Triple-Negative Breast Cancer: Clinical Characteristics, Prognostic Features, and Long-Term Outcome: A Comparative Study

Background: Because of the reported poor prognosis and absence of effective and specific therapeutic approaches, triple-negative breast cancer (TNBC) tumors have remained as an important area of investigations for clinicians and researchers. The aim of this study was to determine the clinical, pathological, histological, prognostic features, and outcome associated with this type of breast cancer in Iran. We also tried to identify main determinants of long-term survival in women suffered from TNBC tumor type. Methods: This is a historical cohort study of 546 consecutive female breast cancer patients with known status of hormonal receptors and diagnosed at the Rasoul-e-Akram University Hospital of Iran between January 2009 and June 2011. Baseline data were collected from patient records and hospital charts. Long-term outcome was determined from clinic records when available or by means of written correspondence with patients' physicians and telephone interviews directly with the patients or with family members. Follow-up data were collected by our research personnel for a mean follow-up duration 5.7 years. Results: A total of 86 of 546 final included participants with breast cancer were identified as having TNBC (15.8%).The patients with TNBC diagnosis were significantly younger than non-TNBC group and family history of breast cancer was more prevalent in former group. Regarding histopathological feature, medullary feature was more prevalent in TNBC group, while other features were similarly revealed in both groups. With respect to tumor grading, TNBC group was graded higher than non-TNBC group that grade III of tumor was reported in 51.1% of the TNBC patients, but in 15.9% of another group. Also, the stage of tumor was significantly higher in the TNBC group. Tumor size > 50 mm was observed in 18.6% of the TNBC and 14.8% of non-TNBC groups. Metastasis to liver as well as concurrent metastasis to brain and pulmonary was more prevalent in TNBC compared with another group. The Kaplan-Meier curves based showed the survival probability at 1-year, 3-year, and 5-year of follow-up in TNBC group was 92.7%, 86.2%, and 44.9%, respectively. This survival rates in non-TNBC group was 98.7%, 87/2%, and 72.5%, respectively. Multivariable logistic regression analysis showed that TNBC diagnosis could strongly predict long-term mortality in breast cancer patients. Besides, tumor size, number of involved lymph nodes and higher tumor grade were other determinants of cancer-related long-term mortality. Conclusion: The present study on Iranian TNBCs population shows that TNBCs account for about 15.8% of all invasive breast cancers, and they usually have a high histological stating and metastasis susceptibility

Conventional Multiplex PCR for Identifying Soil Transmitted Helminthes (Ascaris Lumbricoides, Trichuris Trichura and Ancylostoma Duodenale) in Fecal Specimens

Ascaris lumbricoides, Trichuris trichiura, and Ancylostoma duodenale are soil-transmitted helminths (STHs) and medically neglected in Iraq country in spite of their effect on the public health. A cross-sectional study was performed in the Maternity and Childhood Teaching Hospital and General Education Hospital in Al-Dewanyia Province, included 850 tool samples collected from patients who attended to the O & P Lab. General stool examination (GSE), direct wet mount method DWMM and Kato-Katz were using for diagnosis of STH infections through detecting the adult and the ovum of the helminthes. A conventional multiplex PCR assay was used for detection of STHs in fecal samples. Based on microscopic examination, the results showed that 275/850 range among triple, double and single infection on other hand was 365/850 range among triple, double and single infection. In conclusions, the investigative sensitivity of DWMM is notable for STH; in exception, it is capable to identify patients with the intention of highest requirement of management, and therefore contributes to the universal target to reduce STH as a community healthiness trouble

The effects of synbiotics supplementation on reducing chemotherapy-induced side effects in women with breast cancer: a randomized placebo-controlled double-blind clinical trial

Abstract Background The prevalence of breast cancer and its mortality rate are increasing rapidly among women worldwide. On other hand, the courses of chemotherapy as the main treatment for these patients are too much exhaustive and annoying. This study was designed to evaluate the use of synbiotics (probiotics + prebiotics) supplementation as a safe and inexpensive adjuvant treatment in reducing common chemotherapy side effects in women with breast cancer. Methods The current study was conducted on 67 women with definitive diagnosis of breast cancer who were hospitalized to receive one-day chemotherapy sessions, and met the inclusion criteria. The patients were randomly allocated to the intervention or control group to receive synbiotics or placebo, respectively. They received oral consumption of synbiotics supplements twice a day for 8 weeks. The primary outcome was the changes in severity or experience of chemotherapy complication, analyzed by intention to treat (ITT). The instruments included 7 validated questionnaires which were used to assess chemotherapy complications in the initiation, 4 weeks and 8 weeks after intervention. Dietary intake was measured by 24-h dietary recall at the beginning, week 4 and week 8. Data were analyzed by SPSS software version 24. P-value < 0.05 was considered as statistically significant. Results 67 breast cancer patients participated in the study. 8 weeks after intervention and adjusting the confounders, the severity of chemotherapy complications including unnormal defecation (P = 0.005) and fatigue (P < 0/001) decreased significantly in the synbiotics group compared to the placebo group. Furthermore, nausea/vomiting (P = 0.015), and anorexia (P < 0.001) were decreased at the end of the study compared to the first visit, but it was not statistically significant compared to the placebo group. Conclusions Synbiotics supplementation during chemotherapy can potentially reduce the severity of fatigue and abnormal defecation. It can help reduce anorexia and nausea/vomiting. Trial Registration This study was registered in the Iranian Registry of Clinical Trials (IRCT) (registered code: IRCT20091114002709N56) (date of registration: 5/5/2021). Direct link to the trial page: https://www.irct.ir/trial/54559

Paclitaxel-Induced Peripheral Neuropathy Using NCI-CTCin Isfahan, Iran: Paclitaxel-induced peripheral neuropathy

Paclitaxel is a highly effective anticancer agent. It is active against a broad range of cancers that are generally considered refractory to conventional chemotherapy.Paclitaxel induces a peripheral neuropathy (PN) that is characterized by sensory symptoms such as numbness and paresthesia in a glove and stocking distribution.PN may be severe and dose limiting at initial doses above 275 mg/m2. Our purpose was to evaluate the incidence, severity, dose dependency, and reversibility of paclitaxel-induced neuropathy. We studied 45 patients with breast cancer, treated with Paclitaxel (240, 270, 300 mg/m2) in an average of 4 cycles of treatment.Paclitaxel was administered by a 3 h intravenous infusion every 3 weeks in all patients.We used National Cancer Institute-Common Toxicity Criteria (NCI-CTC) to evaluate peripheral neuropathy. The cumulative dose of paclitaxel in each patient was also measured. The severity of symptoms was graded. Incidence and reversibility of neuropathy was measured in an interview with the patient. Paresthesias appeared in 39 (86.6%) patients after an average cumulative dose of 394 mg/m2.In most patients, PN was seen after the first or second dose (68%) of paclitaxel and then stabilized in 36%, improved in 36%, resolved completely in 24% and progressed in 4%. There was no need to discontinue Paclitaxel in any of the patients due to PN.In view of our experience in the present study, we found that Paclitaxel-induced neuropathy is a dose-dependent phenomenon, and most of the symptoms occurred after the first or second phase of treatment

Early occurrence of acute myelomonocytic leukemia (M4/M5) after liver transplantation: a case report

Abstract Introduction Acute myeloid leukemia is a rare event in post-liver-transplantation recipients. In the present report, we described a case of extramedullary acute myeloid leukemia, M4/M5 subtype, following orthotopic liver transplant. Case presentation The patient was a 50-year-old Iranian woman who underwent orthotopic liver transplant due to hepatitis B-related cirrhosis (Child C, MELD (model for end-stage liver disease score) = 22). Orthotopic liver transplant was performed using the piggy back technique in January 2022. Induction immunosuppressive therapy was 1 gm methylprednisolone for 3 days followed by a triple maintenance immunosuppressive regimen including mycophenolate mofetil, prednisolone, and tacrolimus. About 5 months after orthotopic liver transplant in June 2022, the patient presented with leukocytosis, with white blood cell count of 99.4 × 103/µl, and physical examination revealed only cervical lymphadenopathy. Biopsy of cervical lymph nodes showed a myeloid tumor. She was immediately hospitalized. Eight hours after hospitalization, the patient gradually developed lethargy and decreased O2 saturation to approximately 89%. Flow cytometry demonstrated the markers of a myelomonocytic acute myeloid leukemia (M4/M5). Cytoreduction was immediately started by intensive leukopheresis followed by induction therapy. Because of a septic complication during the induction therapy, further chemotherapy was discontinued and broad-spectrum antibiotics and antifungal treatments started. Unfortunately, our patient died of severe septic shock 42 days after hospitalization. Conclusion Acute myeloid leukemia is a rare phenomenon after liver transplantation, and it can follow a rapidly fatal clinical course