Sexual function index adaptation for breast cancer patients (FSFI-BC)- translation and psychometric properties of Persian version.

BACKGROUND: Effective interventions to improve sexual dysfunction in breast cancer survivors need screening of these dysfunctions with a suitable instrument. The aim of present study was translation and identifying psychometric properties of Female Sexual Function Index - Adapted for Breast Cancer (FSFI-BC) which has been specifically developed for breast cancer survivors. METHOD: This methodological study was performed between February 2017 and October 2018. 200 breast cancer survivors in stage 1 or 2 who were selected through convenience sampling method, completed the questionnaire. Reliability was assessed by Cronbach's alfa and test re-test analysis and construct validity was performed through confirmatory (CFA) and exploratory factor analysis( EFA). RESULTS: Six factors were extracted in exploratory factor analysis (EFA). These factors explained 74.6% of the total variance in in NSA group and 0.821 in SA group. Reliability evaluation indicated high internal consistency and good test re-test reliability. Cronbach's alpha coefficient in all areas of the tool was above 0.7 (the lowest and the highest measures were 0.885 and 0.945, respectively), which is a good indicator for reliability of an instrument. Confirmatory factor analysis showed an acceptable fitness for seven factors of FSFI-BC questionnaire (Normed Fit Index or NFI = 0.9 for both groups, Comparative of Fit Index or CFI = 0.93 and 0.92, χ 2/df = 1.68 and 1.71 for SA(Sexually Active) and NSA(No Sexually Active) individuals, respectively) . CONCLUSION: Study findings suggest that Persian version of FSFI-BC is a suitable instrument for sexual dysfunction screening in breast cancer survivors.

Clinical effectiveness of combined whole body hyperthermia and external beam radiation therapy (EBRT) versus EBRT alone in patients with painful bony metastases: A phase III clinical trial study.

PURPOSE: To evaluate the response rate, pain relief duration, and time it took for pain to decline or resolve after radiation therapy (RT) with or without fever-range Whole Body Hyperthermia (WBH) in bony metastatic patients with mainly primary tumor of prostate and breast cancer leading to bone pain. MATERIALS & METHODS: Bony metastatic patients with pain score ≥4 on the Brief Pain Inventory (BPI) underwent RT of 30 Gy in 10 fractions in combination with WBH with nursing care under medical supervision versus RT-alone. WBH application time was 3-4 h in three fractions with at least 48-h intervals. All patients were stratified primary site, breast or prostate cancer vs others, BPI score, and exclusion criteria. The primary endpoint was complete response (CR) (BPI equal to zero with no increase of analgesics) within two months of follow-up. RESULTS: Based on this study, the RT-alone group showed the worst pain. The study was terminated after the enrollment of a total of 61 patients, 5 years after the first enrollment (April 2016 to February 2021). Finally, the CR rate in RT + WBH revealed the most significant difference with RT-alone, 47.4% versus 5.3% respectively within 2 months post-treatment (P-value <0.05). The time of complete pain relief was 10 days for RT + WBH, while the endpoint was not reached during the RT-alone arm. Pain progression or stable disease was observed in half of the patients in RT-alone group within 4 weeks after treatment. However, this score was near zero in RT + WBHT patients in two months post-treatment. CONCLUSIONS: WBH plus RT showed significant increases in pain relief and shorter response time in comparison with RT-alone for patients with bone metastatic lesions.

Metamer mismatching in practice versus theory.

Metamer mismatching (the phenomenon that two objects matching in color under one illuminant may not match under a different illuminant) potentially has important consequences for color perception. Logvinenko et al. [PLoS ONE10, e0135029 (2015)] show that in theory the extent of metamer mismatching can be very significant. This paper examines metamer mismatching in practice by computing the volumes of the empirical metamer mismatch bodies and comparing them to the volumes of the theoretical mismatch bodies. A set of more than 25 million unique reflectance spectra is assembled using datasets from several sources. For a given color signal (e.g., CIE XYZ) recorded under a given first illuminant, its empirical metamer mismatch body for a change to a second illuminant is computed as follows: the reflectances having the same color signal when lit by the first illuminant (i.e., reflect metameric light) are computationally relit by the second illuminant, and the convex hull of the resulting color signals then defines the empirical metamer mismatch body. The volume of these bodies is shown to vary systematically with Munsell value and chroma. The empirical mismatch bodies are compared to the theoretical mismatch bodies computed using the algorithm of Logvinenko et al. [IEEE Trans. Image Process.23, 34 (2014)]. There are three key findings: (1) the empirical bodies are found to be substantially smaller than the theoretical ones; (2) the sizes of both the empirical and theoretical bodies show a systematic variation with Munsell value and chroma; and (3) applied to the problem of color-signal prediction, the centroid of the empirical metamer mismatch body is shown to be a better predictor of what a given color signal might become under a specified illuminant than state-of-the-art methods.

Object-color-signal prediction using wraparound Gaussian metamers.

Alexander Logvinenko introduced an object-color atlas based on idealized reflectances called rectangular metamers in 2009. For a given color signal, the atlas specifies a unique reflectance that is metameric to it under the given illuminant. The atlas is complete and illuminant invariant, but not possible to implement in practice. He later introduced a parametric representation of the object-color atlas based on smoother "wraparound Gaussian" functions. In this paper, these wraparound Gaussians are used in predicting illuminant-induced color signal changes. The method proposed in this paper is based on computationally "relighting" that reflectance to determine what its color signal would be under any other illuminant. Since that reflectance is in the metamer set the prediction is also physically realizable, which cannot be guaranteed for predictions obtained via von Kries scaling. Testing on Munsell spectra and a multispectral image shows that the proposed method outperforms the predictions of both those based on von Kries scaling and those based on the Bradford transform.

Dietary patterns and breast cancer risk among women.

OBJECTIVE: Breast cancer is the most common type of cancer in women worldwide. Several studies have examined the role of single nutrients and food groups in breast cancer pathogenesis but fewer investigations have addressed the role of dietary patterns. Our main objective was to identify the relationship between major dietary patterns and breast cancer risk among Iranian women. DESIGN: Hospital-based case-control study. SETTING: Shohada Teaching Hospital, Tehran, Iran. SUBJECTS: Overall, 100 female patients aged 30-65 years with breast cancer and 174 female hospital controls were included in the present study. Dietary intake was assessed using a valid and reliable semi-quantitative FFQ consisting of 168 food items. RESULTS: Two dietary patterns were identified explaining 24·31 % of dietary variation in the study population. The 'healthy' food pattern was characterized by the consumption of vegetables, fruits, low-fat dairy products, legumes, olive and vegetable oils, fish, condiments, organ meat, poultry, pickles, soya and whole grains; while the 'unhealthy' food pattern was characterized by the consumption of soft drinks, sugars, tea and coffee, French fries and potato chips, salt, sweets and desserts, hydrogenated fats, nuts, industrial juice, refined grains, and red and processed meat. Compared with the lowest tertile, women in the highest tertile of the 'healthy' dietary pattern score had 75 % decreased risk of breast cancer (OR = 0·25, 95 % CI 0·08, 0·78), whereas women in the highest tertile of the 'unhealthy' dietary pattern had a significantly increased breast cancer risk (OR = 7·78, 95 % CI 2·31, 26·22). CONCLUSIONS: A healthy dietary pattern may be negatively associated with breast cancer risk, while an unhealthy dietary pattern is likely to increase the risk among Iranian women.

Cardioprotective Diet to Prevent Anthracycline-Induced Cardiotoxicity in Patients with Breast Cancer: A Randomized Open-Label Controlled Trial.

Objectives: Several studies have indicated that dietary interventions may offer protection against the development of cardiac damage in the case of anthracycline-induced cardiomyopathy (AIC). The goal of this study was to assess whether an evidence-based cardioprotective diet can be effective in preventing AIC in patients with breast cancer. Design: Randomized, open-label, controlled trial. The study period was set for 18 weeks, and the data were analyzed by generalized estimating equation modeling and one-way repeated measures analysis of variance. Setting/Location: Shahid Rajaie Hospital affiliated (Tehran, Iran). Subjects: Fifty anthracycline-treated patients with breast cancer. Interventions: Patients were randomized to receive either a 2-hour training in evidence-based cardio-protective diet or Carvedilol 6.25 mg bid. Outcome Measures: The primary outcome was the number of patients with abnormal left ventricular ejection fraction (LVEF) after 18 weeks. Results: At week 18, 12 (48%) out of 25 participants in the cardioprotective diet group had abnormal LVEF in comparison with 21 (84%) out of 25 in the carvedilol group (p = 0.007). Also, 2 (8%) out of 25 in the cardioprotective diet group compared with 7 (28%) out of 25 participants in the carvedilol group had abnormal global longitudinal strain (p = 0.066). The diet group showed significant improvements in the quality-of-life dimensions named "health change" and "general health" compared with the carvedilol group using the Short Form-36 Health Survey questionnaire. Conclusions: This study suggests that an evidence-based cardioprotective diet can contribute to the prevention of AIC. Although current treatments for AIC can be effective, further research is mandatory for more options.

Efficacy and Safety of Jollab (a Saffron-Based Beverage) on Cancer-Related Fatigue in Breast Cancer Patients: A Double-Blind Randomized Clinical Trial.

INTRODUCTION: Fatigue is a common complaint in cancer patients and profoundly affects the quality of life of the patients. Therefore, we designed a clinical trial to evaluate the safety and efficacy of Jollab (containing saffron, honey, and rose water) as a tonic beverage in the management of cancer-related fatigue in breast cancer patients. METHODS: Seventy-five patients were randomly assigned into two groups, patients received either 4 weeks Jollab or the placebo (20 mL three times daily). Fatigue was assessed with scores of Visual Analogue Fatigue Scale (VAFS), Fatigue Severity Scale (FSS), and Cancer Fatigue Scale (CFS) at weeks 0 and 4 (before and after the intervention). RESULTS: In the Jollab group, VAFS showed a significant decrease (p = 0.000), but in the placebo group, there was no significant difference (p = 0.258). In the Jollab group, FSS decreased significantly (p = 0.000), while in the placebo group, it slightly decreased (p = 0.096). CFS physical and cognitive subscales also showed improvement of fatigue in the Jollab group compared to the placebo group (p < 0.05), but affective subscale score did not show a significant change after the intervention in both groups (p > 0.05). CONCLUSIONS: Jollab beverage has significant positive effects on reducing fatigue in women with breast cancer. However, larger-scale trials with further sample size and longer period of the intervention are needed to confirm and develop our preliminary findings.

Effect of Post IORT Wound Fluid Secretion (PIWFS) on the Behavior of Breast Cancer Cells: Stimulator or Inhibitor; Report of an Experimental Study on Breast Cancer.

BACKGROUND: Although investigating the probable side effects of post intraoperative radiotherapy wound fluid secretion (PIWFS) is crucial, especially in clinical cases, no report has been published on the effect of PIWFS on the remaining tumor cells (in the vital state) in cavity side margins or surrounding regions. These tumor cells might be directly/indirectly exposed to intraoperative radiation therapy (IORT). Here, for the first time, we investigated the effect of PIWFS on tumor cells of the same patient extracted from the excised tumor in the spheroid form. METHODS: We generated 8 human-derived breast tumor spheroids from 4 patient specimens who received to IORT, dissociated and cultured them in microfluidic devices. The spheroids from each sample were treated with the patients' PIWFS and DMEM medium separately. Two different parameters, called area and number of detached cells (NDCs), were determined and investigated to evaluate the spheroids' vital and proliferative states. RESULTS: The results showed severe transformation in tumor spheroids' function into more invasive and proliferative functions after treatment with PIWFS. CONCLUSION: Although the radiation-induced bystander effect may have a role in this observation, further experiments must be done to better clarify the probable desired or non-desired effects of post-IORT secretion for both the remaining tumor cells and the surrounding immune cells.

Comparison of IORT (Radical and Boost Dose) and EBRT in Terms of Disease-Free Survival and Overall Survival according to Demographic, Pathologic, and Biological Factors in Patients with Breast Cancer.

BACKGROUND: The standard treatment for breast cancer is breast-conserving surgery (BCS) with radiotherapy. If external beam radiation therapy (EBRT) can be safely replaced with intraoperative radiotherapy (IORT), it will help patients to save their breast and to have equivocal or better results in DFS and overall survival (OS). METHODS: A total of 2022 patients with breast cancer treated during 6 years were enrolled in the current study. A total of 657, 376, and 989 patients received EBRT, radical, and boost dose by IORT, respectively, according to the IRIORT consensus protocol. The primary endpoint was recurrence and death. The secondary endpoint was the role of variables in recurrence and death. RESULTS: With a mean follow-up of 34.5 and 40.18 months for the IORT and EBRT groups, respectively, there was a significant difference in DFS between electron boost and X-ray boost groups (P=0.037) and the electron radical group compared with EBRT (P=0.025), but there was no significant difference between other boost and radical groups in DFS and OS. CONCLUSIONS: IORT can be a preferred treatment modality because of its noninferior outcomes, and in some special conditions, it has superior outcomes compared to EBRT, particularly in delivering radical dose with IORT.

COVID19 Prevention & Care; A Cancer Specific Guideline.

On March 11th 2020, the coronavirus outbreak was declared a pandemic by the WHO. One of the groups that is considered high risk in this pandemic are cancer patients as they are treated with a variety of immune system suppressor treatment modalities and this puts them in a great risk for infectious disease (including COVID-19). Therefore, cancer patients require higher level measures for preventing and treating infectious diseases. furthermore, cancer patients may bear additional risk due to the restriction of access to the routine diagnostic and therapeutic services during such epidemic. Since most of the attention of health systems is towards patients affected with COVID-19, the need for structured and unified approaches to COVID-19 prevention and care specific to cancer patients and cancer centers is felt more than ever. This article provides the recommendations and possible actions that should be considered by patients, their caregivers and families, physician, nurses, managers and staff of medical centers involved in cancer diagnosis and treatment. We pursued two major goals in our recommendations: first, limiting the exposure of cancer patients to medical environments and second, modifying the treatment modalities in a manner that reduces the probability of myelosuppression such as delaying elective diagnostic and therapeutic services, shortening the treatment course, or prolonging the interval between treatment courses.

Bioinformatics Analysis of Key Genes and Pathways for Medulloblastoma as a Therapeutic Target

Introduction: One of the major challenges in cancer treatment is the lack of specific and accurate treatment in cancer. Data analysis can help to understand the underlying molecular mechanism that leads to better treatment. Increasing availability and reliability of DNA microarray data leads to increase the use of these data in a variety of cancers. This study aimed at applying and evaluating microarray data analyzing, identification of important pathways and gene network for medulloblastoma patients to improve treatment approaches especially target therapy. Methods: In the current study, Microarray gene expression data (GSE50161) were extracted from Geo datasets and then analyzed by the affylmGUI package to predict and investigate upregulated and downregulated genes in medulloblastoma. Then, the important pathways were determined by using software and gene enrichment analyses. Pathways visualization and network analyses were performed by Cytoscape. Results: A total number of 249 differentially expressed genes (DEGs) were identified in medulloblastoma compared to normal samples. Cell cycle, p53, and FoxO signaling pathways were indicated in medulloblastoma, and CDK1, CCNB1, CDK2, and WEE1 were identified as some of the important genes in the medulloblastoma. Conclusion: Identification of critical and specific pathway in any disease, in our case medulloblastoma, can lead us to better clinical management and accurate treatment and target therapy.

Evaluation of Silibinin Effects on the Viability of HepG2 (Human hepatocellular liver carcinoma) and HUVEC (Human Umbilical Vein Endothelial) Cell Lines.

Human hepatocellular carcinoma is one of the most common recurrent malignancies since there is no effective therapy for it. Silibinin, a widely used drug and supplement for various liver disorders, demonstrated anti-cancer effects on human hepatocellular carcinoma, human prostate adenocarcinoma cells, human breast carcinoma cells, human ectocervical carcinoma cells, and human colon cancer cells. Considering the anti-hepatotoxic activity of silibinin and its strong preventive and anti-cancer efficacy against various epithelial cancers, we investigated the efficacy of silibinin against human HCC and HUVEC cell lines. Silibinin effects on the growth and mode of cell death of these two cell lines are presented in this paper. HepG2 and HUVEC cells were incubated with different doses of silibinin (12.5, 25, 50, 100, 150 and 200 µg/mL) at 24, 48, and 72 h. Cytotoxicity was assessed using MTT and Trypan blue assays. Mode of cell death induced by silibinin was investigated using LDH assay and acridine orange/PI double dye staining. The results showed that silibinin has dose-dependent inhibitory effect on the viability of HepG2 and HUVEC cells. However, Silibinin causes a more continuous dose-dependent cytotoxicity in HepG2 cells compared to the HUVEC cells in which some degrees of resistance is apparent at the beginning. The mode of cell death looks also different in these two cell lines with HepG2 cells being more in favor of apoptosis while necrosis is more evident for the HUVEC cells.

Evaluating the Prevalence of the Epidermal Growth Factor Receptor in Transitional Cell Carcinoma of Bladder and its Relationship With Other Prognostic Factors.

BACKGROUND: The most common malignancy in the urinary system has been bladder cancer and the most predominant histologic subtype has been transitional cell carcinoma (TCC). There were many molecular risk factors, related with poor prognosis. One of these factors was expression of epidermal growth factor receptor (EGFR). OBJECTIVES: The aim of this study was to evaluate the prevalence of the epidermal growth factor receptor in transitional cell carcinoma of bladder and its relationship with other prognostic factors. PATIENTS AND METHODS: This analytic descriptive study has performed with 61 patients with TCC of bladder after radical cystectomy whom have been hospitalized in Labbafinejad hospital in Tehran, Iran between 2007 and 2010. We have used Chi-square and t-test to analyze our data samples. RESULTS: Records of 61 patients have studied. Fifty three of the total samples were positive for EGFR expression (86.9%). Fifty samples of these fifty-three belonged to men and three others were women's samples (P = 0.46). Among the group with EGFR expression the results were as follows: 25 patients (47.2%) were 60 years old or less and 28 patients (52.8%) were older than 60 (P = 0.023), 16 patients (30.2%) had invasion to lamina properia, and the rest of them had invasion to deeper layers (P = 0.56). For most patients we could not determine the invasion of tumoral cells into the lymph nodes (Nx) (P = 0.067). Thirty four patients (64.2%) had not lymphovascular invasion (P = 0.44) and in forty three of patients (81.1%), perineural invasion have not seen (P = 0.23). Finally, 36 patients (67.9%) were grade 3 (P = 0.27). CONCLUSIONS: In this study we have concluded that most patients had EGFR positive expression. Also, except for the age, there was not any significant relation between expression of EGFR and the other prognostic factors such as, gender, invasion of the tumor into the layers, involving the lymph nodes, lymphovascular or perineural invasion, and grading.

Gaussian-Based Hue Descriptors.

A robust and accurate hue descriptor that is useful in modeling human color perception and for computer vision applications is explored. The hue descriptor is based on the peak wavelength of a Gaussian-like function (called a wraparound Gaussian) and is shown to correlate as well as CIECAM02 hue to the hue designators of papers from the Munsell and Natural Color System color atlases and to the hue names found in Moroney's Color Thesaurus. The new hue descriptor is also shown to be significantly more stable under a variety of illuminants than CIECAM02. The use of wraparound Gaussians as a hue model is similar in spirit to the use of subtractive Gaussians proposed by Mizokami et al., but overcomes many of their limitations.

Rethinking Colour Constancy.

Colour constancy needs to be reconsidered in light of the limits imposed by metamer mismatching. Metamer mismatching refers to the fact that two objects reflecting metameric light under one illumination may reflect non-metameric light under a second; so two objects appearing as having the same colour under one illuminant can appear as having different colours under a second. Yet since Helmholtz, object colour has generally been believed to remain relatively constant. The deviations from colour constancy registered in experiments are usually thought to be small enough that they do not contradict the notion of colour constancy. However, it is important to determine how the deviations from colour constancy relate to the limits metamer mismatching imposes on constancy. Hence, we calculated metamer mismatching's effect for the 20 Munsell papers and 8 pairs of illuminants employed in the colour constancy study by Logvinenko and Tokunaga and found it to be so extensive that the two notions-metamer mismatching and colour constancy-must be mutually exclusive. In particular, the notion of colour constancy leads to some paradoxical phenomena such as the possibility of 20 objects having the same colour under chromatic light dispersing into a hue circle of colours under neutral light. Thus, colour constancy refers to a phenomenon, which because of metamer mismatching, simply cannot exist. Moreover, it obscures the really important visual phenomenon; namely, the alteration of object colours induced by illumination change. We show that colour is not an independent, intrinsic attribute of an object, but rather an attribute of an object/light pair, and then define a concept of material colour in terms of equivalence classes of such object/light pairs. We suggest that studying the shift in material colour under a change in illuminant will be more fruitful than pursuing colour constancy's false premise that colour is an intrinsic attribute of an object.

The efficacy of Radachlorin-mediated photodynamic therapy in human hepatocellular carcinoma cells.

BACKGROUND: Photodynamic therapy (PDT) is a relatively novel modality for the treatment of cancer and some non-malignant lesions. PDT uses a photosensitive drug and light to destroy malignant cells. The aim of this study was to determine in vitro efficacy of Radachlorin-based PDT (Radachlorin-PDT) on human hepatocellular carcinoma (HCC). METHODS: The study used human liver cancer cells (HepG2) and normal liver cells (HFLF-PI4) to evaluate cell viability using the standard 2-(4, 5-dimethyl-2-thiazolyl)-3,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The mechanism of cell death following Radachlorin-PDT was determined by DNA agarose gel electrophoresis and flow cytometry. RESULTS: Radachlorin without light irradiation had no toxic effect on HepG2 and HFLF-PI4 cells. Cell survival of HepG2 and HFLF-PI4 cells were decreased following PDT in a concentration-dependent manner. However, HepG2 cells were much more sensitive to Radachlorin-PDT than HFLF-PI4 cells. Radachlorin LD50 on HepG2 cells was 30µg/ml and 20µg/ml, 24h after exposure to doses of 5J/cm(2) and 15, or 25J/cm(2), respectively. Optimal Radachlorin and light dose to kill HepG2 cells with minimal effects on normal HFLF-PI4 cells were 100µg/ml and 15J/cm(2), respectively. Our results also showed that apoptosis is induced in HepG2 cells following Radachlorin-PDT. CONCLUSION: Our in vitro data suggest that the use of PDT with Radachlorin can be effective in the treatment of HCC.

Frequency of Human Papillumavirus among Women with High-Grade Squamous Intraepithelial Lesions and Invasive Cervical Cancer Attending Shahid Beheshti University of Medical Sciences Clinics, Tehran, Iran.

BACKGROUND: The previous studies reported some information about prevalence release of high-risk HPV types in HSIL or cervical cancer globally and in Iran, however, this information is not enough for final judgment about vaccination against HPV or any screening program. The aim of the present study was to assess the HPV type distribution in HSIL and ICC specimens of women attending Shahid Beheshti University of Medical Sciences teaching hospitals, Tehran, Iran for treatment during 10 years. METHODS: This retrospective- descriptive study evaluated the HPV type distribution of pathologic specimens of Iranian women with invasive cervical cancer (ICC) and high-grade squamous cell intraepithelial lesions (HSIL). Formalin-fixed tumor biopsies that were retrieved from women presenting with histological confirmation for ICC and 17 pathologic confirmation for HSIL specimens. RESULTS: The most frequently identified HPV type 16 among both groups, women with invasive cervical cancer (4-2.18%) and women with High Grade Squamous Intraepithelial Lesion (29.41%), followed by HPV18, HPV31 and 26. HPV16 and / or 18 accounted for 82.2% of all infected samples. CONCLUSION: The dominance of HPV16 over other high-risk types might be even higher than in a region with low HPV exposure. However, there was no strong evidence for any judgment that show to the policy makers; which one is cost-effectiveness and feasibility for cervical cancer prevention in Iran, vaccination, screening or both? More population based study and national meta-analysis needed for better understanding of HPV prevalence and HPV DNA patterns in Iran.

Survival rate of breast cancer based on geographical variation in iran, a national study.

BACKGROUND: Breast cancer is the most common cancer among women worldwide. Based on the latest Iranian national cancer department report, the total number of women registered with breast cancer was 6976 cases during 2007. Five year survival is one of the indicators used for evaluation of the quality for care to different types of malignancies including breast cancer. OBJECTIVES: The aim of this study was to estimate survival rate of breast cancer in 6147 Iranian patients at a national level in different geographic regions. MATERIALS AND METHODS: 6147 cases of breast cancer, which had telephone number and were diagnosed between 2001-2006, were called to obtain information about their life status. Survival estimates were calculated using the Kaplan-Meier method, and the survival probability was calculated for the overall cohort and in different categories of gender, age and pathologic type of tumor. Hazard ratios (HR) according to demographic and risk variables were calculated by Cox's proportional hazard model. RESULTS: The overall 5-year survival rate was 71.0%. The mean survival time was different between men and women, which was statistically significant. The number of men involved with breast cancer was 172 (2.8%) of all cases. The 5-year survival rate for patients in age group 41-50 years was significantly higher than other age groups (P = 0.001). The likelihood of death was higher in patients with 61 years old or more years rather than those below forty years old (HR = 1.31; 95% CI: 1.12-1.55). CONCLUSIONS: THE FINDINGS OF THIS STUDY MIGHT HELP IRANIAN HEALTH MANAGERS: 1) to be more conscious about geographical and regional determinants which will affect overall survival rate. 2) To carry preventive activities such as public education particularly in Iranian men. 3) To think about screening and early detection of breast cancer.

A multicentre cross-sectional study of arm lymphedema four or more years after breast cancer treatment in Iranian patients.

BACKGROUND: We performed a cross-sectional multicentre study to assess the prevalence of lymphedema after breast cancer treatment in Iran. PATIENTS AND METHODS: All female breast cancer patients who attended our follow-up clinics four or more years after their surgery with no sign of disease were asked to participate in this study. Lymphedema was defined as an increase of 10% in the circumference of the arm on the involved side compared to the opposite arm. RESULTS: The total number of patients participating in this study was 355. The prevalence of lymphedema in the study patients was 17.5%, with the rate varying significantly (between 4 and 21%) among the three study centres (p = 0.007). The mean number of months post surgery was larger for patients with lymphedema (84 months) than for those without (79 months), though this was not statistically significant (p > 0.1). The relationships of various treatment factors and the education levels of the patients to the presence of lymphedema were also evaluated. None of the observed differences were statistically significant aside from those for the type of surgery (mastectomy vs. conservative surgery, p = 0.055), treatment with radiotherapy (p = 0.099), and prescription of a supraclavicular radiation field (p = 0.057), which were only just significant. CONCLUSION: The rate of lymphedema in our patients was 17.5%, ranging from 4 to 21% in different study centres. Time post surgery, treatment with radiotherapy and the technique used, and nodal radiation seem to be factors that are related to this large variation.

Relation between HER-2 gene expression and Gleason score in patients with prostate cancer.

INTRODUCTION: HER-2 is a proto-oncogene of the tyrosine kinase receptor family on chromosome 17. Overexpression of this gene affects the growth and prognosis of some tumors. This study was performed to evaluate the expression of the HER-2 gene in patients with prostate cancer and its relation with the Gleason score. MATERIALS AND METHODS: Pathology specimens of all men with prostate cancer who had undergone radical prostatectomy without any supportive treatment were studied. The Gleason scores of the specimens and the expression of HER-2 gene were examined. The expression of HER-2 was scored between zero and 3+ in accordance with the HercepTest method. Patients with scores of 2+ and 3+ were considered to be positive for HER-2 overexpression. RESULTS: Of 150 cancerous prostate specimens evaluated, 20 (13.3%) were positive for HER-2 gene overexpression. A weakly positive HER-2 overexpression (2+) was seen in 15 of them (75%) and the remaining 5 (25%) were strongly positive. The Gleason score was not different between the HER-2-positive and HER-2-negative patients (P = .08). Fourteen out of 97 patients (14.4%) with a Gleason score less than 7 and 6 out of 53 (11.3%) with scores of 7 or greater were positive for HER-2 overexpression. CONCLUSION: The frequency of HER-2 gene overexpression is not very high in our patients with prostate cancer, and we failed to show any association of HER-2 expression and the Gleason score.