhagen and 55 of these were positive in the screen at KCL indicating 96% agreement.
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TMSB4Y is a candidate tumor suppressor on the Y chromosome and is deleted in male breast cancer

TMSB4Y is a candidate tumor suppressor on the Y chromosome and is deleted in male breast cancer

In this study, we addressed whether loss of the Y chromosome contributes to male breast carcinogenesis. Using fluorescent in situ hybridization (FISH) and droplet digital PCR (ddPCR), our results show clonal Y chromosome loss at a frequency of ~16% (5/31) in two independent cohorts of male breast cancer patients. Furthermore, we observed that Y chromosome loss can occur in ductal carcinoma in situ (DCIS) lesions. In order to identify a possible tumor suppressor within the Y chromosome, we used sequence-tagged-site PCR (STS-PCR) in male breast cancer specimens without Y chromosome loss, and show somatic deletion of the TMSB4Y gene in a male breast cancer patient, confirming prior reports showing loss of this region. We then created tetracycline-inducible clones of TMSB4Y in the human non-tumorigenic female breast epithelial cell line MCF- 10A. Our results show that induced expression of TMSB4Y led to aberrant morphological changes, persistent reduction in cell proliferation, and a corresponding reduction in the fraction of metaphase cells. Using proximity ligation assays (PLA) and immunoprecipitation with western blotting, we show that TMSB4Y interacts directly with β-actin, a main component of the actin cytoskeleton and a modulator of cell cycle progression. Taken together, our results show that in situ clonal loss of the human Y chromosome may play an important role in male breast cancer tumorigenesis, and suggest that TMSB4Y has tumor suppressive properties.
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RanGTPase: A Candidate for Myc Mediated Cancer Progression

RanGTPase: A Candidate for Myc Mediated Cancer Progression

Patients and specimens were described previously (8). A total of 320 formalin-fixed, paraffin-embedded breast carcinoma speci- mens were taken from an archive that was collected between 1976 and 1986 at the Breast Unit, Royal Liverpool Hospital. The mean age of the patients was 57 years (range = 29–92 years). No sign of metastasis was seen in these patients before specimen procure- ment. Treatment was either mastectomy or radical mastectomy with no prior endocrine or other systemic therapy. Follow-up data were collected between 14 and 20 years after treatment had been administered. All patient data were made confidential by using an anonymized system by the Merseyside Cancer Registry. A  total of 113 formalin-fixed, paraffin-embedded early-stage, non–small cell lung cancer specimens obtained from Dublin St. James’ Hospital and resected by either lobectomy or pneumonec- tomy were incorporated into a tissue microarray for immunohis- tochemical staining. Among these patients, 109 had not received any form of adjuvant chemotherapy before the procurement of the specimens. Anonymized follow-up information, including patient survival, histology, and tumor node metastasis classification of malignant tumors staging were provided by the Northern Ireland Cancer Registry. Informed consent was obtained from patients. The Liverpool breast cancer patient cohort was approved by the Liverpool Adult Research Ethics Committee (07/H1005/93), whereas the Dublin lung cancer patient cohort was approved by Saint James’s Hospital and Adelaide and Meath Hospital, Dublin (TCD041018/8804).
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Understanding the Body Paragraph: A Handbook for EFL Teachers & Students

Understanding the Body Paragraph: A Handbook for EFL Teachers & Students

The literature review revealed that breast cancer patient’s treatment often leads to chronic conditions during survivorship that are not often managed or understood by the survivor as they transition following treatment. Burris, Armeson and Regan-Sterba (2015) surveyed breast cancer patients in a randomized clinical trial regarding their unmet survivorship needs. Using a 42 item Cancer Survivors’ Unmet Needs survey instrument, measuring symptom severity and symptom “interference,” the researchers obtained the baseline data at two to three weeks before completion of treatment (and before the tested intervention) and then 10 weeks after completion of treatment. The researchers found the top five unmet needs pertained to (1) information; (2) interaction with other survivors; (3) explaining cancer to others; (4) stress management; and (5) complications from treatment.
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tients with suspected recurrent breast cancer in the breast or loco regional tissues. After routine analyses in twenty-eight women (clinical examination, ultrasound, X-ray mammography, and fi ne needle aspiration biopsy) they were examined by scintimammography. All patients with suspected recurrent cancer in the breast or loco regional tissues () undergone surgery and the fi nal diagnosis was determined by histopathological examination. Another  patients were followed - months. Th e scintigraphic studies were correlated with radiological fi ndings and/ or with histopathology. Th ere were  patients with recurrent tumours ( with loco-regional recurrent and  in another breast). X-ray mammography identifi ed  of these cancers. mTc- sestamibi scintimammography identifi ed seventeen of recurrent breast cancers. In the seven out of nine patients without cancer, scintimammography were reported as having no changes consis- tent with cancer. X-ray mammography showed suspected cancer lesions in four out of nine pa- tients without cancer. Th ere were two false-positive scintimammograms and one false negative. Axillary lymph node recurrence occurred in four patients. All of them were positive on scinti- mammography. mTc-sestamibi scintimammography showed higher sensitivity, specifi city and accuracy per patient than did X-ray mammography (, vs. ,, , vs. , and , vs. ,, respectively). To identifying recurrent breast cancer disease is better to use scintimammo- raphy than X-ray mammography.
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Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy

Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy

The Breast Cancer Systemic Therapy Decision Quality Instrument demonstrated strong reliability and validity as a measure of patient knowledge about chemotherapy for early stage breast cancer in this sample, but its ability to measure concordance was limited. In this population, no patient goal was associated with treatment, and most patients reported they were not asked their preference, suggesting that patients’ goals may not have been ad- equately considered in treatment decision making about chemotherapy. Further testing will be important to understand the performance of the survey in newly diag- nosed patients who are actively making the decision, to evaluate alternative approaches to eliciting patients’ goals, to examine the responsiveness of the knowledge score to interventions, such as patient decision aids, and to gather data to help set benchmarks for knowledge and concordance scores.
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A Within Subject Study Comparing Breast Board Immobilisation with Vacuum Bag for Radiotherapy in Breast Cancer: Setup Precision, Patient Comfort and Treatment Time

A Within Subject Study Comparing Breast Board Immobilisation with Vacuum Bag for Radiotherapy in Breast Cancer: Setup Precision, Patient Comfort and Treatment Time

In our study the magnitude of random errors was higher in the longitudinal axis as compared to the lateral and vertical axis. This error is probably caused by day to day variations in arm position. While positioning a patient for treatment, the technologists aligns the anteriorly placed tattoo to the central axis of the field and also the laterally placed tattoos are matched with the room lasers. If the patient is setup on a breast board, all these tattoo marks are placed on the patient. Whereas, when using a vacuum bag the lateral alignment of patient is based on markings on the sides of a vacuum bag. When a patient is positioned on a breast board, to match for the skin tattoos laterally the arm position may vary. Due to these the skin stretches differently each day contributing to the longitudinal shift. In case of vacuum bag, since the lateral markings are not placed on skin, longitudinal shifts tend to be of a lesser magnitude as shown in this study. Furthermore, a breast board is inclined and there is a chance of sliding down when positioned, whereas, a vacuum bag does not have any inclination and hence lesser longitudinal shifts.
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Treatment and prognosis of leptomeningeal disease secondary to metastatic breast cancer: A single-centre experience.

Treatment and prognosis of leptomeningeal disease secondary to metastatic breast cancer: A single-centre experience.

Metastatic cancer affecting the meninges, or leptomeningeal disease (LMD), is an uncommon complication of advanced breast cancer (ABC). Previously estimated to occur in 5% of ABC patients[1], the prevalence is thought to be increasing due to increased diagnostic accuracy and longer survival in breast cancer. Usually this is a late complication of ABC, but rarely it can be a presenting feature[2,3]. Symptoms of LMD vary according to the affected site, for example motor or sensory symptoms may occur from LMD affecting the meninges around the spinal cord or cauda equina, and headache, nausea and seizures can occur secondary to raised intracranial pressure from obstructive hydrocephalus. Diagnosis is normally made by MRI scan with gadolinium contrast, sometimes confirmed by cytological evaluation of cerebro-spinal fluid (CSF). As the sensitivity of CSF cytology is low[4], CSF examination for other biochemical markers such as CA15-3 have been investigated[5], but have not reached routine clinical practice. The mechanism of LMD development is not well understood, but it appears to occur via direct extension through the dura from spinal or skull bony metastases in most patients[6], and via haematogenous spread, sometimes in association with parenchymal brain metastases in others. The optimal management strategy for LMD remains unclear, and may differ according to the affected site, extent of disease and resulting symptoms. Triple negative disease and HER2 positive disease are associated with a higher risk of developing parenchymal brain metastases than luminal breast cancer[7], but the risk factors for developing LMD are less clearly defined. An Italian cohort study identified both ER negative and HER2 positive as risk factors for developing LMD, as well as grade 3 tumours, young age, primary tumours >15mm and the involvement of 3 or more lymph nodes at breast cancer diagnosis [8]. Other retrospective studies have noted over representation of triple negative breast cancer and lobular histology [9–11].
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Current Progresses of Single Cell DNA Sequencing in Breast Cancer Research

Current Progresses of Single Cell DNA Sequencing in Breast Cancer Research

A tumor initially arises from a single cell, which then undergoes clonal expansion to a population of cancer cells. During tumorigenesis and evolution process, cancer cells undergo different degrees of genetic instability and consequently obtain varied genetic aberrations. Clonal expansions driven by the acquisition of different mutations are main portraits for clonal evolution [32, 62] (Figure 2), but not all expansions are induced by genetic events. Driver mutations (i.e. mutations that allow cells gain growth advantages) are the key mutational events that drive clonal expansions in a given microenvironment [63]. Under a certain set of selective pressure, clones acquire driver mutations, and are also accompanied by passenger alterations, which may change into driver aberrations if the selective pressures change [63]. During the tumor progression, the mutational rate also changes, subsequently the clones acquire new mutations, which lead to genetic heterogeneity within the tumor [63, 64]. The clonal evolution has been revealed in breast cancer. Several somatic coding mutations that vary between primary and metastatic breast tumor have been discovered by using next
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Breast amyloidosis: a case report

Breast amyloidosis: a case report

In the vast majority of patients, breast amyloidosis is part of a systemic AL type disease (usually kappa light chain proteins). It can be associated with malignancies of the breast including invasive ductal or lobular carcinoma but mainly it is associated with hematologic malignancies. Moreover, breast cancer may sometimes be the cause of amyloid, the so-called amyloid tumour of the breast but it is rare. [3]

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The role of breast ultrasound in assessing patients with mastalgia in Erbil, Iraq

The role of breast ultrasound in assessing patients with mastalgia in Erbil, Iraq

In conclusion, ultrasound is a relatively in- expensive and a more accessible modality for evaluating breast pain. It should be the first line investigation especially in women under the age of 35 years and as an ad- junct to mammography over the age of 35 years when mammography is available. In areas where mammography is not accessi- ble or very expensive especially in devel- oping countries, ultrasound may be used as a primary modality to further evaluate a breast pain and for ultrasound guided pro- cedures. Even in the presence of mam- mography, breast sonography should be included in the work-up of symptomatic breast disease.
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Thymidylate synthase gene (TYMS) polymorphisms in sporadic and hereditary breast cancer

Thymidylate synthase gene (TYMS) polymorphisms in sporadic and hereditary breast cancer

In recent years risk factors for BC have been identified, although the etiology of the disease is still not under- stood. Risk factors that contribute to the development of BC include age, ethnicity, reproduction, some kind of hormones, lifestyle, bone density, genetic factors [3] and family history [4]. The majority of hereditary breast can- cer (HBC) susceptibility can be attributed to germline mutations of to Breast Cancer 1 and Breast Cancer 2 genes (BRCA1 and BRCA2), which are responsible for 30-40% of HBC. Clinically, the basis of HBC is estab- lished at an early age, family history, bilateral BC, male
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Ambulatory surgery for the patient with breast cancer: current perspectives

Ambulatory surgery for the patient with breast cancer: current perspectives

Abstract: Ambulatory breast cancer surgery is well accepted and is the standard of care at many tertiary centers. Rather than being hospitalized after surgery, patients are discharged on the day of surgery or within 23 hours. Such early discharge does not adversely affect patient outcomes and has the added benefits of better psychological adjustment for the patient, economic savings, and a more efficient utilization of health care resources. The minimal care needed post-discharge also means that the caregiver is not unduly burdened. Unplanned conversions to inpatient admission and readmission rates are low. Wound complications are infrequent and no issues with drain care have been reported. Because the period of postoperative observation is short and monitoring is not as intensive, ambulatory surgery is only suitable for low-risk procedures such as breast cancer surgery and in patients without serious comorbidities, where the likelihood of major perioperative events is low. Optimal management of pain, nausea, and vomiting is essential to ensure a quick recovery and return to normal function. Regional anesthesia such as the thoracic paravertebral block has been employed to improve pain control during the surgery and in the immediate postoperative period. The block provides excellent pain relief and reduces the need for opiates, which also consequently reduces the incidence of nausea and vomiting. The increasing popularity of total intravenous anesthesia with propofol has also helped reduce the incidence of nausea and vomiting in the postoperative period. Ambulatory surgery can be safely carried out in centers where there is a well-designed workflow to ensure proper patient selection, counseling, and education, and where patients and caregivers have easy access to medical services should problems arise after discharge.
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Editorial-Inheriting the Journal

Editorial-Inheriting the Journal

Examination revealed a frail woman in moderate dis- tress. Active, passive and resisted ranges of motion of the cervical spine were moderately restricted and painful in flexion, lateral flexion and rotation. Extension of the cer- vical spine was markedly limited due to elicitation of se- vere C/T pain. Cervical Kemp’s (compression, extension and rotation), Jackson’s (cervical rotation plus compres- sion), Spurling’s (cervical lateral flexion and compression) and thoracic outlet tests created some local pain but did not elicit upper extremity symptoms. Valsalva maneuver caused some increased pain in her cervicothoracic region. Spinous percussion was unremarkable. The Soto-Hall test (passive head and neck flexion with stabilization of the sternum of the supine patient) exacerbated her neck pain. Palpation revealed tenderness in the rhomboid, trapez-
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Molecular profiling of patient derived breast cancer xenografts

Molecular profiling of patient derived breast cancer xenografts

Results: Comparison analysis showed that 14/18 pairs of tumors shared more than 56% of copy number alterations (CNA). Unsupervised hierarchical clustering analysis showed that 16/18 pairs segregated together, confirming the similarity between tumor pairs. Analysis of recurrent CNA changes between patient tumors and xenografts showed losses in 176 chromosomal regions and gains in 202 chromosomal regions. Gene expression profile analysis showed that less than 5% of genes had recurrent variations between patient tumors and their respective xenografts; these genes largely corresponded to human stromal compartment genes. Finally, analysis of different passages of the same tumor showed that sequential mouse-to-mouse tumor grafts did not affect genomic rearrangements or gene expression profiles, suggesting genetic stability of these models over time. Conclusions: This panel of human BC xenografts maintains the overall genomic and gene expression profile of the corresponding patient tumors and remains stable throughout sequential in vivo generations. The observed
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<p>Oncologists&rsquo; perspectives on adherence/non-adherence to adjuvant endocrine therapy and management strategies in women with breast cancer</p>

<p>Oncologists&rsquo; perspectives on adherence/non-adherence to adjuvant endocrine therapy and management strategies in women with breast cancer</p>

The perspectives of health care providers on AET adher- ence and its management, however, has been little explored worldwide, 23 and if we are to consider adherence not only as a patient problem, there is clearly a need to analyze oncologists and health care providers ’ perspectives and roles from AET initiation to long-term follow-up care. The latter varies across countries where primary health care providers such as general practitioners and/or BC nurses are the main point of contact once women are dis- charged from hospital. In the case of Argentina, clinical oncologists are the chief prescribers of AET and are respon- sible for follow-up care, although other cancer specialists (mastologists, gynecological oncologists, radiation oncolo- gists) can also do so for early BC, thus making all these specialists relevant to analyze in relation to patients ’ adher- ence to medication. Whether specialists consider drug side effects signi fi cant or not or how they facilitate discussion on medication-taking or manage patients ’ complaints and con- cerns with AET could have an impact on adherence. In
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Evaluating a digital tool for supporting breast cancer patients: a randomized controlled trial protocol (ADAPT).

Evaluating a digital tool for supporting breast cancer patients: a randomized controlled trial protocol (ADAPT).

Breast Cancer, mHealth, Patient Activation, Health-Related Quality of Life, Health Resource 2.. Utilisation, Patient-Reported Outcome Measures 3.[r]

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Efficient development and usability testing of decision support interventions for older women with breast cancer

Efficient development and usability testing of decision support interventions for older women with breast cancer

about management and to provide decision support for patients. As part of this program of work, decision support interventions (DESIs) for two treatment choices (primary endocrine therapy or surgery+endocrine therapy and adjuvant chemotherapy or no chemotherapy) were developed. DESIs are tools that aim to support shared decision-making between clinicians and patients. The DESIs developed as part of this study each included a brief decision aid to be used within a consultation (a table of frequently asked questions with the answers for each treatment option), along with a booklet for patients which provided detailed information and a values clarification exercise (see “Methods” for more details) for use at home, with family or friends if desired. Guidelines from the International Patient Decision Aid Standards (IPDAS) 15
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