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1.
Bone health in women with breast cancer.
Ramchand, SK, Cheung, YM, Grossmann, M
Climacteric : the journal of the International Menopause Society. 2019;(6):589-595
Abstract
Women with early, estrogen receptor-positive breast cancer are treated with adjuvant endocrine therapy, using aromatase inhibitors or selective estradiol receptor modulators such as tamoxifen, to deprive breast tissue from the deleterious effects of estradiol action, hence improving long-term prognosis. Aromatase inhibitors and, in premenopausal women, tamoxifen accelerate bone loss and increase fracture risk. Therefore, all women commencing endocrine therapy need a targeted work-up to assess the baseline fracture risk, and monitoring of bone health during endocrine therapy should be individualized based on this baseline risk. While high-level evidence specific to early breast cancer is lacking, non-pharmacologic measures to maintain optimal bone health such as weight-bearing exercise and calcium and vitamin D sufficiency should be implemented in all women. Antiresorptive treatment should be initiated in all women with preexisting fragility fractures (including vertebral morphometric fractures) and should be considered in women with areal bone mineral density (BMD) T-scores < -2.0 (or Z-scores in women aged <50 years) or those experiencing rapid bone loss (≥5% per year), taking into consideration the baseline BMD and other risk factors for fracture. Further clinical trial evidence is required to provide definitive guidance regarding criteria to initiate antiresorptive treatment, choice of agents, and duration of treatment, taking into account potential oncologic benefits of antiresorptive therapy on breast cancer-related outcomes.
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2.
Angiomammography: A review of current evidences.
Dromain, C, Vietti-Violi, N, Meuwly, JY
Diagnostic and interventional imaging. 2019;(10):593-605
Abstract
Although mammography is currently the imaging technique of choice for screening and diagnosis, it has some limitations, especially in patients with high-density breasts. The evolution from film screen to full-field digital mammography has recently led to the development of new imaging techniques, which are less expensive and widely available. Contrast-enhanced spectral mammography (CESM) is one of them, coupling X-ray breast imaging to the intravenous administration of an iodinated contrast material. CESM provides both morphological information, similar to mammography, and functional information of tumor perfusion. In this review, the imaging technique, the specificity of interpretation of CESM compared to MRI and the currently available data are presented. The clinical performances of CESM versus those of mammography and MRI and its additional value in preoperative local assessment and screening is discussed. The potential advantages and disadvantages are mentioned and we also discuss how CESM contributes to the detection of lesions and how it can be used in daily clinical workflow.
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3.
A Review on Targeting Nanoparticles for Breast Cancer.
Alqaraghuli, HGJ, Kashanian, S, Rafipour, R
Current pharmaceutical biotechnology. 2019;(13):1087-1107
Abstract
Chemotherapeutic agents have been used extensively in breast cancer remedy. However, most anticancer drugs cannot differentiate between cancer cells and normal cells, leading to toxic side effects. Also, the resulted drug resistance during chemotherapy reduces treatment efficacy. The development of targeted drug delivery offers great promise in breast cancer treatment both in clinical applications and in pharmaceutical research. Conjugation of nanocarriers with targeting ligands is an effective therapeutic strategy to treat cancer diseases. In this review, we focus on active targeting methods for breast cancer cells through the use of chemical ligands such as antibodies, peptides, aptamers, vitamins, hormones, and carbohydrates. Also, this review covers all information related to these targeting ligands, such as their subtypes, advantages, disadvantages, chemical modification methods with nanoparticles and recent published studies (from 2015 to present). We have discussed 28 different targeting methods utilized for targeted drug delivery to breast cancer cells with different nanocarriers delivering anticancer drugs to the tumors. These different targeting methods give researchers in the field of drug delivery all the information and techniques they need to develop modern drug delivery systems.
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4.
Acquired haemophilia A in a patient with breast cancer and lung carcinoma: a case report and literature review.
Biesheuvel, V, Hiddema, SM, Levenga, H, Eikenboom, J, van der Deure, WM
The Netherlands journal of medicine. 2019;(4):153-155
Abstract
Acquired haemophilia A is a rare disorder caused by spontaneous formation of auto-antibodies (inhibitors) against coagulation factor VIII. This can lead tolife-threatening haemorrhages. Six to twenty-two percent of patients with acquired haemophilia have an underlying malignancy. We describe a 69-year-old woman with metastatic breast cancer and non-small cell lung carcinoma who presented at the emergency room with spontaneous bruising, and who was using a vitamin K antagonist. She had a prolonged activated partial thromboplastin time (aPTT) due to a coagulation factor VIII deficiency caused by factor VIII antibodies. She was treated with prednisone and cyclophosphamide.
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5.
A clinical evaluation of treatments that target cell cycle machinery in breast cancer.
Fedele, P, Sanna, V, Fancellu, A, Cinieri, S
Expert opinion on pharmacotherapy. 2019;(18):2305-2315
Abstract
Introduction: The dysregulation of cell cycle control can lead to cancer development. In breast cancer, cyclin D, CDK 4,6 and the retinoblastoma protein play a central role in the control of cell proliferation, in crosstalk with the estrogen receptor and Her2 pathways. Although the mechanisms by which the CDK4/6 complex is involved in the control of cell growth in triple negative breast cancer (TNBC) are still unclear, some TNBCs might be sensitive to CDK4/6 inhibitors.Areas covered: The authors provide an overview of the treatments that target cell cycle machinery in breast cancer and provide their perspectives for the future.Expert opinion: CDK 4/6 inhibitors are active drugs in HR+ MBC, but some unresolved issues remain. We need to identify biomarkers of response. Moreover, we need to determine the optimal timing for the incorporation of CDK 4/6 inhibitors in the current treatment algorithm. In the Her2 positive subtype, the triple combination of anti Her2 therapies with CDK4/6 inhibitors and endocrine therapy seems to be a promising chemotherapy free approach. Efforts must still be made for the treatment of the TNBC subtype, even though new CDK 4/6 combinations are emerging as promising approaches to selected patients.
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6.
Biomarker of long-chain n-3 fatty acid intake and breast cancer: Accumulative evidence from an updated meta-analysis of epidemiological studies.
Yang, B, Ren, XL, Wang, ZY, Wang, L, Zhao, F, Guo, XJ, Li, D
Critical reviews in food science and nutrition. 2019;(19):3152-3164
Abstract
Objective: We aimed to summarize the up-to-date epidemiology evidence on biomarkers of long-chain (LC) n-3 fatty acid (FA) intake in relation to breast cancer (BC).Methods: Epidemiology studies determining FA levels in biospecimen (circulating blood or adipose tissue (AT)) were identified from PubMed, EMBASE, and Cochrane Library databases until March 2018. Multivariate-adjusted risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effect model. Difference in biospecimen proportions of LC n-3 FA between BC cases and non-cases were analyzed as a standardized mean difference (SMD).Results: Thirteen cohort and eleven case-control studies were eligible for the present meta-analysis. The estimated SMD was -0.14 (95% CI: -0.27, -0.11) for LC n-3 FA and -0.27 (95% CI: -0.42, -0.11) for LC n-3/n-6 FA ratio. When comparing the top tertiles with the bottom baseline levels, circulating LC n-3 FA was significantly associated with a lower risk of BC (RR: 0.84, 95% CI: 0.74, 0.96), but not AT (RR: 1.02, 95% CI: 0.70, 1.48). Significant inverse dose-response associations were observed for each 1% increment of circulating 20:5n-3 and 22:6n-3.Conclusion: This meta-analysis highlights that circulating LC n-3 FA as a biomarker of intake may be an independent predictive factor for BC, especially 20:5n-3 and 22:6n-3.
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7.
Preventive drug therapy and contralateral breast cancer: summary of the evidence of clinical trials and observational studies.
Bens, A, Langballe, R, Bernstein, JL, Cronin-Fenton, D, Friis, S, Mellemkjaer, L
Acta oncologica (Stockholm, Sweden). 2019;(11):1581-1593
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Abstract
Background: Breast cancer patients have a lifelong 2-4-fold increased risk of developing a second primary tumor in the contralateral breast compared with the risk for a first primary breast cancer in the general female population. Prevention of contralateral breast cancer (CBC) has received increased attention during recent decades. Here, we summarize and discuss the available literature on drug preventive therapy and CBC.Results: The endocrine-targetting drugs, tamoxifen and aromatase inhibitors are used as standard adjuvant treatment for estrogen receptor (ER)-positive breast cancer. Both are associated with relative risk reductions of CBC of up to 50%, but incur serious side effects. Several prescription drugs originally developed for other purposes, including bisphosphonates, statins, non-steroidal anti-inflammatory drugs, metformin, anti-hypertensives and retinoids, have shown anti-cancer activity in preclinical models. However, results of observational studies on CBC are sparse and inconsistent, with only statins demonstrating promise as preventive agents and a potential treatment option for ER-negative breast cancer patients.Conclusion: Future studies are needed to assess the effect of statins in risk reduction and to identify other drugs with chemopreventive potential against CBC. Eventually, efforts must be directed towards identifying those breast cancer patients likely to benefit most from specific preventive therapies.
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8.
GPCR Modulation in Breast Cancer.
Lappano, R, Jacquot, Y, Maggiolini, M
International journal of molecular sciences. 2018;(12)
Abstract
Breast cancer is the most prevalent cancer found in women living in developed countries. Endocrine therapy is the mainstay of treatment for hormone-responsive breast tumors (about 70% of all breast cancers) and implies the use of selective estrogen receptor modulators and aromatase inhibitors. In contrast, triple-negative breast cancer (TNBC), a highly heterogeneous disease that may account for up to 24% of all newly diagnosed cases, is hormone-independent and characterized by a poor prognosis. As drug resistance is common in all breast cancer subtypes despite the different treatment modalities, novel therapies targeting signaling transduction pathways involved in the processes of breast carcinogenesis, tumor promotion and metastasis have been subject to accurate consideration. G protein-coupled receptors (GPCRs) are the largest family of cell-surface receptors involved in the development and progression of many tumors including breast cancer. Here we discuss data regarding GPCR-mediated signaling, pharmacological properties and biological outputs toward breast cancer tumorigenesis and metastasis. Furthermore, we address several drugs that have shown an unexpected opportunity to interfere with GPCR-based breast tumorigenic signals.
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[Bone and calcium metabolism associated with malignancy. The function of sex hormone receptors in sex hormone-dependent cancers.].
Kato, S, Nishimura, KI, Ochi, M, Shimmura, H, Mori, JI
Clinical calcium. 2018;(11):1457-1463
Abstract
Both Breast and prostate cancers are dependent on the actions of sex hormones mediated through their nuclear receptors in onset and development of the cancers. Nuclear estrogen and androgen receptors(ER and AR)are DNA-binding transcription factors and regulate expressions of the target mRNA genes by modulating chromatin structure and function. In this short review, the function of nuclear sex hormone receptors in sex hormone-depend cancers are overviewed in the chromatin reorganization for target gene regulations. Moreover, the role of enhancer RNA(eRNA), one of the non-coding RNAs, in chromatin reconfiguration is discussed for enhancer function in tumor development.
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10.
Types of advanced optical microscopy techniques for breast cancer research: a review.
Dravid U, A, Mazumder, N
Lasers in medical science. 2018;(9):1849-1858
Abstract
A cancerous cell is characterized by morphological and metabolic changes which are the key features of carcinogenesis. Adenosine triphosphate (ATP) in cancer cells is primarily produced by aerobic glycolysis rather than oxidative phosphorylation. In normal cellular metabolism, nicotinamide adenine dinucleotide (NADH) is considered as a principle electron donor and flavin adenine dinucleotide (FAD) as an electron acceptor. During metabolism in a cancerous cell, a net increase in NADH is found as the pathway switched from oxidative phosphorylation to aerobic glycolysis. Often during initiation and progression of cancer, the developmental regulation of extracellular matrix (ECM) is restricted and becomes disorganized. Tumor cell behavior is regulated by the ECM in the tumor micro environment. Collagen, which forms the scaffold of tumor micro-environment also influences its behavior. Advanced optical microscopy techniques are useful for determining the metabolic characteristics of cancerous, normal cells and tissues. They can be used to identify the collagen microstructure and the function of NADH, FAD, and lipids in living system. In this review article, various optical microscopy techniques applied for breast cancer research are discussed including fluorescence, confocal, second harmonic generation (SHG), coherent anti-Stokes Raman scattering (CARS), and fluorescence lifetime imaging (FLIM).