Biomarker for Breast Cancer

Less Invasive Serum Biomarker for Diagnosis of Breast Cancer and Therapeutic Targets

By Ramadhani Chambuso

Breast cancer is the most frequent malignancy in women and the second leading cause of cancer-related mortalities worldwide.

It is worth noting that better understanding of potential biomarkers and therapeutic targets of breast cancer will facilitate improvement in the survival rate of patients with breast cancer.

However, a recent study found that beta-thymosin (TMSB10), which is originally found from the thymus gland on the upper front part of the chest, is significantly elevated in human breast cancer cells and tissues. It further correlates with advanced clinicopathological features, metastasis status and poor prognosis.

On the other hand, overexpression of TMSB10 promotes, while silencing of TMSB10 inhibits, proliferation, invasion and migration of breast cancer cells in vitro and in vivo.

In conclusion, these findings indicate that TMSB10 may be potential future valuable serum biomarker for the diagnosis of breast cancer and as a potential therapeutic target for the treatment of the disease.

Source link: Zhang et al., 2017.

Unintended Pregnancy during Radiotherapy

Healthy Child after Accidental Pregnancy during Radiotherapy for Cancer Treatment

By Ramadhani Chambuso

In 2009, a 27-year-old woman gave birth to a healthy child after an unintended pregnancy during cancer treatment for stage II lymphoma, following several cycles of chemo and radiation therapy without even abdominal shielding.

Earlier, her physician advised to terminate the pregnancy, but she decided to continue with it after contacting a teratology information service for further information regarding the risks of radiation exposure for her fetus.

Although the available information on radiation-induced embryonic damage in humans is mainly extrapolated from animal studies and follow-up of individuals exposed to atomic bomb radiation effects in Japan, to date, this case still gives special interests for scientists to re-evaluate the required dose for radiation teratogenic effects on fetal development.

Furthermore, women do occasionally conceive during radiotherapy for oncologic diseases, however, many physicians advise patients to terminate pregnancies for fear of the high risk of teratology from radiation adverse effects.

Therefore, this practical evidence reflects the need for further evaluations on chemo-radiation dose-effect relationship for embryogenesis.

Source link: Nature Reviews Clinical Oncology 6, 175–178(2009). doi:10.1038/ncponc1320.

Detection of Breast Cancer by Mass Screening

Reducing Death from Breast Cancer by Mass Screening: Rethinking Strategies for LMICs

By Christabel Abewe and Vester Gunsaru

Breast cancer is the most common cancer diagnosed in women and the most common cause of death from cancer. Globally, breast cancer incidence, mortality, and survival rates vary considerably between the regions (approximately fourfold). However, what has been unequivocally consistent across the regions is that the incidence of breast cancer is increasing, and in regions without early detection programs, mortality is also increasing. The global trajectory is that breast cancer incidence is higher in the developed countries as compared with the developing countries, yet paradoxically; the breast cancer mortality in the developing countries is almost equal to that in the developed countries. This implies that breast cancer disproportionately affects women in developing countries. The high mortality in developing countries is largely attributed to the fact that about 75% of women diagnosed with breast cancer in low and middle income countries (LMICs) present with clinical stages III & IV of the disease. On the contrary, 70% of women with breast cancer in North America are diagnosed in stages 0 & I. Developing countries now face the challenge of effectively detecting and treating a disease that was previously considered too uncommon to warrant the allocation of finite health care resources.

Mammographic screening is the ONLY technique that has been found to sufficiently reduce breast cancer mortality and while mass screening using mammography has been well established and implemented in developed countries, it has not been replicated in LMICs due to the huge financial and human resources that are required for the technique. Aside from the huge financial resources needed for mammography, the appropriateness of this screening technique among women from sub-Saharan Africa has become a point of debate. The argument against considering mammography as the gold standard for screening for breast cancer is hinged on the fact that the bulk of the women who need screening for breast cancer in sub-Saharan Africa are between 30-45 years. This implies that the proportion of the demographic that requires screening in sub-Saharan Africa is composed of women who have dense breasts making it very difficult to tell abnormal and normal tissue apart on the X-ray film. Mammography is typically recommended and most effective when it is used to screen older women 50-69 years.

The use of Ultrasound scans has been advocated for in some LMICs such as Uganda as a stopgap measure to screen the most at risk women (30-45 years) of breast cancer in the absence of mammographic and other image screening services. Ultrasound scans are almost 50% cheaper than mammograms, easier to use, require less human resource expertise and are up to 10 fold more available than mammograms in most LMICs. Although ultrasonography is not up to par with the gold standard (i.e., lower specificity and sensitivity and higher false positives) it is still better than no screening at all. Breast cancer is and should be viewed as extremely fatal and yet can be cured if detected early and treated properly. The proposition to use ultrasonography for mass screening in LMICs where mammography is out of reach is therefore not to lower the standards of breast cancer diagnosis but rather an interim measure to fill the gap of unmet need until these countries have sufficient resources to afford more effective imaging screening tools. There is therefore need to investigate the efficacy of ultrasonography for breast cancer in LMICs and subsequently estimate the resource requirements for implementing population level screening using this method.

Source link: Okello et al. (2014), Jedy-Agba et al. (2016)Galukande and Kiguli-Malwadde (2010), Lauby-Secretan et al. (2015), Dey (2014), Lee et al. (2010).