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Background: Breast cancer remains the leading cause of cancer-related deaths among women of all ages. As age increases, so does the risk of both cancer and cardiovascular diseases, heightening the likelihood of short-term and long-term cardiovascular side effects. Therefore, strategies for early diagnosis and prevention of cardiotoxicity are crucial. he optimal use of conventional echocardiographic parameters is important, especially given the limited access to advanced echocardiography in developing countries. Aims: To evaluate changes in left ventricular (LV) ultrasound parameters, including diastolic parameters, in postmenopausal women with breast cancer (BC), as a high-risk group receiving anthracycline-trastuzumab-containing regimens. Study Design: A prospective 24-month single-center study. Place and Duration of Study: From December 2019 to March 2024 at the ultrasound laboratory of Tbilisi State University Medical Center, Tbilisi, Georgia Methodology: Seventy-four postmenopausal patients with primary BC receiving anthracycline or anthracycline-trastuzumab were assessed for LV systolic and diastolic parameters before the anticancer therapy and at six subsequent visits. Cardio-protection was administered to high-risk patients preventively and to others when cardiotoxicity developed. Multiple regression was used to estimate relationships between various independent and dependent variables. Cardiotoxicity was assessed using survival analysis tools (Kaplan-Meier curves and Cox proportional model). Results: The two-year CTRCD survival rate was 63.5%. During the 2-year follow-up, the mean E/e' increased across the entire cohort, but remained within the normal range. E/e' >15 was noted only in CTRCD patients at 6th month mark (4.1%, n=3, P=.056) within the high-risk group, peaking at 9th month (10.8%, n=8, P< .00). Multiple regression indicated a significant association of IVRT baseline value with late cardiotoxicity (adj. beta-coefficient= 0.32; t = 2.73, P=.008) and DT baseline value with early cardiotoxicity (adj. beta-coefficient = -0.25; t = -3.31, P=0.002). GLS demonstrated predictive value from the first month in 13.5% of the cohort and in 34.5% of patients with CTRCD (P< .00). Conclusion: Our 2-year longitudinal prospective study of anthracycline–trastuzumab-containing regimens in postmenopausal women with early BC revealed that: 1) Predictive association of E/e' with cardiotoxicity was not detected. 2) A reliable association with late cardiotoxicity (T7) from the diastolic parameters was revealed only by IVRT baseline value 3) A reliable association with early cardiotoxicity (T4) from diastolic parameters was revealed only by DT baseline. 4)GLS is superior to E/e' in its prognostic value and diagnostic ability of cardiotoxicity .

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Cancer is a multifactorial, multi-step process of pathogenesis; however, in the case of familial cancers, genetic aetiology can play a significant role. Identifying genetic variants in cancer patients having a strong family history of cancer as well as their unaffected blood relatives can unravel their role in predisposition to cancer. Here, we report the findings of whole-exome sequencing in a patient (77/F) diagnosed with ovarian cancer and her daughters (61/F) and (59/F) who were diagnosed with breast and ovarian cancers along with her asymptomatic son (53/M). All the four family members show segregation of RAD51D (rs200564819). Other incidental findings ADAMTS13 (rs142572218) and SYCE1 (rs201873178) genetic variants in proband and son, and LIAS (rs546751789) and PDHA1 (rs747051654) genetic variants in son have also been reported.

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Abstract Introduction : Breast cancer is still one of the main causes of cancer mortality in women worldwide, and death rates are even greater in vulnerable populations. A delay in diagnosis usually comes with advanced-stage disease, which impacts patient survival. The aim of this study was to evaluate the time for first medical consul tation among women with breast cancer attending the Magdalena V. de Martínez Hospital and to determine the causes that may influence patient delay and its impact on cancer stage at diagnosis. Materials and methods : Three hundred and six breast cancer patients were interviewed using a self-report questionnaire, and socioeconomic and demographic variables, namely, highest education level completed, employment status and breast cancer awareness, were collected. The answers were associated with patient clinical records, such as clinical staging and tumor size. Results : Forty-nine percent of the patients were diag nosed with advanced-stage disease. These women had either a deficiency in breast cancer awareness, did not visit a gynecologist after age 40 or, were unemployed, while those patients diagnosed with early-stage breast cancer had nonpalpable tumors, declared a sufficient household income or delayed less than four weeks in seeking medical attention. Moreover, the delay in the first medical visit was more than one month in 78% of the patients, being disregard the most common cause of postponement. Additionally, patient delays were associ ated with larger tumors and with incomplete education. Discussion : These results indicate that early detec tion efforts should be made to reduce the disease stage at diagnosis, which may impact on overall survival.

Resumen Introducción : El cáncer de mama (CM) es una de las principales causas de mortalidad por cáncer en mujeres, y las tasas de mortalidad son aún mayores en poblaciones vulnerables. Un retraso en el diagnós tico suele acompañarse con estadios avanzados de la enfermedad, lo que impacta en la supervivencia del paciente. El objetivo fue evaluar el tiempo transcurrido para la primera consulta médica entre mujeres con CM que asisten al Hospital Magdalena V. de Martínez y determinar las causas que pueden influir en la demora del paciente y su impacto en el estadio al momento del diagnóstico. Materiales y métodos: Se entrevistaron 306 pacientes con CM utilizando un cuestionario autoinformado, y se recopilaron variables socioeconómicas y demográficas, entre ellas, nivel educativo más alto completado, situa ción laboral y conocimiento sobre el CM. Las respuestas se asociaron con los registros clínicos de las pacientes. Resultados : El 49% de las pacientes fueron diag nosticadas con enfermedad en estadios avanzados. Estas mujeres tenían deficiencias en el conocimiento sobre el CM, no consultó al ginecólogo después de los 40 años o estaba desempleada, mientras que aquellas diagnosticadas con CM en estadios tempranos tenían tumores no palpables, declaraban un ingreso familiar suficiente o demoraban menos de cuatro semanas en buscar atención médica. Además, la demora en la pri mera visita médica fue de más de un mes en el 78% de las pacientes, siendo el desinterés la causa más común de postergación. Asimismo, las demoras estaban aso ciadas con tumores más grandes y con una educación incompleta. Discusión : Este estudio sugiere la necesidad de desa rrollar estrategias de sensibilización y educación sobre el CM, así como de políticas para mejorar el acceso a la atención médica, especialmente para poblaciones vulne rables, con el fin de reducir el retraso en el diagnóstico y mejorar la salud de las pacientes con CM.

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Introducción Las sobrevivientes de cáncer de mama suelen ver afectada negativamente su calidad de vida por síntomas físicos y psicológicos pre y post tratamiento. La práctica regular de ejercicio físico se asocia a mejor calidad de vida y menor recurrencia del cáncer, por esto es recomendado a todos los pacientes oncológicos. Sin embargo, existe baja adherencia a este. El propósito de este artículo es identificar barreras, facilitadores y preferencias de sobrevivientes de cáncer de mama chilenas para realizar ejercicio físico. Métodos Estudio cualitativo fenomenológico, basado en entrevistas en profundidad a 12 sobrevivientes de cáncer de mama que terminaron la radioterapia adyuvante hace tres o más meses. Resultados Las sobrevivientes de cáncer de mama desconocían la importancia del ejercicio físico durante y después del tratamiento. Las barreras identificadas fueron síntomas físicos, barreras psicológicas, socioculturales, del sistema de salud; desinformación y sedentarismo. Los facilitadores fueron físicos, psicológicos, contar con información y práctica de ejercicio físico antes del diagnóstico. Las preferencias fueron ejercicios indoloros y familiares. El ejercicio preferido fue caminar. Conclusiones Es posible que las sobrevivientes de cáncer de mama adhieran al ejercicio físico, a pesar de las barreras cuando hay ciertos facilitadores presentes. Estos pueden ser generados por el equipo médico al informar los beneficios del ejercicio físico, prescribir ejercicio físico personalizado, seguro e indoloro y educar a la paciente y a su familia sobre el rol del ejercicio físico en la recuperación de sobrevivientes de cáncer de mama.

Introduction Breast cancer survivors often experience pre and post-treatment physical and psychological symptoms, negatively affecting their quality of life. Regular physical exercise is associated with better quality of life and lower recurrence of cancer, and therefore all oncological patients are recommended to practice it in a regular basis. Despite this, breast cancer survivors have low adherence to physical exercise. The purpose of this study is to identify barriers, facilitators and preferences of Chilean breast cancer survivors to practice physical exercise. Methods Phenomenological qualitative study of 12 in-depth interviews with adjuvant radiation therapy concluded at least three months ago. Results Breast cancer survivors ignored the benefits of physical exercise during and after treatment. The barriers were physical symptoms, psychological barriers, sociocultural barriers, health system barriers, disinformation and sedentary lifestyle. Facilitators were coping with physical symoptoms, psychological issues, having information and active lifestyle. The preferences were painless and familiar exercises. Preferred exercise was walking. Conclusions Breast cancer survivors may adhere to physical exercise despite barriers when certain facilitators are present, which may be promoted by the health team when reporting the benefits of the physical exercise, prescribing personalized, safe and painless physical exercise and educating both patient and her family about the role of the physical exercise in cancer recovering process.

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Background: Presenting advanced breast cancer in Sudan is a significant challenge. Consequently, the objective of this investigation was to evaluate the breast lesion pattern in Western Sudan. Methodology: This study was a retrospective descriptive analysis carried out in two major entities that offer histopathology services in the northern region of Kordofan State. The study encompassed a total of 190 patients, with 110 of them having malignant lesions and 79 having benign breast lesions. Results: Among the 110 cases of breast cancer, 59% were classified as invasive ductal carcinoma (DC), 12.7% as infiltrating DC, and 9% as invasive lobular carcinoma (LC). We identified 37.9% of the 79 non-cancerous growths as fibroadenoma, 25.3% as fibrocystic changes, and 6.3% as Phyllodes tumors. Conclusion: In Sudan, the advanced presentation of breast cancer is common. When a patient presents with a lump, the likelihood of a malignant diagnosis is higher. Breast cancer is a significant concern for younger Sudanese women, particularly those under the age of 45 years.

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Background: Many methods have been developed for localizing non?palpable breast lesions. This study investigated the success rate and surgical results of the magnetic seed (Magseed) and radiofrequency identification (RFID) method, which are relatively new compared to standard wire?guided localizations. Materials and Methods: 20 simulation (10 Magseed, 10 RFID) models were created using turkey breasts and raisins. Raisins containing magnetic seed and RFID tags were placed on the turkey breast. Sentimag® probe was used for the Magseed group, and Faxitron LOCalizer™ System device was used in the RFID group. Both methods were evaluated in terms of accuracy in detecting breast lesion localization, operation times, excised tissue weights, total resection volume, surgical margin negativity, and re?excision rates. Results: Lesion localization success in both techniques was 100%. While procedure times were statistically significantly shorter in the Magseed group, incision lengths were shorter in the RFID group (P = 0.013, P = 0.007, respectively). No statistically significant difference was found between the groups for the weight of the removed parts, total resection volume, and surgical margin distance (P > 0.05). Conclusion: In this feasibility study, it was concluded that neither the RFID nor Magseed methods had a significant advantage over each other, in terms of localization detection and surgical margin negativity, and both methods could be used successfully for localization.

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Background: Breast cancer (BC) has become the most common cancer among women in India. Both amlodipine, belonging to calcium channel blockers, and nebivolol, belonging to the beta blockers class have proven anticancer mechanisms. However, the effect has not been compared between these drugs till now. Aim and Objectives: The present study aims to compare the antiproliferation effects of amlodipine and nebivolol against human breast adenocarcinoma MCF-7 cells. Materials and Methods: Cell viability assay was used to screen the antiproliferation effects of the study drug molecules in MCF-7 cell cultures. The IC50 values were derived graphically by plotting the cell viability against drug concentration. Results: Both amlodipine and nebivolol exhibited dose-dependent cytotoxicity against BC cells. The IC50 of amlodipine was 166.6 ?g/mL and nebivolol was 114.6 ?g/mL. Conclusion: In this study, nebivolol showed potent cytotoxicity compared to amlodipine. This inference may provide further insights into future drug research.

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Background & Objective: Cancer is a serious public health concern, particularly in developing countries. The current investigation was to discover novel EGFR and aromatase inhibitors utilizing ligand- and structure-based drug development techniques. This study also focuses on the antimicrobial action of the designed compounds. In- vitro Anti-microbial evaluation of the designed compounds was assessed. Materials and Methods: A series of triazine based aldehyde substituted derivatives were designed and molecular docking studies were carried out against Aromatase inhibitors, HER-2, Dihydrofolate reductase targets by using Autodock 1.5.6. The designed compounds were synthesized by condensing triazine with various aldehydes and characterised using Mass spectrometry. In vitro Antimicrobial activity was studied for the synthesized compounds against the standard drug Ampicillin. Results and Discussion: In silico study revealed that the designed compound had a 3D structure that is comparable to other well-studied anti breast cancer proteins. According to molecular docking, proteins exhibit high binding energy to enzymes. Minimum inhibitory concentration validated the efficiency of the designed compounds utilised for antibacterial activity testing. Antimicrobial susceptibility tests revealed that the compounds have an antimicrobial action. Conclusion: The present study suggests that the synthesized compounds possessing drug-like properties as a plausible therapeutic candidate against microbial activity. However, the designed compounds could be employed as inhibitors of EGFR and aromatase after passing through in vivo and in vitro evaluation.

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Primary signet ring cell carcinoma (SRCC) of the breast is a rare and aggressive type of breast cancer characterized by increased intracellular mucin production. It has a high risk of metastasis and poor prognosis compared to other breast cancer types. We report a 56?year?old woman with primary SRCC of the breast who first presented with retraction on her left breast. Radiological examination revealed a mass that causes the retraction. The patient underwent left modified radical mastectomy, and pathology results showed a 70% signet ring cell pattern. Chemotherapy consists of an adriamycin?cyclophosphamide regimen administered. in this case, we aim to review the literature on this topic and inform the physicians.

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Nanoporous glass (NPG) microparticles were produced by conventional melt-quenching followed by acidalkali leaching to get material for anticancer drug carriers. NPG exhibited a positive zeta potential of 34 mV after [3-(2-aminoethylamino) propyl] trimethoxysilane treatment. The specific surface area and the total pore volume of NPG were 47.3 m2 /g and 0.692 cm3 /g, respectively. The 5-Fluorouracil (5FU) loading capacity of NPG was measured as 18.2 ± 0.2 mg5FU/gNPG. The drug release rate was monitored for 120 hours. To evaluate the cytotoxic effects of NPG on both MCF-7 breast cancer cells and MCF-12A, an immortalized cell line, the study employed the 2,3-bis [2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium5-carboxanilide inner salt (XTT) assay. The XTT results revealed that NPG showed a time and concentration-dependent cytotoxic effect. It is anticipated that NPG is a safe and effective material for drug delivery systems for in vitro and a promising alternative material for in vivo applications.

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Circadian clocks, biochemical oscillators that are regulated by environmental time cues including the day/night cycle, have a central function in the majority of biological processes. The disruption of the circadian clock can alter breast biology negatively and may promote the development of breast tumors. The expression status of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) were used to classify breast cancer into different molecular subtypes such as triple-negative breast cancer (TNBC). Receptor status-dependent expression of circadian clock genes have been previously studied in breast cancer using relatively small sample sizes in a particular population. Here, using TCGA-BRCA data (n=1119), we found that the expressions of CRY1, PER1, PER2, PER3, BMAL1, CLOCK, RORA, RORB, RORC, NR1D1, NR1D2, and FBXL3 were higher in ER+ breast cancer cells compared with those of ER? status. Similarly, we showed that transcript levels of CRY2, PER1, PER2, PER3, BMAL1, RORA, RORB, RORC, NR1D1, NR1D2, and FBXL3 were higher in PR+ breast cancer cells than in PR? breast cancer cells. We report that the expressions of CRY2, PER1, BMAL1, and RORA were lower, and the expression of NR1D1 was higher, in HER2+ breast cancer cells compared with HER2? breast cancer cells. Moreover, we studied these receptor status-dependent changes in the expressions of circadian clock genes also based on the race and age of breast cancer patients. Lastly, we found that the expressions of CRY2, PER1, PER2, PER3, and CLOCK were higher in non-TNBC than in TNBC, which has the worst prognosis among subtypes. We note that our findings are not always parallel to the observations reported in previous studies with smaller sample sizes performed in different populations and organisms. Our study suggests that receptor status in breast cancer (thus, subtype of breast cancer) might be more important than previously shown in terms of its influence on the expression of circadian clock genes and on the disruption of the circadian clock, and that ER or PR might be important regulators of breast cancer chronobiology that should be taken into account in personalized chronotherapies.

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The occurrence of germline mutations within the BRCA1/2 genes has been linked to an elevated vulnerability toward the onset of breast cancer (BC). At present, ongoing clinical trials are being undertaken to evaluate the efficacy of poly(ADP-ribose) polymerase (PARP) inhibitors as a therapeutic intervention for BC, with particular emphasis on their application in the management of BC patients harboring BRCA1/2 gene mutations. The objective of this research was to investigate the presence of different expression genes in BC with BRCA1/2 mutations compared to the wild type and to evaluate the impact of PARP inhibitor therapy on the DEGs. This study utilized two distinct datasets sourced from the Gene Expression Omnibus (GEO) database. The initial datasets utilized in this study were GSE25835 and GSE40115. These datasets were employed to conduct a comparative analysis of differentially expressed genes (DEGs) in BC cases with BRCA1/2 mutations and those with wild-type status. Whereas in the GSE55399 dataset, the DEGs were compared between PARP inhibitor treatment and no PARP inhibitor treatment. The interactions among DEGs were assessed utilizing the search tool for the retrieval of interacting genes/proteins tool and subsequently displayed through the use of Cytoscape software. The molecular complex detection technique was employed for the identification of gene clusters within the interaction network. The DEGs that were discovered were further analyzed for gene ontology (GO) enrichment using Enrichr and CLueGO. Furthermore, the biological pathways linked to these DEGs were examined using REACTOME. We got significant DEGs by using parameter p-value of 0.05; log2FC > 1 and log2FC < ?1. The GO analysis conducted on the DEGs revealed their significant involvement in crucial biological processes and molecular pathways. For datasets GSE25835 and GSE40115, it showed the effect on BRCA1/2 mutations was upregulating cell cycle response and downregulating mRNA splicing. For dataset GSE55399, the impact of PARP inhibitor treatments was upregulating the interferon signaling and downregulating the cytokine signaling. Our study identified hub genes of cell cycle response (CDK1 and BIRC5) that are strongly linked to BRCA1/2 mutation and hub genes of interferon signaling interferon-induced transmembrane 1 (IFITM1) and cytokine signaling (IL11) that are strongly linked to PARP inhibitor treatments in BRCA1/2 mutant carriers. We identified hub genes of cell cycle response (CDK1 and BIRC5) that are strongly linked to BRCA1/2 mutation. PARP inhibitor treatments in BRCA1/2 mutant carriers are strongly related to the upregulation of IFITM1 (interferon signaling) and the downregulation of IL11 (cytokine signaling). Therefore, PARP inhibitors may improve the treatment by activation/modulation the immune system and attenuating the inflammatory response. However, the dataset used to analyze the DEGs of PARP inhibitor treatments in BRCA1/2 mutant carriers still used BC cell lines, forthcoming research may be able to use clinical patients as the subjects. Moreover, functional studies are further needed to validate this finding.

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The gut microbiota is a complex ecosystem of microorganisms that maintains a symbiotic relationship with its host, contributing to digestion, metabolism, and immunity. Studies suggest that the microbiota may play a role in several non-communicable diseases, including certain cancers. It may also influence circulating estrogen levels through enzymes like ?-glucuronidase, which affects estrogen reabsorption and thus increases the risk of breast cancer, especially in postmenopausal women. This study aimed to characterize the microbiota of breast cancer patients in Côte d'Ivoire to identify bacterial markers potentially associated with increased plasma estradiol concentrations. A case-control study was conducted at the Oncology Department of the CHU of Treichville, the National Blood Transfusion Center, and the Institut Pasteur de Côte d'Ivoire, recruiting 85 participants, including 39 patients and 46 controls, both premenopausal and postmenopausal. Characterization of the gut microbiota revealed a significant difference in microbiota diversity between breast cancer patients and controls. Quantification of plasma hormones and the use of the LEfSe algorithm identified eight bacterial genera potentially associated with increased plasma estradiol concentrations. These results open research avenues on the gut microbiota and estrogen levels, which could have significant implications for the prevention, diagnosis, and targeted treatment of breast cancer.

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Objective: The current study aimed to investigate the dynamic changes in brain glymphatic function during chemotherapy in breast cancer patients (BCP) and their correlation with cognitive function. Materials and Methods: A total of 40 healthy female participants (control group) and 80 female BCP were included. Various cognitive assessment tools were used to evaluate cognitive function. Diffusion tensor imaging along the perivascular space was employed to measure brain glymphatic function. Results: Following chemotherapy, BCP exhibited a significant decline in various cognitive scores. After chemotherapy, the along the perivascular space index, a parameter indicating brain glymphatic function, was slightly higher than that at baseline and the control group levels and was correlated with cognitive scores. Conclusion: This study unveiled a close relationship between the dynamic changes in brain glymphatic function after chemotherapy and cognitive function in BCP. Our findings contribute to a deeper understanding of the brain mechanisms underlying chemotherapy?related cognitive impairment and provide a theoretical basis for future interventions and treatments. In addition, they offer a new perspective for exploring the relationship between brain function and cognitive states. KEY WORDS: Brain glymphatic function, breast cancer, chemotherapy?related cognitive impairment (CRCI), diffusion tensor imaging along the perivascular space (DTI?ALPS)

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Resumen La neumatosis intestinal y el neumoperitoneo no son entidades patológicas en sí mismas, son signos radio lógicos que resultan de alguna condición subyacente. En general, estos se asocian con procesos graves intra-abdominales que resultan en cirugías de urgencias con resecciones de intestino. A continuación, presentamos el caso de una mujer de 80 años, con diagnóstico de cáncer de mama estadio IV en tratamiento con ful vestrant y ribociclib, que ingresó a nuestro centro por dolor abdominal y vómitos. Se diagnosticó neumatosis intestinal y neumoperitoneo por lo que se procedió a laparotomía exploradora por sospecha de isquemia intestinal. No hubo evidencia de necrosis o perforación intestinal por lo que no se realizó resección. Evolucionó durante la internación de forma satisfactoria y en el control tomográfico al mes del egreso hubo resolución completa del cuadro. Si bien está descrito esta afectación en relación a los episodios de aumento de presión intraabdominal, como en la emesis, también se describió en pacientes con neoplasias, principalmente del tubo digestivo, ya sea por daño local o por toxicidad asociada a la quimioterapia. No encontramos reportes en la literatura de neumatosis intestinal vinculada a esta medicación antineoplásica en humanos. Probablemente en nuestro caso la etiolo gía haya sido multifactorial. Es posible que el ribociclib haya jugado un rol, ya sea por un mecanismo indirecto asociado a los vómitos y la inmunosupresión o directo sobre el enterocito debido a su mecanismo de acción celular no específico.

Abstract Pneumatosis intestinalis and pneumoperitoneum are not pathological entities in themselves, they are radiological signs that result from some underlying condition. In general, these are associated with serious intra-abdominal processes that result in emergency surgeries with bowel resections. Below, we present the case of an 80-year-old woman, diagnosed with stage IV breast cancer under treatment with fulvestrant and ribociclib, who was admitted to our center due to abdominal pain and vomiting. She was diagnosed with intestinal pneumatosis and pneumoperitoneum, so she underwent exploratory laparotomy for sus pected intestinal ischemia. There was no evidence of intestinal necrosis or perforation, so resection was not performed. She progressed satisfactorily during hospitalization and in the tomographic control one month after discharge there was complete resolution of the condition. Although this condition has been described in relation to episodes of increased intra-abdominal pressure, such as emesis, it has also been described in patients with neoplasms, mainly of the digestive tract, either due to lo cal damage or toxicity associated with chemotherapy. We found no reports in the literature of pneumatosis intesti nalis linked to this antineoplastic medication in humans. Probably in our case the etiology was multifactorial. It is possible that ribociclib played a role, either through an indirect mechanism associated with vomiting and im munosuppression or directly on the enterocyte due to its non-specific cellular mechanism of action.

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Abstract Metastases to the thyroid gland from nonthyroidal malignant tumors are rare but significant. They are often asymptomatic, indicating advanced-stage primary tumors and poor prognosis. Although infrequently, breast cancer (BC) can metastasize to the thyroid gland. We present the case of a 56-year-old woman with a history of BC who pre sented with a nodular goiter. Physical examination and im aging revealed a thyroid nodule and cervical lymph nodes with suspicious features. Fine-needle aspiration biopsy (FNAB) confirmed the presence of atypical epithelial cells in the thyroid nodule and lymph nodes. Further evaluation, including positron emission tomography, histological biop sy, and immunohistochemistry, supported the diagnosis of metastatic BC to the thyroid gland. Due to the local extent of the disease, total thyroidectomy was not feasible. The treatment with ribociclib and letrozole was initiated, but unfortunately, the patient had an unfavorable progression with the development of metastasis in the nervous system. Metastatic carcinoma to the thyroid gland is rare but has increased due to improved diagnostic techniques. BC can metastasize to the thyroid. Diagnosis involves imaging, FNAB, and immunohistochemistry. Treatment options include surgery, radiotherapy, and chemotherapy, but the prognosis is generally poor.

Resumen Las metástasis en la glándula tiroides a partir de tu mores malignos no tiroideos son raras pero significativas. A menudo son asintomáticas, lo que indica tumores primarios en etapas avanzadas y un mal pronóstico. Aunque infrecuentemente, el cáncer de mama puede metastatizar en la glándula tiroides. Presentamos el caso de una mujer de 56 años con antecedente de cáncer de mama que consultó por bocio nodular. El examen físico y las imágenes revelaron un nódulo tiroideo y ganglios linfáticos cervicales con características sospechosas. La punción aspiración con aguja fina confirmó la presencia de células epiteliales atípicas en el nódulo tiroideo y los ganglios linfáticos. Una evaluación adicional, que incluyó tomografía por emisión de positrones, biopsia histológica e inmunohistoquímica, respaldó el diagnóstico de cáncer de mama metastásico en la glándula tiroides. Debido a la extensión local de la enfermedad, no fue factible realizar una tiroidectomía total. Se inició el tratamiento con ri bociclib y letrozol, pero desafortunadamente la paciente tuvo una progresión desfavorable con el desarrollo de metástasis en el sistema nervioso. El carcinoma metas tásico en la glándula tiroides es raro, pero ha aumentado debido a las técnicas de diagnóstico mejoradas. El cáncer de mama puede metastatizar en la tiroides. El diagnóstico implica imágenes, punción aspiración con aguja fina e in munohistoquímica. Las opciones de tratamiento incluyen cirugía, radioterapia y quimioterapia, pero el pronóstico generalmente es desfavorable.

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Abstract: Background: Breast cancer is the second most common malignancy in Indian women. The role of estrogen and progesterone receptors (ER and PR) is well established in predicting the prognosis and management of therapy. However, the role of androgen receptor (AR) expression is unclear in the Indian context. This study aims to evaluate the expression of AR in breast cancer and to find its association with clinicopathological parameters and hormone receptor status like ER, PR, HER2/neu and Ki 67 and also molecular subtypes of breast cancer. Materials and Methods: A retrospective study included 64 patients of histopathologically proven breast cancer with known hormone receptor and Ki 67 status. Demographic and histopathologic details were retrieved. Immunohistochemistry for AR was done and was correlated with clinicopathological parameters and hormone receptor status, Ki 67 status and molecular subtypes of breast cancer to find its association. P value <0.05 was considered significant. Results: AR expression was noted in 67.2% of the cases. Out of 42 ER positive and 33 PR positive cases, 34 (81%) and 27 (81.8%) showed AR expression respectively. AR positivity was noted in 30.8% of triple?negative tumors. AR expression was significantly associated with ER (P=0.001 ), PR (p=0.010), Luminal B (P=0.002) and triple negative cancer patients (p =0.003). No significant association was found with pathological parameters studied like laterality, tumor size, histological type, grade, lymphovascular invasion and lymph node status. Conclusion: We conclude that breast cancer express AR which is significantly associated with ER and PR and is significantly expressed in Luminal B and triple negative cases. Since a subset of triple negative cases showed positive AR expression, further studies are required to determine whether AR could be of therapeutic target in these patients.

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Aims: To explore the impact of seroma volume reduction on dosimetry during whole breast radiation therapy (WBRT) and evaluate the significance of adaptive planning. Presentation of Case: A 71-year-old female with left breast invasive carcinoma underwent lumpectomy and radiotherapy. An initial CT (CT1) six weeks taken post-op showed a seroma cavity, and a second CT (CT2) five weeks later documented a 65% seroma volume reduction (from 217 c.c. to 75 c.c.). Five radiotherapy techniques were evaluated: two-field conventional, three-field conventional, forward IMRT, inverse IMRT, and VMAT. Inverse IMRT and VMAT achieved better high-dose coverage and reproducibility but had larger dose variations. They also showed higher maximum doses and increased hot spot volumes, indicating potential overdosage risks. Conventional techniques provided stable lower-dose coverage but less uniform high-dose distribution compared to IMRT and VMAT. Discussion: The significant reduction in seroma volume affected dosimetry, highlighting the importance of adaptive planning. In this case, daily KV and weekly MV imaging were used for alignment, but CBCT may better monitor seroma changes. Adaptive radiotherapy, repeated CT simulations, and CBCT are essential for effective treatment. Further research should focus on improving treatment precision through advanced imaging and radiotherapy technologies. Conclusion: This single WBRT case highlights the dosimetric impact of seroma reduction and the importance of imaging and adaptive strategies. Advanced techniques like inverse IMRT and VMAT improve precision but need careful IGRT monitoring. These findings emphasize the need for individualized adaptive planning considerations and further research to optimize protocols for managing seroma volume changes during WBRT.

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RESUMEN Introducción. Este artículo presenta un resumen de la guía de práctica clínica (GPC) para el tamizaje de cáncer de mama en el Seguro Social del Perú (EsSalud). Objetivo. Brindar recomendaciones clínicas fundamentadas en la evidencia para el tamizaje de cáncer de mama en EsSalud. Métodos. Se conformó un grupo elaborador de la guía (GEG) compuesto por especialistas médicos y metodólogos. El GEG formuló 5 preguntas clínicas a ser respondidas en esta GPC. Durante 2022, se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando fue necesario, de estudios primarios en PubMed y Cochrane CENTRAL. La evidencia fue seleccionada para responder cada una de las preguntas. La certeza de la evidencia fue evaluada mediante la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones periódicas, el GEG utilizó la metodología GRADE para revisar la evidencia y desarrollar las recomendaciones, puntos de buenas prácticas clínicas y el flujograma de tamizaje. La GPC fue aprobada mediante la Resolución N° 98-IETSI-ESSALUD-2022. Resultados. Esta GPC abordó 5 preguntas clínicas relacionadas con el examen físico y el uso de métodos de diagnóstico por imágenes para el tamizaje de cáncer de mama, resultando en la formulación de 8 recomendaciones (2 fuertes y 6 condicionales), 7 puntos de buenas prácticas clínicas, y un flujograma. Conclusión. Este artículo resume la metodología empleada y los hallazgos basados en evidencia de la GPC para el tamizaje de cáncer de mama en EsSalud.

ABSTRACT Introduction. This article provides an overview of the clinical practice guideline (CPG) for breast cancer screening in the Social Security of Peru (EsSalud). Objective. To offer evidence-based clinical recommendations for breast cancer screening within EsSalud. Methods. The CPG for breast cancer screening was developed by establishing a guideline development group (local GDG) consisting of medical specialists and methodologists. The local GDG formulated 5 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and, when it was considered pertinent, primary studies were conducted in Pubmed and Cochrane CENTRAL during 2022. The evidence to answer each of the posed clinical questions was selected. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of screening Finally, the CPG was approved with Resolution No. 68-IETSI-ESSALUD-2022. Results. The CPG examined 5 clinical questions related to physical examination and diagnostic imaging for breast cancer screening. This led to the development of 8 recommendations (2 strong and 6 conditional), 7 best practice points, and 1 flowchart. Conclusion. This article outlines the methodology and evidence-based findings of the CPG for breast cancer screening at EsSalud.

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Objective: Cancer being a deadly disease and global threat, necessitate the use of anticancer agents. Hence, continuous Adverse Drug Reaction (ADR) reporting should be carried out in the oncology departments of health care systems. The objective of the study was to assess commonly prescribed anticancer agents and report ADRs associated with the anticancer treatment. Material and Method: This observational, cross-sectional study was done in the Radiotherapy department of a tertiary care teaching hospital for a period of three months. Female Patients of breast carcinoma attending Radiotherapy department for chemotherapy were included. Patients were enquired about occurrence of any ADRs and details were noted. Preventability and severity of ADRs were assessed by modied Schumock and Thornton scale. Result: A total of 60 patients were included in the study. Nausea was the most commonly reported ADR followed by tingling of feet, vomiting, alopecia and abdominal pain. Conclusion: Inspite of various prophylactic antiemetic treatment majority of patients had nausea and vomiting which indicates that more vigorous prophylactic measures to prevent emesis need to be undertaken since these ADRs of the antineoplastic drugs are usually preventable.