Exposure to Pesticides and Breast Cancer in an Agricultural Region in Brazil.

Rural workers are disproportionally exposed to pesticides and might be at an increased risk of developing chronic diseases. Here, we investigated the impact of pesticide exposure on breast cancer (BC) risk and disease profile in rural female workers. This is a case-control study that prospectively included 758 individuals. The study was conducted in the Southwest region of Paraná state in Brazil, a region characterized by family-based agriculture and intensive use of pesticides. We found that this region has a 41% higher BC diagnosis rate and 14% higher BC mortality rate than the mean rates in Brazil, as well as a pesticide trade volume about 6 times higher than the national average. We showed substantial exposure in this population and found that even women who did not work in the fields but performed equipment decontamination and clothes washing of male partners who worked in the fields had urine samples positive for glyphosate, atrazine, and/or 2,4-D. The crude association showed a significantly higher risk of BC among women exposed to pesticides (OR: 1.58, 95% CI 1.18-2.13). Adjusted analyses showed a lower and nonstatistically significant association (OR: 1.30, 95% CI 41 0.87-1.95). Stratification on disease profile showed a significantly higher risk of lymph node metastasis (adjusted OR: 2.19, 95% CI 1.31-3.72) in women exposed to pesticides. Our findings suggest that female populations exposed to pesticides are at a higher risk of developing BC with a more aggressive profile and draw attention to the need to monitor rural populations potentially exposed to pesticides in the field or at home.

A Case Study in Breast Density Evaluation Using Bioimpedance Measurements.

(1) Background: As breast cancer studies suggest, a high percentage of breast density (PBD) may be related to breast cancer incidence. Although PBD screening is one of the strongest predictors of breast cancer risk, X-ray-based mammography evaluation is subjective. Therefore, new objective PBD measuring techniques are of interest. A case study analyzing the PBD of thirteen female participants using a bioimpedance-based method, the anomalies tracking circle (ATC), is described in this paper. (2) Methods: In the first stage, the breast bioimpedance of each participant was measured. Then, the participant breast density was determined by applying a mammogram just after the breast bioimpedance measurement stage. In the third stage, the ATC algorithm was applied to the measured bioimpedance data for each participant, and a results analysis was done. (3) Results: An ATC variation according to the breast density was observed from the obtained data, this allowed the use of classification techniques to determine the PBD. (4) Conclusions: The described breast density method is a promising approach that might be applied as an auxiliary tool to the mammography in order to obtain precise and objective results for evaluation of breast density and with that determine potential breast cancer risk.

Endocrine disruptor chlorpyrifos promotes migration, invasion, and stemness phenotype in 3D cultures of breast cancer cells and induces a wide range of pathways involved in cancer progression.

Organophosphorus chlorpyrifos (CPF) is currently considered an endocrine disruptor (ED), as it can imitate hormone actions both in vitro and in vivo. We recently reported that CPF induces migration and invasion in 2D cultures and changes the expression of key molecular markers involved in epithelial mesenchymal transition in MCF-7 and MDA-MB-231 cell lines. In this study, we investigated whether CPF could behave as a predisposing factor for tumors to become more metastatic and aggressive using 3D culture models. In MCF-7 cells, 0.05 µM CPF induced an increase in the number and size of mammospheres via estrogen receptor alpha (ERα) and c-SRC. Furthermore, 0.05 µM CPF increased the area of spheroids generated from MCF-7 cells, induced invasion using both Matrigel® and type 1 collagen matrices, and increased cell migration capacity via ERα in this 3D model. In turn, 50 µM CPF increased cell migration capacity and invasion using type 1 collagen matrix. In monolayers, CPF increased the phosphorylation and membrane translocation of c-SRC at both concentrations assayed. CPF at 0.05 µM boosted p-AKT, p-GSK-3ß and p-P38. While p-AKT rose in a ERα-dependent way, p-GSK-3ß was dependent on ERα- and c-SRC, and p-P38 was only dependent on c-SRC. On the other hand, the increase in p-AKT and p-P38 induced by 50 µM CPF was dependent on the c-SRC pathway. We also observed that 0.05 µM CPF increased IGF-1R and IRS-1 expression and that 50 µM CPF induced IGF-1Rß phosphorylation. In the MDA-MB-231 cell line, 0.05 and 50 µM CPF increased p-c-SRC. Finally, p-AKT and p-GSK-3ß were also induced by CPF at 0.05 and 50 µM, and an increase in p-P38 was observed at 50 µM. Taken together, these data provide support for the notion that CPF may represent a risk factor for breast cancer development and progression.

Association between single-nucleotide polymorphisms in miRNA and breast cancer risk: an updated review.

Breast cancer (BC), a heterogeneous, aggressive illness with high mortality, is essentially a genomic disease. While the high-penetrance genes BRCA1 and BRCA2 play important roles in tumorigenesis, moderate- and low-penetrance genes are also involved. Single-nucleotide polymorphisms (SNPs) in microRNA (miRNA) genes have recently been identified as BC risk factors. miRNA genes are currently classified as low-penetrance. SNPs are the most common variations in the human genome. While the role of miRNA SNPs in BC susceptibility has been studied extensively, results have been inconsistent. This review analyzes the results of association studies between miRNA SNPs and BC risk from countries around the world. We conclude that: (a) By continent, the largest proportion of studies to date were conducted in Asia (65.0 %) and the smallest proportion in Africa (1.8 %); (b) Association studies have been completed for 67 different SNPs; (c) 146a, 196a2, 499, 27a, and 423 are the most-studied miRNAs; (d) The SNPs rs2910164 (miRNA-146a), rs11614913 (miRNA-196a2), rs3746444 (miRNA-499) and rs6505162 (miRNA-423) were the most widely associated with increased BC risk; (e) The majority of studies had small samples, which may affect the precision and power of the results; and (f) The effect of an SNP on BC risk depends on the ethnicity of the population. This review also discusses potential explanations for controversial findings.

Prevalence of Known Risk Factors in Uruguayan Women Treated for Breast Cancer at a University Hospital.

INTRODUCTION: In Uruguay, breast cancer has the highest incidence and mortality of all cancer in women. Knowledge of the distribution of risk factors related to disease development supports the implementation of prevention strategies in routine clinical practice. This study aimed to determine the epidemiological profile for breast cancer and the frequency of mammographic surveillance in the surveyed population. MATERIALS AND METHODS: A survey was conducted among Uruguayan women diagnosed with breast cancer who were assisted in the mastology unit of the oncology service of the Hospital de Clínicas in Montevideo, Uruguay, from September 1, 2018, to March 1, 2020. RESULTS: This study included 398 respondents, with a median (SD) age at diagnosis of 61 (34-86) years. A total of 310 respondents (78.0%) had 1 or more risk factors. Most women aged over 50 years (264 out of a total of 338 [78.1%]) underwent mammographic surveillance at least biennially. CONCLUSIONS: Consistent with international reports, most respondents had a risk factor. Among the group of respondents aged over 50 years, most underwent mammographic and clinical surveillance at least biennially. Although it is only possible to formulate conclusions about the surveyed women because of the study design, the obtained data further our understanding of the epidemiological profile of the Uruguayan population, which can contribute to prevention practices.

Association between single-nucleotide polymorphisms in miRNA and breast cancer risk: an updated review

Breast cancer (BC), a heterogeneous, aggressive illness with high mortality, is essentially a genomic disease. While the high-penetrance genes BRCA1 and BRCA2 play important roles in tumorigenesis, moderate- and low-penetrance genes are also involved. Single-nucleotide polymorphisms (SNPs) in microRNA (miRNA) genes have recently been identified as BC risk factors. miRNA genes are currently classified as low-penetrance. SNPs are the most common variations in the human genome. While the role of miRNA SNPs in BC susceptibility has been studied extensively, results have been inconsistent. This review analyzes the results of association studies between miRNA SNPs and BC risk from countries around the world. We conclude that: (a) By continent, the largest proportion of studies to date were conducted in Asia (65.0 %) and the smallest proportion in Africa (1.8 %); (b) Association studies have been completed for 67 different SNPs; (c) 146a, 196a2, 499, 27a, and 423 are the most-studied miRNAs; (d) The SNPs rs2910164 (miRNA-146a), rs11614913 (miRNA-196a2), rs3746444 (miRNA-499) and rs6505162 (miRNA-423) were the most widely associated with increased BC risk; (e) The majority of studies had small samples, which may affect the precision and power of the results; and (f) The effect of an SNP on BC risk depends on the ethnicity of the population. This review also discusses potential explanations for controversial findings.

Nivel de conocimiento sobre los factores de riesgo y las medidas preventivas del cáncer de mama en estudiantes de ciencias de la salud / estudiantes de ciencias de la salud Level Of Knowledge On Risk Factors And Preventive Measures For Breast Cancer In Health Science Students

Introducción: El cáncer de mama es uno de los cánceres más comunes a nivel mundial y en el Perú, por ello es importante que los estudiantes en salud conozcan las medidas preventivas y factores de riesgo. Objetivo: Evaluar el nivel de conocimiento sobre los factores de riesgo y medidas de prevención para el cáncer de mama en estudiantes de la escuela de medicina de una universidad privada, 2019. Métodos: Estudio cuantitativo, descriptivo de corte transversal, se contó con una muestra de 319 estudiantes de la Facultad de Medicina de la Universidad Católica Santo Toribio de Mogrovejo en el año 2019,que hayan estado matriculados en alguna de las escuelas profesionales. Se utilizó un cuestionario que constó de 18 preguntas, 5 ítems que abordaron datos sociodemográficos y 13 midieron el nivel de conocimiento sobre los factores de riesgo y medidas de preventivas del cáncer de mama. Se usó estadística descriptiva. Resultados: Después de la exclusión, se contó con 292 estudiantes, 72% fueron mujeres. La media de edad fue 20,5. 23,6 % fueron de segundo ciclo. Los factores de riesgo menos conocidos fueron beber alcohol, tener más de 45 años, menarquia antes de los 12 años y menopausia después de los 55 años, asimismo, las medidas de prevención menos conocidas fueron: edad correcta para realizar mamografía 71% y frecuencia para realizar autoexamen 63% en mayor porcentaje. Conclusión: El conocimiento sobre factores de riesgo y medidas de prevención de cáncer de mama fue adecuado.

Introduction: breast cancer is one of the most common cancers worldwide and in Peru. Health studentsneed to know preventive measures and risk factors. Objective: to assess the level of knowledge aboutrisk factors and prevention measures for breast cancer in students of the private medical school, 2019.Methods: a quantitative, descriptive cross-sectional study was conducted with a sample of 319 studentsfrom the Faculty of Medicine of the Universidad Católica Santo Toribio de Mogrovejo in 2019, who havebeen enrolled in one of the professional schools. We used a questionnaire consisting of 18 questions, 5items that addressed sociodemographic data, and 13 measured the level of knowledge about risk factorsand preventive measures of breast cancer. Descriptive statistics were used. Results: After exclusion,there were 292 students, 72% were women. The mean age was 20.5, 23.6% were from the second year.The least known risk factors were drinking alcohol, being over 45 years of age, menarche before 12years of age, and menopause after 55 years of age, and the least known prevention measures were:correct age for mammography 71% and frequency for self-examination 63% in a higher percentage.Conclusion: knowledge about risk factors and breast cancer prevention measures was adequate.

Germline Variants in Driver Genes of Breast Cancer and Their Association with Familial and Early-Onset Breast Cancer Risk in a Chilean Population.

The genetic variations responsible for tumorigenesis are called driver mutations. In breast cancer (BC), two studies have demonstrated that germline mutations in driver genes linked to sporadic tumors may also influence BC risk. The present study evaluates the association between SNPs and SNP-SNP interaction in driver genes TTN (rs10497520), TBX3 (rs2242442), KMT2D (rs11168827), and MAP3K1 (rs702688 and rs702689) with BC risk in BRCA1/2-negative Chilean families. The SNPs were genotyped in 489 BC cases and 1078 controls by TaqMan Assay. Our data do not support an association between rs702688: A>G or rs702689: G>A and BC risk. The rs10497520-T allele was associated with a decreased risk in patients with family history of BC or early-onset BC (OR = 0.6, p < 0.0001 and OR = 0.7, p = 0.05, respectively). rs2242442-G was associated with a protective effect and rs11168827-C was associated with increased BC risk in families with a strong history of BC (OR = 0.6, p = 0.02 and OR = 1.4, p = 0.05, respectively). As rs10497520-T and rs2242442-G seemed to protect against BC risk, we then evaluated their combined effect. Familial BC risk decreased in a dose-dependent manner with the protective allele count, reflecting an additive effect (p-trend < 10-4). To our knowledge, this is the first association study of BC driver gene germline variations in a Chilean population.

Human Epidermal Growth Factor Receptor-2 gene polymorphism and breast cancer risk in women from the Northeastern region of Brazil

OBJECTIVES: In the Human Epidermal Growth Factor Receptor-2 (HER2) rs1136201 variant, the presence of the G allele may promote cellular alterations and increase breast cancer risk, in addition to enhanced cellular proliferation, tumor aggressiveness, and metastases. The aim of this study was to investigate the presence of the single-nucleotide polymorphism (SNP) variant, rs1136201, within the HER2 gene in women from the Northeastern region of Brazil and breast cancer risk. METHODS: The study included 140 women who were divided into two groups, case (breast cancer) and control (without breast cancer), with 70 women in each group. Peripheral blood of each woman was drawn for the study of genomic Deoxyribonucleic acid (DNA) extracted from leukocytes using the genotyping technique by real-time polymerase chain reaction. RESULTS: The GG genotype occurred in 1 woman in both groups (1.4%) (p=0.32), while the AG genotype occurred in 19 (27.2%) and 13 (18.6%) women in the case and control (p=1.00) groups, respectively. No statistically significant difference in GG and AG genotypes was observed between the case and control groups in premenopausal women (p=1.00). Furthermore, no significant difference in genotypes was observed between the groups, among postmenopausal women (p=0.14). CONCLUSION: In this study, the HER2 rs1136201 polymorphism did not show any statistically significant association with breast cancer, both in premenopausal and postmenopausal women. Nevertheless, further studies with a larger sample size should be performed to assess the association of HER2 polymorphism with breast cancer risk in women from the Northeastern region of Brazil.

Hormonal contraception and risk of breast cancer: a critical look.

Today health professionals are not only required to know medicine, but scientific reading, interpretation, and communication of new data. The new information about contraception and hormonal therapies must be analyzed by gynecologists to determine whether or not the new data are applicable to their patients and if it has an impact on their health. Recently a new study of hormonal contraceptives and the risk of breast cancer was published. In this study, the investigators found an elevation of the relative risk of breast cancers on the users versus the nonusers of hormonal contraception. After analyzing the publication and other data available, it is our opinion that it is a very low increase of the risk and its impact should be evaluated case by case, not forgetting to take into account the numerous beneficial effects that hormonal contraception have.

BRCA mutations: is everything said?

BACKGROUND: Mutations in the BRCA1 and BRCA2 genes constitute a risk factor for breast cancer development. BRCA mutation research has been an active field since the discovery of the genes, and new mutations in both genes are constantly described and classified according to several systems. AIM: We intend to provide an overview of the current state of BRCA1 and BRCA2 mutation description and classification. We wanted to know whether there was a trend towards a more frequently described mutation type and what the proportion of pathogenic mutations was. RESULTS: We found that, although new mutations are described each year as reflected in current database records, very few of them are reported in papers. Classification systems are highly heterogeneous and a consensus among them is still under development. Regarding their function, a large number of mutations are yet to be analyzed, a very complex task, due to the great number of possible variations and their diverse effect in the BRCA gene functions. After individual analysis, many variants of unknown significance turn out to be pathogenic, and many can disrupt interactions with other proteins involved in mechanisms such as DNA damage repair pathways. Recent data suggest that looking for mutation patterns or combinations would shed a wider light on BRCA-derived cancer susceptibility in the upcoming years.

RELATIONSHIP BETWEEN OBESITY AND BREAST CANCER / Relação entre obesidade e câncer de mama

Obesity is a growing clinical condition around the world, considered a risk factor for numerous diseases such as hypertension, myocardial infarction, diabetes, and cancer. Among the neoplasms related to overweight, breast cancer stands out. Therefore, the objective of this review is to elucidate the impact of obesity on the most prevalent cancer among women, either as a direct risk factor for its onset or as a determinant of survival

A obesidade aponta como condição clínica em ascensão pelo mundo, considerada fator de risco para inúmeras doenças como hipertensão, infarto, diabetes e câncer. Dentre as neoplasias relacionadas com o excesso de peso, destaca-se o câncer de mama. O objetivo desta revisão é, portanto, elucidar o impacto que a obesidade causa no câncer mais prevalente entre as mulheres, seja como fator de risco direto para seu aparecimento, seja como determinante na sobrevida

Economic and disease burden of breast cancer associated with suboptimal breastfeeding practices in Mexico.

PURPOSE: Exclusive breastfeeding and longer breastfeeding reduce women's breast cancer risk but Mexico has one of the lowest breastfeeding rates worldwide. We estimated the lifetime economic and disease burden of breast cancer in Mexico if 95% of parous women breastfeed each child exclusively for 6 months and continue breastfeeding for over a year. METHODS: We used a static microsimulation model with a cost-of-illness approach to simulate a cohort of Mexican women. We estimated breast cancer incidence, premature mortality, disability-adjusted life years (DALYs), medical costs, and income losses due to breast cancer and extrapolated the results to 1.116 million Mexican women of age 15 in 2012. Costs were expressed in 2015 US dollars and discounted at a 3% annual rate. RESULTS: We estimated that 2,186 premature deaths (95% CI 2,123-2,248), 9,936 breast cancer cases (95% CI 9,651-10,220), 45,109 DALYs (95% CI 43,000-47,217), and $245 million USD (95% CI 234-256) in medical costs and income losses owing to breast cancer could be saved over a cohort's lifetime. Medical costs account for 80% of the economic burden; income losses and opportunity costs for caregivers account for 15 and 5%, respectively. CONCLUSIONS: In Mexico, the burden of breast cancer due to suboptimal breastfeeding in women is high in terms of morbidity, premature mortality, and the economic costs for the health sector and society.

A deep learning based strategy for identifying and associating mitotic activity with gene expression derived risk categories in estrogen receptor positive breast cancers.

The treatment and management of early stage estrogen receptor positive (ER+) breast cancer is hindered by the difficulty in identifying patients who require adjuvant chemotherapy in contrast to those that will respond to hormonal therapy. To distinguish between the more and less aggressive breast tumors, which is a fundamental criterion for the selection of an appropriate treatment plan, Oncotype DX (ODX) and other gene expression tests are typically employed. While informative, these gene expression tests are expensive, tissue destructive, and require specialized facilities. Bloom-Richardson (BR) grade, the common scheme employed in breast cancer grading, has been shown to be correlated with the Oncotype DX risk score. Unfortunately, studies have also shown that the BR grade determined experiences notable inter-observer variability. One of the constituent categories in BR grading is the mitotic index. The goal of this study was to develop a deep learning (DL) classifier to identify mitotic figures from whole slides images of ER+ breast cancer, the hypothesis being that the number of mitoses identified by the DL classifier would correlate with the corresponding Oncotype DX risk categories. The mitosis detector yielded an average F-score of 0.556 in the AMIDA mitosis dataset using a 6-fold validation setup. For a cohort of 174 whole slide images with early stage ER+ breast cancer for which the corresponding Oncotype DX score was available, the distributions of the number of mitoses identified by the DL classifier was found to be significantly different between the high vs low Oncotype DX risk groups (P < 0.01). Comparisons of other risk groups, using both ODX score and histological grade, were also found to present significantly different automated mitoses distributions. Additionally, a support vector machine classifier trained to separate low/high Oncotype DX risk categories using the mitotic count determined by the DL classifier yielded a 83.19% classification accuracy. © 2017 International Society for Advancement of Cytometry.

Riesgo familiar total en familias con mujeres diagnosticadas con neoplasia de mama / Total family risk in families with women diagnosed with breast cancer / Risco familiar total em famílias com mulheres diagnosticadas com neoplasia da mama

Objetivo: Determinar el riesgo familiar total de las familias con mujeres diagnosticadas con cáncer de mama, que asisten a un centro de salud oncológico en la ciudad de Barranquilla. Materiales y Métodos: El estudio fue de tipo descriptivo, transversal con abordaje cuantitativo. Se utilizó el instrumento Riesgo Familiar Total RFT 5-33. El universo estuvo conformado por familias con mujeres diagnosticadas con cáncer en mama. La muestra fue de 41 familias que integraron a 154 miembros; se abordó el estudio de manera censal, y no por medio de una muestra, porque el acceso a la información de la totalidad de las familia fue viable. Resultados: Los resultados mostraron que las familias, en su mayoría, son de tipo 2. El 68 % de las pacientes categorizan sus familias como amenazadas, el 5 % como familias de alto riesgo y un 27 % de las familias con un bajo riesgo. Conclusiones: Los hallazgos encontrados en esta investigación son importantes para las familias, lo cual permitirá establecer acciones y actividades que logren orientar e implementar procesos de atención específicos con el propósito de cuidar a las familias para que se mantengan sanos en un nivel de bajo riesgo; además, desarrollar controles y seguimiento a aquellas familias que se encuentran en un riesgo alto de amenazas, mediante acciones de promoción y prevención de la enfermedad de una manera amplia. Por lo anterior, se deben emprender programas más agresivos de prevención y promoción, especialmente con las familias que asisten en busca de apoyo médico para este padecimiento; de esta forma, se podrán diagnosticar los casos de forma temprana y proceder al respectivo tratamiento.

Objective: To determine the total family risk with women diagnosed with breast cancer, that attend an oncological health center in the city of Barranquilla. Materials and Methods: The study was descriptive, cross-sectional with a quantitative approach. The instrument of Total Family Risk RFT 5-33 was used. The universe was composed by families with women diagnosed with breast cancer. The sample were 41 families integrated by 154 members; the study was approached as a census, and not through samples, because the access to the information in its entirety was viable. Results: The results showed that the families, in their majority are from type 2. 68% of the patients categorize their families as threatened, 5% as families of high risk, and 27% of the families as low risk. Conclusion: The data found in this research, is important for the families, which will allow to establish actions and activities to orientate and implement processes of specific attention, with the purpose of taking care of the families in order to keep them healthy and in a level of low risk; also, to develop controls and monitoring, to those families that have a high risk of threat through actions of promotion and prevention of the disease in a broad manner. Consequently, more aggressive programs of prevention and promotion must begin, especially with the families that attend in search of medical support for this condition; this way breast cancer cases can be diagnosed early and proceed to the proper treatment.

Objetivo: Determinar o risco familiar total das famílias com mulheres diagnosticadas com câncer de mama, que assistem a um centro de saúde oncológica na cidade de Barranquilla - Colômbia. Materiais e Métodos: O estudo foi de tipo descritivo, transversal com abordagem quantitativa. Utilizou-se o instrumento Risco Familiar Total RFT 5-33. O universo esteve conformado por famílias com mulheres diagnosticadas com câncer de mama. A amostra foi de 41 famílias que integraram a 154 membros; se abordou o estudo utilizando um censo, e não por meio de uma amostra, porque o acesso à informação de todas as famílias foi viável. Resultados: Os resultados mostraram que as famílias em sua maioria são de tipo 2. O 68% das pacientes categorizam suas famílias como ameaçadas, o 5% como famílias de alto risco, e um 27% das famílias com um baixo risco. Conclusões: Os resultados encontrados nesta pesquisa, são importantes para as famílias, já que podem-se estabelecer ações e atividades que logrem orientar e implementar processos de atendimento específicos, com o propósito de cuidar às famílias para que se mantenham saudáveis num nível de baixo risco; assim como também desenvolver controles e seguimentos, sobretudo a aquelas famílias que se encontram num risco alto de ameaças, através de ações de promoção e prevenção da doença de uma maneira ampla. Portanto, se devem empreender programas mais agressivos de prevenção e promoção, especialmente com as famílias que assistem em procura de apoio médico para este padecimento; e desta maneira conseguir diagnosticar os casos de forma precoce e proceder ao respectivo tratamento.

Phthalate exposure, flavonoid consumption and breast cancer risk among Mexican women.

OBJECTIVE: To evaluate if selected phthalate exposure and flavonoid intake interact on breast cancer (BC) risk. MATERIAL AND METHODS: Interviews and urine samples were obtained from 233 women with histologically confirmed BC and 221 healthy controls matched by age and place of residence, from various states of northern Mexico. Urinary metabolites concentrations of diethyl phthalate (DEP), butyl benzyl phthalate (BBzP) and dioctyl phthalate (DOP) were determined by solid-phase extraction coupled with high-performance liquid chromatography/isotope dilution/tandem mass spectrometry. Using a semiquantitative food frequency questionnaire, consumption of five types of flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones and flavonols) was estimated according to three food groups: vegetables, fruits and legumes-oil seeds. RESULTS: A higher intake of anthocyanidins and flavan-3-ols (from vegetables), synergistically increased the negative association between BBzP and BC. No other significant flavonoid-phthalate multiplicative interactions on the risk for BC were found. CONCLUSION: The consumption of some flavonoids may interact with exposure to phthalates on the risk of BC. Epidemiological and underlying mechanisms information is still insufficient and requires further investigations.

Long-term use of calcium channel blocking drugs and breast cancer risk in a prospective cohort of US and Puerto Rican women.

BACKGROUND: In a recent case-control study, long-term use of calcium channel blocking drugs was associated with a greater-than-twofold increased breast cancer risk. If prospectively collected data confirm that calcium channel blocker use increases breast cancer risk, this would have major implications for hypertension treatment. The objective of this study was to determine whether women using calcium channel blockers for 10 years or more were at increased risk of developing breast cancer compared with women not using calcium channel blockers. METHODS: The Sister Study is a prospective volunteer cohort study of women from the USA and Puerto Rico designed to evaluate environmental and genetic risk factors for breast cancer. Beginning in 2003, women between the ages of 35 and 74 were recruited. They were eligible to participate if they had a sister with breast cancer but had not been diagnosed with breast cancer themselves. In total, 50,884 women enrolled in the cohort between 2003 and 2009; 50,757 women with relevant baseline data and available follow-up data are included in this study. The exposure of interest is current use of calcium channel blocking drugs and the reported duration of use at entry into the cohort. Secondary exposures of interest were the duration and frequency of use for all other subclasses of antihypertensive drugs. Our main outcome is a self-reported diagnosis of breast cancer during the study follow-up period. With patient permission, self-reported diagnoses were confirmed using medical records. RESULTS: Results showed 15,817 participants were currently using an antihypertensive drug, and 3316 women were currently using a calcium channel blocker at study baseline; 1965 women reported a breast cancer diagnosis during study follow-up. Using Cox proportional hazards modeling, we found no increased risk of breast cancer among women who had been using calcium channel blockers for 10 years or more compared with never users of calcium channel blockers (HR 0.88, 95 % CI 0.58-1.33). CONCLUSIONS: We saw no evidence of increased risk of breast cancer from 10 years or more of current calcium channel blocker use. Our results do not support avoiding calcium channel blocking drugs in order to reduce breast cancer risk.

Prevalence of the STK15 F31I polymorphism and its relationship with mammographic density

Several studies have identified the single nucleotide polymorphism STK15 F31I as a low-penetrance risk allele for breast cancer, but its prevalence and risk association in the Brazilian population have not been determined. The goal of this study was to identify the frequency of this polymorphism in the Brazilian setting. Considering the high degree of admixture of our population, it is of fundamental importance to validate the results already reported in the literature and also to verify the relationship between this variant and breast cancer risk. A total of 750 women without breast cancer were genotyped using the TaqMan PCR assay for STK15 F31I polymorphism. Clinical information was obtained from review of the medical records and mammographic density from the images obtained using the BI-RADS System. The estimated risk of developing cancer was calculated according to the Gail model. The genotypic frequencies observed in this study were 4.5, 38.7, and 56.6 percent, respectively, for the STK15 F31I AA, AT and TT genotypes. The AT and AA genotypes were encountered significantly more often in premenopausal women with moderately dense, dense and heterogeneously dense breast tissue (P = 0.023). In addition, the presence of the TT genotype was significantly associated with age at menarche ≥12 years (P = 0.023). High mammographic density, associated with increased breast cancer risk, was encountered more frequently in premenopausal women with the risk genotypes STK15 F31I AA and AT. The genotypic frequencies observed in our Brazilian sample were similar to those described in other predominantly European populations.

Conocimientos y comportamientos sobre factores de riesgo de cáncer de mama en un grupo de mujeres / Knowledge and behaviors on breast cancer risk factors among a group of women

Introducción: En México cada 2 horas muere una mujer por cáncer de mama (CaMa), enfermería debe asumir un rol protagónico en promover la salud de la mama. Objetivo: Explorar la relación que existe entre conocimientos y comportamientos sobre factores de riesgo y detección oportuna del cáncer de mama en un grupo de mujeres. Material y métodos: Estudio piloto observacional, descriptivo y transversal, incluyó 52 mujeres mayores de 25 años de una institución educativa. Las variables fueron: factores de riesgo para CaMa, antecedentes personales, conductas protectoras o de riesgo, conocimientos y screening, Resultados: con una K Richardson 0.73. La media de edad 38±8, las mujeres de 47-57 años tienen menor nivel de escolaridad (Z= - 2.87, p=0.004), y menos conocimientos (Anova p=0.02). Las mujeres que no reportaron datos de enfermedad crónica tienen un promedio mayor de conductas de riesgo (3±1) que aquellas que si lo presentan (2±1, t= 2.944, gl=50, p < 0.005). Discusión: Los resultados concuerdan con lo reportado en la literatura, los conocimientos son deficientes y no se relacionan con conductas saludables ni garantizan que las mujeres realicen detección oportuna. Conclusiones:En el espacio universitario se deben implementar estrategias que incrementen los conocimientos y la detección oportuna de CaMa.

Introduction: In Mexico, every two hours a woman dies of breast cancer (BrCa); thus Nursing should assume a principal roll in the promotion of women's health. Objective: explore the relationship between knowledge and behavior related to risk factors and BrCa early detection. Materials and methods: basic, descriptive, and observational study pilot, which included 52 women older than 25 working in an education institution. The variables were BrCa risk factors, personal background, protecting or risk conducts, knowledge and screening. Results: K Richardson was .73. Average age was 38 +- 8. Women between 47-57 reported a lower level of education (Z = -2.87, p = .004), and less knowledge (ANOVA p = .02). Women who did not report chronic illness data reported greater average number of risk conducts (3+-1) than those who did (2+-1, t = 2.944, gl = 50, p < .005). Discussion: our results are consistent with those of the literature: when knowledge is insufficient women do not behave healthy and do not perform early detection practices. Conclusion: it is necessary to implement strategies to enhance knowledge and frequency of BrCa early detection practices.

Actividad física y riesgo de cáncer de mama en mujeres mexicanas / Physical activity and breast cancer risk in Mexican women

OBJETIVO: Evaluar el efecto de la actividad física moderada (en horas por semana y METs-hora por semana) sobre el riesgo de cáncer de mama (CM). MATERIAL Y MÉTODOS: Se trata de la primera fase de un estudio multicéntrico de casos y controles con base poblacional que se desarrolló en el Distrito Federal, Monterrey y Veracruz, México, en el año 2004. Se analizaron 58 casos y 58 controles pareados a los casos por quinquenio de edad, y pertenencia al sistema de salud; participaron tres hospitales del Instituto Mexicano del Seguro Social, tres del Instituto de Seguridad Social al Servicio de los Trabajadores del Estado y tres de la Secretaría de Salud. RESULTADOS: En mujeres posmenopáusicas se observó una reducción del riesgo de CM por cada hora semanal adicional de actividad física moderada (RM= 0.91; IC95 por ciento 0.85-0.97); en mujeres premenopáusicas, la disminución del riesgo no tuvo significancia estadística (RM= 0.99; IC95 por ciento 0.94-1.05) (p= 0.048, modificación de efecto). CONCLUSIONES: La actividad física reduce el riesgo de CM en mujeres mexicanas posmenopáusicas.

OBJECTIVE: To evaluate the effect of moderate physical activity (hours per week and METs hours per week) on the risk of breast cancer (BC) in Mexican women. MATERIAL AND METHODS: This is the initial stage of a case control multicentric study based in the Federal District, Monterrey and Veracruz, Mexico, during 2004. Fifty eight cases paired to 58 control cases on quinquennium of age, and belonging to the health system were analyzed: three hospitals from the IMSS, three from ISSSTE and three from SS participated. RESULTS: In postmenopausal women, there was a reduction of the risk in BC by every additional hour per week of moderate physical activity (RM= 0.91; IC95 percent 0.85-0.97); in premenopausal women, the reduction of the risk was not statistically significant (RM= 0.99; IC95 percent 0.94-1.05) (p= 0.048, effect modification). CONCLUSIONS: Moderate physical activity reduces the risk of BC in postmenopausal Mexican women.