Adherence to cancer prevention recommendations and risk of breast cancer in situ in the United Kingdom Biobank

A health-conscious lifestyle may protect against breast cancer in situ. However, breast cancer in situ is mainly detected by screening, and many studies lack information on screening participation. Thus, we evaluated the association between prediagnostic lifestyle and risk of breast cancer in situ, accounting for screening participation at recruitment. A score reflecting the adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations was constructed, using the recommendations on healthy body weight, physical activity, consumption of plant-based foods, red and processed meat, alcohol and avoidance of sugar. Cox proportional hazards regression models were used to investigate the association between the lifestyle score and breast cancer in situ risk, while accounting for important confounders. The lifestyle score was not significantly associated with breast cancer in situ risk (HRcontinuous = 0.96, 95% CI = 0.91-1.03) in the overall cohort. In participants not reporting dietary changes in the past 5 years, the lifestyle score was inversely associated with breast cancer in situ risk (HRcontinuous = 0.92, 95% CI = 0.85-0.99). In those reporting dietary changes in the past 5 years due to illness or other reasons, the lifestyle score was not associated with breast cancer in situ risk (HRcontinuous = 1.04, 95% CI = 0.94-1.15). Lifestyle was inversely associated with breast cancer in situ risk in women not reporting recent changes in their dietary habits. This inverse association is consistent with inverse associations reported in previous studies. Our findings suggest that breast cancer in situ and invasive breast cancer share a similar risk factor profile. Keywords: breast cancer in situ; cancer; cohort; lifestyle; prevention; score

Prevalence of incidental breast cancer and precursor lesions in autopsy studies: A systematic review and meta-analysis

Abstract Background Autopsy studies demonstrate the prevalence pool of incidental breast cancer in the population, but estimates are uncertain due to small numbers in any primary study. We aimed to conduct a systematic review of autopsy studies to estimate the prevalence of incidental breast cancer and precursors. Methods Relevant articles were identified through searching PubMed and Embase from inception up to April 2016, and backward and forward citations. We included autopsy studies of women with no history of breast pathology, which included systematic histological examination of at least one breast, and which allowed calculation of the prevalence of incidental breast cancer or precursor lesions. Data were pooled using logistic regression models with random intercepts (non-linear mixed models). Results We included 13 studies from 1948 to 2010, contributing 2363 autopsies with 99 cases of incidental cancer or precursor lesions. More thorough histological examination (≥20 histological sections) was a strong predictor of incidental in-situ cancer and atypical hyperplasia (OR = 126·8 and 21·3 respectively, p < 0·001), but not invasive cancer (OR = 1·1, p = 0·75). The estimated mean prevalence of incidental cancer or precursor lesion was 19·5% (0·85% invasive cancer + 8·9% in-situ cancer + 9·8% atypical hyperplasia). Conclusion Our systematic review in ten countries over six decades found that incidental detection of cancer in situ and breast cancer precursors is common in women not known to have breast disease during life. The large prevalence pool of undetected cancer in-situ and atypical hyperplasia in these autopsy studies suggests screening programs should be cautious about introducing more sensitive tests that may increase detection of these lesions

Prognostic value of CEACAM1 in breast cancer in situ

Background & Objectives: Ductal breast cancer can be divided into invasive and non-invasive types (cancer in situ – DCIS). Although there is information about molecular features of these tumours, DCIS remains none fully described pathology. Thus we need to find novel reliable diagnostic markers. One could be the сarcinoembryonic antigen related cell adhesion molecules 1 (CEACAM1). This molecule was described in diverse invasive types of cancers. The aim our study presented here was to characterise the exact expression pattern of CEACAM1 in various types of DCIS

Precise navigation surgery of tumours in the lung in mouse models enabled by in situ fluorescence labelling with a killer-reporter adenovirus.

BackgroundCurrent methods of image-guided surgery of tumours of the lung mostly rely on CT. A sensitive procedure of selective tumour fluorescence labelling would allow simple and high-resolution visualisation of the tumour for precise surgical navigation.MethodsHuman lung cancer cell lines H460 and A549 were genetically transformed to express red fluorescent protein (RFP). Tumours were grown subcutaneously for each cell line and harvested and minced for surgical orthotopic implantation on the left lung of nude mice. Tumour growth was measured by fluorescence imaging. After the tumours reached 5 mm in diameter, they were injected under fluorescence guidance with the telomerase-dependent green fluorescent protein (GFP)-containing adenovirus, OBP-401. Viral labelling of the lung tumours with GFP precisely colocalised with tumour RFP expression. Three days after administration of OBP-401, fluorescence-guided surgery (FGS) was performed.ResultsFGS of tumours in the lung was enabled by labelling with a telomerase-dependent adenovirus containing the GFP gene. Tumours in the lung were selectively and brightly labelled. FGS enabled complete lung tumour resection with no residual fluorescent tumour.ConclusionsFGS of tumours in the lung is feasible and more effective than bright-light surgery

Multidrug resistance of non-adherent cancer cells

Metastases are the cause of 90% of human cancer deaths. Cancer in _situ_ can usually be effectively removed by surgery. Once cancer cells disseminate from the original site and start to circulate in blood, lymph, or other body fluids, the disease becomes almost incurable. Here we show that cancer cells in a non-adherent, 3-dimentional growth pattern are highly drug resistant compared to their adherent counterparts that grow in monolayer, attaching to the wall of tissue culture plates. The non-adherent cancer cells retain the adhering potential and can attach to an appropriate surface to reacquire adherent phenotype. Once the non-adherent cancer cells become attached, they regain drug response, similar to the original adherent cells. A significant increase in the expression of CD133, CD44, Nanog, survivin, and thymidylate synthase was observed in the non-adherent cancer cells compared to their adherent counterparts, which may underlie the mechanisms of multidrug resistance of the cells. Since the non-adherent cancer cells cultured in vitro resemble the circulating metastatic cells in vivo in that both cells exhibit suspended non-adherent phenotype, possess re-attaching potential, and are highly drug resistant, we suggest that circulating metastatic cells can attach to an appropriate surface to gain adherent phenotype and subsequently acquire drug sensitivity. We propose that devices coated with cell attachment materials or small particles of extracellular matrix and collagen that mimic the structural framework of real human tissues to which cells can attach and grow may be able to stabilize the circulating metastatic cells. Once the metastatic cells undergo attachment and become adherent, they gain drug sensitivity and can be killed by anticancer drugs that are either administered to the blood or conjugated to the devices

Early discharge of low-risk women from cervical screening

Background: The Scottish Cervical Screening Programme currently offers three-yearly screening to all women between the ages of 20 and 60. However, previous studies have indicated that well-screened women over the age of 50 are likely to be at low risk of cervical neoplasia. This study aimed to explore the implications of discharging these women from screening in a typical area of Scotland. Methods: A case–control study of the screening histories of women with and without screen-detected cervical neoplasia between ages 50 and 59 in Lanarkshire was carried out, as well as a cross-sectional study of the prevalence of adequate screening histories among women currently aged 50 in Lanarkshire. Routine screening programme statistics were used to estimate the effects of introducing an early discharge policy. Results: Women reaching the age of 50 with two recent, consecutive, negative smears had reduced odds of screen-detected neoplasia in the subsequent decade. The estimated odds ratio for all screen-detected neoplasia (CIN 1–3, adenocarcinoma in situ and invasive carcinoma) was 4.4 [95 per cent confidence interval (CI) 1.6–13.2, p = 0.002]. The estimated odds ratio for screen-detected high-grade CIN and invasive squamous carcinoma was 17.0 (95 per cent CI 2.4–243.0, &#254; = 0.0004). A total of 54.0 per cent (95 per cent CI 47.9–59.9 per cent) of screening participants currently aged 50 fulfilled the definition of adequate screening. Discharging these women might be expected to reduce screening workload by approximately 10 per cent, but those discharged would be at increased risk of neoplasia. Conclusion: Now that full screening histories are available in all health board areas since 1990, the identification of a low-risk group within the screened population could be the first step towards a screening programme targeted more closely on those with the greatest capacity to benefit

Recent changes in breast cancer incidence and risk factor prevalence in San Francisco Bay area and California women: 1988 to 2004

IntroductionHistorically, the incidence rate of breast cancer among non-Hispanic white women living in the San Francisco Bay area (SFBA) of California has been among the highest in the world. Substantial declines in breast cancer incidence rates have been documented in the United States and elsewhere during recent years. In light of these reports, we examined recent changes in breast cancer incidence and risk factor prevalence among non-Hispanic white women in the SFBA and other regions of California.MethodsAnnual age-adjusted breast cancer incidence and mortality rates (1988 to 2004) were obtained from the California Cancer Registry and analyzed using Joinpoint regression. Population-based risk factor prevalences were calculated using two data sources: control subjects from four case-control studies (1989 to 1999) and the 2001 and 2003 California Health Interview Surveys.ResultsIn the SFBA, incidence rates of invasive breast cancer increased 1.3% per year (95% confidence interval [CI], 0.7% to 2.0%) in 1988-1999 and decreased 3.6% per year (95% CI, 1.6% to 5.6%) in 1999-2004. In other regions of California, incidence rates of invasive breast cancer increased 0.8% per year (95% CI, 0.4% to 1.1%) in 1988-2001 and decreased 4.4% per year (95% CI, 1.4% to 7.3%) in 2001-2004. In both regions, recent (2000-2001 to 2003-2004) decreases in invasive breast cancer occurred only in women 40 years old or older and in women with all histologic subtypes and tumor sizes, hormone receptor-defined types, and all stages except distant disease. Mortality rates declined 2.2% per year (95% CI, 1.8% to 2.6%) from 1988 to 2004 in the SFBA and the rest of California. Use of estrogen-progestin hormone therapy decreased significantly from 2001 to 2003 in both regions. In 2003-2004, invasive breast cancer incidence remained higher (4.2%) in the SFBA than in the rest of California, consistent with the higher distributions of many established risk factors, including advanced education, nulliparity, late age at first birth, and alcohol consumption.ConclusionOngoing surveillance of breast cancer occurrence patterns in this high-risk population informs breast cancer etiology through comparison of trends with lower-risk populations and by highlighting the importance of examining how broad migration patterns influence the geographic distribution of risk factors

Cancer Niche as a Garbage Disposal Machine: Implications of TCM-Mediated Balance of Body-Disease for Treatment of Cancer.

Cancer epidemic led to worldwide to search for a new "game changer" concept to govern cancer research and cancer treatment. Western medicine-based cancer research has been extending the impasse without resolution in sigh for improving survival of patients with solid malignant tumors in the last four decades due to heterogeneity in cancer tissues. Such a deadlock charts a course to learn lessons from the developing countries, directly or indirectly to complement the exhausted Western medicine. We propose a new concept of "Cancer niche as a garbage disposal machine" with implications of traditional Chinese medicine-mediated restoration of normal balance between body and disease to bring the fight against cancer under control

Do mammographic tumor features in breast cancer relate to breast density and invasiveness, tumor size, and axillary lymph node involvement?

Breast density and mammographic tumor features of breast cancer may carry prognostic information. The potential benefit of using the combined information obtained from breast density, mammographic tumor features, and pathological tumor characteristics has not been extensively studied