Energy homeostasis genes modify the association between serum concentrations of IGF-1 and IGFBP-3 and breast cancer risk.

Breast cancer is a multifactorial disease in which the interplay among multiple risk factors remains unclear. Energy homeostasis genes play an important role in carcinogenesis and their interactions with the serum concentrations of IGF-1 and IGFBP-3 on the risk of breast cancer have not yet been investigated. The aim of this study was to assess the modifying effect of the genetic variation in some energy homeostasis genes on the association of serum concentrations of IGF-1 and IGFBP-3 with breast cancer risk. We analyzed 78 SNPs from 10 energy homeostasis genes in premenopausal women from the 4-Corner's Breast Cancer Study (61 cases and 155 controls) and the Mexico Breast Cancer Study (204 cases and 282 controls). After data harmonization, 71 SNPs in HWE were included for interaction analysis. Two SNPs in two genes (MBOAT rs13272159 and NPY rs16131) showed an effect modification on the association between IGF-1 serum concentration and breast cancer risk (Pinteraction < 0.05, adjusted Pinteraction < 0.20). In addition, five SNPs in three genes (ADIPOQ rs182052, rs822391 and rs7649121, CARTPT rs3846659, and LEPR rs12059300) had an effect modification on the association between IGFBP-3 serum concentration and breast cancer risk (Pinteraction < 0.05, adjusted Pinteraction < 0.20). Our findings showed that variants of energy homeostasis genes modified the association between the IGF-1 or IGFBP-3 serum concentration and breast cancer risk in premenopausal women. These findings contribute to a better understanding of this multifactorial pathology.

Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.

BACKGROUND: An alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries. METHODS: We evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed. RESULTS: Radiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms. CONCLUSIONS: Given the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography.

Recurrent BRCA1 and BRCA2 mutations in Mexican women with breast cancer.

BACKGROUND: Germline mutations in the BRCA1 and BRCA2 genes confer an estimated 58% to 80% lifetime risk of breast cancer. In general, screening is done for cancer patients if a relative has been diagnosed with breast or ovarian cancer. There are few data on the prevalence of mutations in these genes in Mexican women with breast cancer and this hampers efforts to develop screening policies in Mexico. METHODS: We screened 810 unselected women with breast cancer from three cities in Mexico (Mexico City, Veracruz, and Monterrey) for mutations in BRCA1 and BRCA2, including a panel of 26 previously reported mutations. RESULTS: Thirty-five mutations were identified in 34 women (4.3% of total) including 20 BRCA1 mutations and 15 BRCA2 mutations. Twenty-two of the 35 mutations were recurrent mutations (62.8%). Only five of the 34 mutation carriers had a first-degree relative with breast cancer (three with BRCA1 and two with BRCA2 mutations). CONCLUSION: These results support the rationale for a strategy of screening for recurrent mutations in all women with breast cancer in Mexico, as opposed to restricting screening to those with a sister or mother with breast or ovarian cancer. IMPACT: These results will impact cancer genetic testing in Mexico and the identification of at-risk individuals who will benefit from increased surveillance. Cancer Epidemiol Biomarkers Prev; 24(3); 498-505. ©2014 AACR.

[Model to estimate epidemic patterns of influenza A (H1N1) in Mexico]. / Modelo para estimación del comportamiento epidémico de la influenza A (H1N1) en México.

OBJECTIVE: Apply a mathematical model to estimate the epidemic patterns of influenza A (H1N1) in Mexico during the stages of application and suspension of measures to mitigate the epidemic. METHODS: The effective reproductive number (R) for each state of Mexico during and after the application of social distancing measures was estimated by the SIR model (susceptible, infected, and recovered individuals) based on data published by the Ministry of Health of Mexico. RESULTS: From the beginning of the outbreak until suspension of school activities (28 April-13 May 2009), the national median of R was 1.13. In the following period (14 May-17 July 2009) the national median of R decreased to 1.01. CONCLUSIONS: It was demonstrated that several epidemic scenarios occurred at the national level. It is suggested that heterogeneous patterns at the state level be taken into account in decision-making on the adoption of measures to mitigate influenza epidemics.

Modelo para estimación del comportamiento epidémico de la influenza A (H1N1) en México / Model to estimate epidemic patterns of influenza A (H1N1) in Mexico

Objective. Apply a mathematical model to estimate the epidemic patterns of influenza A (H1N1) in Mexico during the stages of application and suspension of measuresto mitigate the epidemic.Methods. The effective reproductive number (R) for each state of Mexico during and after the application of social distancing measures was estimated by the SIR model (susceptible, infected, and recovered individuals) based on data published by the Ministry of Health of Mexico. Results. From the beginning of the outbreak until suspension of school activities (28 April–13 May 2009), the national median of R was 1.13. In the following period (14 May–17 July 2009) the national median of R decreased to 1.01. Conclusions. It was demonstrated that several epidemic scenarios occurred at thenational level. It is suggested that heterogeneous patterns at the state level be taken into account in decision-making on the adoption of measures to mitigate influenza epidemics.

Objetivo. Aplicar un modelo matemático para estimar el comportamiento epidémico de la influenza A (H1N1) en México durante las etapas de aplicación y suspensión de medidas para mitigar la epidemia. Métodos. Se estimó el número reproductivo efectivo (R) para cada estado de México mediante el modelo SIR (individuos susceptibles, infectados y removidos) durante y después dela aplicación de las medidas de distanciamiento social a partir de los datos publicados por la Secretaría de Salud de México. Resultados. Desde el inicio del brote hasta la suspensión de actividades escolares (28 de abril al 13 de mayo del 2009), la mediana nacional de R fue de 1,13. En el período posterior (14 de mayo al 17 de julio del 2009) la mediana nacional de R disminuyó a 1,01.Conclusiones. Se demostró que se presentaron diversos escenarios de la epidemia a nivel nacional. Se sugiere tener en cuenta el comportamiento heterogéneo a nivel estatal para la tomade decisiones sobre la adopción de medidas para mitigar epidemias de influenza.