Accuracy Rate of Methylene Blue Injection in Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer Patients: A Prospective Observational Study.

Objective: Breast cancer is the most prevalent cancer in women and can spread to the lymph nodes in the axilla. The sentinel lymph node is the first lymph node to be targeted for the spread or metastasis of cancer cells involving the lymph nodes. The aim of this study is to compare the accuracy rate of methylene blue injection into sentinel lymph nodes in early-stage breast cancer patients who have undergone incisional and excisional biopsies. Methods: This is a prospective observational study conducted in two general hospitals in West Java, Indonesia. The research subjects in this study were early-stage breast cancer patients with no lymph node metastasis (N0) who had undergone a biopsy. There were 83 study subjects included in this study. The sentinel lymph node biopsy was taken after injection of methylene blue into the peritumoral area. Blue nodes in the axilla were marked as positive lymph node biopsy results and sent for histopathology examination. Results: Patients who underwent excisional biopsy surgery had a sensitivity rate of 85.3% and a specificity of 93.3%, while the accuracy rate in patients who underwent incisional biopsy surgery had a sensitivity rate of 79.2% and a specificity of 80%. Conclusion: There was no difference in the accuracy of SLNB using methylene blue in patients with early-stage breast cancer with N0 who had a history of incisional and excisional biopsy.

Broodstock development, induced spawning and larval rearing of the bilih, Mystacoleucus padangensis (Bleeker, 1852), a vulnerable species, and its potential as a new aquaculture candidate.

Background: Mystacoleucus padangensis living in Lake Singkarak, Indonesia, has high potential market demand but is threatened by overfishing and has not been successfully cultured. This study describes the first broodstock development, induced breeding, and larval rearing of M. padangensis. Methods: A total of 1,000 female and 1,000 male broodfish were collected from the wild and reared in two concrete ponds (128 m 2) at the Centre for Biodiversity Conservation, P.T. Semen Padang, Indonesia. The broodfish were fed commercial feed to satiation at 09:00 and 17:00 h. The females (average weight 7.56 ± 0.85 g) and males (4.86 ± 1.20 g) were selected at a ratio of 1:4 (female:male), and gonad maturation was induced with a single dose of GnRH analogue (Ovaprim) of 0.1 ml/fish. At 16 h after hormone injection, eggs were collected individually into a plastic vessel. Spermatozoa were collected with sterile syringes. Eggs were fertilized using the "dry" method, and 0.5 ml samples (equal to 100 eggs) were taken. The eggs were incubated in a plastic strainer with a water volume of 1.57 litres and placed in a tarpaulin pond with a volume of 150.72 litres. Results: The overall hatching rate was 78.93 ± 4.13%. The newly hatched larvae were 3900.81 µm long, with a yolk sac of 82881.480 µm 2. The mouth opened at 72 days post hatching (DPH) with a gape measuring approximately 61.880 µm. The protocol of larval feeding started with artificial feed, followed by Artemia nauplii up to 30 DPH. Weaning of larvae started at 4 DPH. Larvae started metamorphosis by 15 DPH and ended by 22 DPH when the larvae reached 7430.27 µm. Larval rearing resulted in an average survival rate of 28.4 ± 3.04%. Conclusions: Its successful spawning induction and high larval hatching and survival rates make M. padangensis an excellent aquaculture candidate.

The Role of Lisinopril and Bisoprolol to Prevent Anthracycline Induced Cardiotoxicity in Locally Advanced Breast Cancer Patients.

BACKGROUND: Anthracyclines are a class of chemotherapeutic agents that are used to treat many different cancers, including breast cancer. Although anthracyclines remain an effective and commonly used therapy, their use is limited by cardiotoxicity. Heart failure and left ventricular (LV) dysfunction are the short and long-term complications of anthracyline exposure occurring in 5% to 23% of patients. Recent prospective studies have investigated the prophylactic role of ACE inhibitors and beta-blockers as cardioprotective agents. This study aimed to evaluate whether the addition of lisinopril and bisoprolol could prevent anthracycline induced cardiotoxicity. METHODS: In this randomized, controlled trial, 74 subjects with locally advanced breast cancer were randomly assigned to a group receiving lisinopril and bisoprolol (n=37) or to a control group (n=37). Lisinopril and bisoprolol was started simultaneously 24 h before the first cycle of chemotherapy. The initial dose was 2.5 mg each, once daily, and was increased gradually under close supervision to 10 mg if SBP persistently remained >90 mmHg and HR >60 bpm. Echocardiographic studies were performed before and after the 6th cycle of neoadjuvant anthracycline-based chemotherapy (FAC). The primary endpoint was the change from baseline LVEF. RESULTS: There was no difference in baseline LVEF between intervention and control group (65.77 ± 4.56 % v 65.64 ± 455 %, p = 0.92). There was also no difference in total anthracycline doses between 2 groups (579.48 ± 65.10 mg vs 557.50 ± 47.76 mg, p = 0.18). However, after 6 cycles of FAC, the rate of decline in LVEF was greater in control group (-5.52 ± 8,90 %) than in the intervention group (-0.27 ± 5.73 %) with p = 0.017. No severe adverse effects occurred in the intervention group related to the treatment with lisinopril and bisoprolol. CONCLUSION: Combined treatment with lisinopril and bisoprolol may prevent anthracycline-induced cardiotoxicity in patients with locally advanced breast cancer treated with anthracycline-based chemotherapy. The clinical relevance of this study should be confirmed in larger studies with longer follow up time.

The Ethanol Extract of Marine Sponge Aaptos suberitoides Suppress Cell Viability, Cell Proliferation and Cell Migration in HER2-Positive Breast Cancer Cell Line.

OBJECTIVE: This study aimed to investigate the cytotoxicity, anti-proliferation and anti-migration effect of the ethanol extract of Aaptos suberitoides on trastuzumab-resistant HER2+ breast cancer cell line. METHODS: Aaptos suberitoides was collected from Tinjil Island, Banten, Indonesia, and was processed with maceration and ethanol extraction. HCC-1954 cells were treated with the ethanol extract and then followed by 3- [4, 5-dimethylthiazol-2-yl] -2.5 diphenyl tetrazolium bromide (MTT) assay to assess cytotoxicity, clonogenic assay and three-dimensional (3D) spheroid assay to evaluate anti-proliferative effect in two-dimensional and 3D model, respectively, and wound healing assay to determine anti-cell migration effect. Four parametric regression was used to analyse the IC50. RESULTS: This study revealed that the ethanol extract of Aaptos suberitoides suppressed cell viability in correlation with cell death induction. The IC50 values of the ethanol extract of Aaptos suberitoides using MTT assay and clonogenic assay were 12.0 ppm and 4.36 ppm, respectively. The extract demonstrated an inhibition effect on spheroid growth. In low concentration, the extract of Aaptos suberitoides inhibited cell migration. Furthermore, MS analysis showed that the most abundant compounds in this extract has molecular weight m/z 229.81 [M+H]+. CONCLUSION: This study revealed that the ethanol extract of Aaptos suberitoides demonstrates cytotoxicity, anti-proliferation and anti-migration effect as well as inhibition effect on three-dimensional spheroid growth in trastuzumab-resistant HER2+ breast cancer cell line.
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