Breast Cancer Research in the Caribbean: Analysis of Reports From 1975 to 2017.

PURPOSE: Breast cancer is among the leading causes of death resulting from cancer in Caribbean women. Studies examining exogenous and genetically predetermined endogenous risk factors are critical to define breast cancer susceptibility in Caribbean women. The purpose of this systematic review is to assess the existing scientific literature in the last 42 years (1975 to 2017) to describe the body of research generated for the population of this region and determine future research directions. METHODS: We selected published research articles using a combination of definite keyword searches in PubMed. Only articles presenting the Caribbean population as the focus of their research objectives were included in this analysis. RESULTS: Studies on breast cancer in the Caribbean are limited. A majority of publications on Caribbean populations were descriptive, focusing on cancer trends and clinicopathologic factors. High incidence and mortality rates for breast cancer are reported for the region, and there seem to be some differences between countries in the frequency of cases according to age at presentation. A limited number of epidemiologic, behavioral, and genetic and molecular studies were conducted in more recent years. CONCLUSION: A regional strategy for cancer registration is needed for the Caribbean to address possible underestimates of breast cancer incidence. Furthermore, behavioral, molecular, genetic, and epidemiologic investigations of breast cancer are critical to address the concerns related to currently described high incidence and mortality rates in the Caribbean.

Immunotherapeutic Impact of Toll-like Receptor Agonists in Breast Cancer.

Onset of tumors in breast cancer is a multi-factorial event at different ages and ethnic populations. The conventional treatment strategy suggests use of anti-estrogen drugs and selective estrogen receptor modulators (SERMs). Although, this strategy has achieved significant success to prevent tumor growth and metastasis and is still developing under an active field of research, the emergence of immunotherapy is a potential modern approach for breast cancer. In addition to SERMs, the screening of selective agonists for toll-like receptor (TLR) signals confers a new area of breast cancer therapy. Recent investigations also indicate significance of TLR signals in the regulation of tumor suppressor p53 gene expression. The TLR agonists have an ability to facilitate activation of natural killer cells, CD8 T cells, B cells, and alpha and beta interferons and induce cellular cytotoxicity. The ongoing developments in cancer research also suggested an approach for intra-tumoral generation of cellular cytotoxicity to induce apoptosis. Both of these events promote destruction of tumor cells in a localized manner and thus, having impact on immunotherapy. Keeping a cautious eye on the context, we propose the prospect of TLR signals in the development of therapy for breast cancer.