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Anti-proliferative and pro-apoptotic effects of gallic acid on the breast adenocarcinoma cell lines SKBR3 versus normal fibroblast cells (HU-02)
Roghayeh Larki, Leila Rouhi , Seyed Hossein Hejazi ,
Volume 76, Issue 3 (6-2018)
Abstract
Background: Breast cancer is a malignant proliferation of epithelial cells that lining the ducts or lobules of the breast. Breast cancer is the second common cancer (after lung cancer) in women. Gallic acid, being a polyphenols, has been reported for its antiproliferative activity against many cancer cell lines. Objective of the present study is effect of gallic acid on proliferation and apoptosis of the human breast adenocarcinoma cell lines SKBR3 and normal fibroblasts cells.
Methods: This experimental study was performed in cellular and developmental biology of Shahrekord Islamic Azad University, Iran from April to August 2015. For anti-cancer activity, in this study SKBR3 cells and normal fibroblast cells (HU-02) were cultured in Dulbecco's modified eagle's medium, DMEM (Gibco, Life Technologies, Inc., New York, USA) medium with 10% fetal bovine serum, FBS (Gibco, Life Technologies, Inc., New York, USA). The SKBR3 and normal fibroblast cells were treated in the medium of DMEM medium and gallic acid (20, 40, 80, 100 and 200 µg/ml) for 24, 48 and 72 hours. Cells viability was assessed by MTS (Methyl- Thiazol-) assay. Cells were seeded at 5×103 cells/ml in 96 well plates and incubated for 24 hours. Then metabolites of bacteria were added, after indicated times MTS (20µl) was added and the absorbance was measured at 492 nm using ELISA plate reader. The percentage of apoptosis induction was determined by flow cytometry analysis using Annexin-V fluorescein isothiocyanate (FITC) kit (BioVision Products, CA, USA) in 20, 40, 80, 100 and 200 µg/ml concentration of gallic acid at 48 hours incubation.
Results: Gallic acid decreases significantly the viability of SKBR3 cell line in a time and dose dependent manner. So that the most effective concentration of this substance was 200 µg/ml and 72 hours after treatment (P< 0.05). According to the data of Annexin-PI, the highest apoptosis induction rate was seen in 200 µg/ml (P< 0.05). While gallic acid in various concentrations had no significant effect on normal fibroblast cells.
Conclusion: Objective of the present study is effect of gallic acid on proliferation and apoptosis of the human breast adenocarcinoma cell lines SKBR3 and normal fibroblasts cells.

Following a patient with breast cysts using thermal imaging: case report
Hossein Ghayoumi Zadeh , Mostafa Danaeian , Ali Fayazi , Cyrus Ahmadi Toussi , Nasrin Ahmadinejad , Mitra Navid ,
Volume 76, Issue 7 (10-2018)
Abstract
Background: Breast cancer is a common malignancy in which early breast cancer detection by the help of imaging can improve the treatment outcome. Thermography utilizes infrared beams which are fast, non-invasive, and non-contact and the output created images by this technique are flexible and useful to monitor the temperature of the human body.
Case presentation: Our patient is a 25-year-old woman who was referred to Tehran's Imam Khomeini Hospital, Tehran University of Medical Sciences, in October 2014 and June 2017 to perform clinical examinations of breast cancer at the Invasive and New Radiology Research Center of Tehran. The results of the sonography for the left breast and bilateral axillary regions and sonography guided biopsy from the left axillary region indicated that:  it was consistent with the tangential prominence at 11-12 O’ clock in the left breast tissue and echo gene was found without any suspected findings. Then, using the non-contact infrared imaging camera VisIR 640 (Thermoteknix Systems Ltd, Cambridge, UK), the feasibility of thermography method in the patient's follow-up was investigated.
Conclusion: Thermography can be used to detect abnormal areas in the breast tissue that may have cystic origin. The results indicated that the accuracy of the identification and matching of patient cysts in mammography and ultrasonography with the results of thermography in both periods of October 2014 and June 2017. Considering the results, it is noteworthy that the diagnostic clock of the breast cysts in the patient is consistent with the results of the clinical trials with the thermography. Moreover, in a 2 years intervals, the status of thermal morphology status of the cystic region did not considerably change which showed a relatively stable status.

Relationship between diet diversity score and breast cancer risk
Sepideh Haghifar , Yasaman Jamshidi Naeini , Mohammad Esmaeil Akbari , Morteza Abdollahi , Mahdi Shadnoush , Marjan Ajami , Sayed Hossein Davoodi ,
Volume 76, Issue 8 (11-2018)
Abstract
Background: The average age of women with breast cancer in Iran is at least 10 years lower in comparison to developed countries and the incidence of the disease in Iranian women is on a rise. According to studies, diets that are diverse in food groups can play a role in protecting against chronic diseases including cardiovascular diseases and cancer. Diet diversity score is an indicator used to measure diversity between and within food groups. This study aimed to assess the relationship between diet diversity score and breast cancer risk.
Methods: This case-control study was carried out from April 2014 to February 2015 at Shohada Hospital in Tajrish, Tehran. Demographic and anthropometric data of 298 participants including 149 breast cancer cases and 149 apparently healthy women were collected. A valid food frequency questionnaire containing 168 food items was completed to assess usual dietary intake through face to face interviews. Energy was calculated using Nutritionist 4 software (First Databank Inc., Hearst Corp., San Bruno, CA, USA) and diet diversity score was calculated using five food group scoring. Odds ratios with 95% confidence intervals were obtained using logistic regression test to evaluate the association between breast cancer risk and diet diversity score tertiles.
Results: There was no significant difference in weight, height, body mass index between the two groups, but physical activity level and daily energy intake showed a significant difference (P<0.001). After adjusting for the effect of confounding variables including energy, body mass index, physical activity, menopause status, family history of breast cancer, contraceptive use, number of pregnancy, age of menarche and smoking, the risk for developing breast cancer was 86% lower in those in the highest tertile of diet diversity score compared to those in the first tertile (OR=0.14, 95% CI=0.06-0.31). An inverse and significant association was found between breast cancer risk and diversity scores of fruits and milk groups (P<0.001).
Conclusion: Higher diet diversity score is associated with reduced risk of breast cancer.

Spatial structure of breast cancer using Poisson generalized linear mixed model in Iran
Mansour Rezaei , Abdullah Jalilian , Behzad Mahaki , Maryam Veismoradi ,
Volume 77, Issue 3 (6-2019)
Abstract
Background: Breast cancer is one of the most common diseases in women and causes more deaths rather than other cancers. The increasing trend of breast cancer in Iran makes clear the need of extensive breast cancer research in this area. Some studies showed that in the variety countries and even in the different areas in one country has different risk of breast cancer incidence and this is a reason that there is a correlation between region of life and risk of breast cancer. The purpose of this study was to determine the spatial structure associated with the incidence of breast cancer based on statistical models and identification of areas with high incidence of breast cancer in Iran.
Methods: This ecological study was conducted in Kermanshah University of Medical Sciences, Iran, from February to July 2018. Data on breast cancer patients in all provinces of Iran (30 provinces) were investigated since 2004 to 2009. Risk factors in this study included fruit and vegetable consumption, physical activity, overweight or obesity, and human development index. In this study, we have used routine and spatial Poisson's generalized linear mixed models for data analysis.
Results: In both routine and spatial models, direct and significant correlation was found between the incidence of breast cancer and the human development index (P<0.05). In addition to human development index, overweight or obesity factors were also had direct and significant relationship to the incidence of breast cancer in the spatial Poisson's generalized linear mixed model (P<0.05). In the spatial Poisson's generalized linear mixed model with correlation structure of Besag Yorg Molie (BYM), two provinces of Gilan and East Azerbaijan had the highest risk of breast cancer incidence and province of Kohgiluyeh and Boyer Ahmad had the lowest risk of breast cancer incidence.
Conclusion: The results showed that the distribution of breast cancer incidence in Iran has a spatial structure. That is, the adjacent provinces have similar incidences of this disease.

Evaluation of matrix metalloproteinases 1 and 13 in the patients with breast cancer and their association with the clinical features
Solmaz Khalighfard , Shiva Irani , Ramesh Omranipour , Ali Mohammad Alizadeh ,
Volume 77, Issue 6 (9-2019)
Abstract
Background: Metalloproteinase enzymes can lead to the digestion of the extracellular matrix and its compounds and ultimately facilitate the metastasis of cancer cells to other tissues. This study aimed to evaluate the activity of matrix metalloproteinases (MMPs) 1 and 13 in the tissue and plasma samples of the patients with breast cancer and their relationship with clinical features of the disease.
Methods: In this experimental study, twenty-five patients with the diagnosis of non-metastatic luminal A breast cancer in the stage 2 or 3 from the patients referred to the Cancer Institute of Iran, as well as eight healthy subjects which was performed in the Cancer Research Center of Tehran University of Medical Sciences from March 2017 to September 2017, were entered into the study. After obtaining written consent, a few biopsies of breast tumor tissues and 10 cc of the whole blood were collected from all the subjects. Then, the collagen zymography assay was used to evaluate the activity of MMPs 1 and 13.
Results: The results of the present study showed that the activity of MMPs 1 and 13 in the plasma samples was significantly increased in comparison with the healthy group (respectively P=0.0055 and P=0.0263). Unlike the MMP-13, the activity level of the MMP-1 in the tumor and plasma samples was significantly different (P=0.0227). Plasma activity levels of MMP-1 (P=0.0037) and MMP-13 (P=0.0311) were also significantly different in stages 2 and 3 of the disease. Unlike the MMP-13, the activity level of MMP-1 was significantly different in lymph nodes between the tissue and plasma samples (respectively P=0.03 and P=0.015). Moreover, there was no significant difference in the activity level of MMPs 1 and 13 with menopausal and non-menopausal status between the tissue and plasma samples.
Conclusion: The results of the present study showed that plasma concentrations of the MMPs 1 and 13 in comparison with their tissue concentrations could be an appropriate diagnostic tool for breast cancer patients.

A review of neural network detection methods for breast cancer: review article
Homayoon Yektaei, Mohammad Manthouri,
Volume 78, Issue 6 (9-2020)
Abstract
Breast cancer is the most common cancer among women and the earlier it is diagnosed, the easier it is to treat. The most common way to diagnose breast cancer is mammography. Mammography is a simple chest x-ray and a tool for early detection of non-palpable breast cancers and tumors. However, due to some limitations of this method such as low sensitivity especially in dense breasts, other methods such as 3d mammography, ultrasound and magnetic resonance imaging are often suggested to obtain additional useful information. Recently, computer-aided diagnostic or intelligent diagnostic have been developed to assist radiologists to improve diagnostic accuracy. In general, a computer system consists of four steps: pre-processing, dividing areas of interest, extracting and selecting features, and finally classification. Nowadays, the use of imaging techniques in the identification of patterns for diagnosis and automatic determination of breast cancer by mammography and even digital pathology (which is one of the emerging trends in modern medicine) reduces human errors and speeds up the diagnosis. In this article, We reviewed recent findings and their disadvantages and benefits in the diagnosis of breast cancer by neural networks, especially the artificial neural network, which is widely used in the diagnosis of cancers and intelligent breast cancers. This literature review shows that hybrid algorithms have been better at improving classification and detection accuracy. Providing a convenient way to diagnose tumors in the breast by computer-assisted diagnosis systems will be of great help to the physicians. Much work has been done in recent years to diagnose breast cancer, and many advances have been made in improving and diagnosing breast cancer by computer. All methods have a significant error percentage and are different depending on the type of breast, but compared to other types of neural networks, convolution and combining methods with convo have better results. Another advantage of the convoluted network is the automatic extraction of desirable features. Today, the best percentages of accuracy in detecting benign or malignant cancerous mass are achieved by convolution.
Dosimetric comparison of treatment of left breast cancer using two different dose schedules Dosimetric comparison of treatment of left breast cancer using two different dose schedules
Arezoo Kazemzadeh, Iraj Abedi, Alireza Amouheidari, Atefeh Shirvany,
Volume 78, Issue 9 (12-2020)
Abstract
Background: To date, different kinds of treatment methods have been proposed for radiotherapy of cancer patients. Choosing the kind of treatment method affects the quality of the patient's treatment. This study aims to investigate the effect of the number of radiation treatment sessions on the dose received by the patient and the distribution of tumor dose and dose received by organs at risk in breast cancer radiation therapy. These results help us to select the appropriate treatment schedules for the treatment of left breast patients.
Methods: This prospective cross-sectional study was performed on the treatment plans of 35 patients with left breast cancer who referred to Isfahan Milad Hospital between July 2019 and April 2020. They were candidates for left breast radiation therapy. Also, these patients had no history of surgery or chemotherapy, and no supraclavicular or axillary lymph nodes were involved. Patients were treated with a conventional fraction regimen (CF) or hypofractionated (HF) treatment schedule. Different dosimetry parameters for the target and organ at risks such as conformity index, homogeneity index and mean dose were obtained from the dose-volume histogram plot. Finally, the results of both plans were compared with each other.
Results: The data obtained from this study indicate a decrease in the average dose of all organs in the hypo fractionated regimens compared to conventional plans. The differences between two plans were statistically significant for tumor, lung, and skin (P=0.0). Moreover, the maximum dose for the skin was also reduced when hypofractionated regimens were used. However, the values of the homogeneity index and conformity index of tumor in the two methods did not show a significant difference (P were 0.99 and 0.86, respectively).
Conclusion: In general, the results of the current study indicate that the hypofractionated regimen leads to a reduction in dosimetric factors compared to conventional fraction plans. It seems that this method can be used as an alternative treatment plan for breast cancer radiation therapy due to the reduced duration of the treatment period.
 
Development of a persian version of the BREAST-Q and validity and reliability of the reconstruction module for the assessment of the quality of life and patient satisfaction following breast surgery
Bita Eslami, Ramesh Omranipour , Bahare Hesamifar, Zahra Behboodi Moghadam , Amirmohsen Jalaeefar,
Volume 78, Issue 11 (2-2021)
Abstract
Background: Breast cancer is the most common cancer in women and its treatment includes various surgeries. Breast-Q is a new patient-reported outcome instrument for breast surgery and it should be validated appropriately for clinical research. This study aimed to develop the Persian version of the Breast-Q and validate the reconstruction module to evaluate the quality of life and satisfaction of Iranian women with a previous history of breast reconstruction.
Methods: This study was descriptive and analytical cross-sectional. The study population consisted of women with a previous history of breast cancer and various breast surgeries referred to the outpatient clinic of Cancer Institute, Imam Khomeini Hospital from September 2017 to October 2019, using convenience sampling. After obtaining permission from the MAPI institute and translating all questionnaires into Persian, the validity, and reliability of the breast reconstruction module were evaluated. To confirm face validity, a questionnaire was given to patients to judge each item. To confirm the content validity of the questionnaire, two qualitative and quantitative methods were used. Content validity ratio (CVR) was calculated based on the expert opinion (Lawshe formula). Waltz & Bausell’s method was used to examine the content validity index (CVI). Finally, a new version of the questionnaire was assessed in 20 women who had undergone TRAM flap breast reconstruction at least 6 months ago.
Results: After translation of the questionnaire into Persian, and face and content validation process, the 116 items of the first questionnaire converted to 72 with an acceptable impact score greater than 1.5 and CVR and CVI. The internal validity of the breast reconstruction module was approved by Cronbach's alpha value of 0.94.
Conclusion: Considering the limitation of the specific questionnaires for various breast surgery procedures, the Breast-Q questionnaire can be an efficient tool for the evaluation of the quality of life and satisfaction in patients. Since the translation of the questionnaire has become valid and reliable, it can be used for future research by other researchers.

Deep learning-based CAD systems for mammography: A review article
Ali Ameri, Mahmoud Shiri, Masoumeh Gity , Mohammad Ali Akhaee,
Volume 79, Issue 5 (8-2021)
Abstract
Breast cancer is one of the most common types of cancer in women. Screening mammography is a low‑dose X‑ray examination of breasts, which is conducted to detect breast cancer at early stages when the cancerous tumor is too small to be felt as a lump. Screening mammography is conducted for women with no symptoms of breast cancer, for early detection of cancer when the cancer is most treatable and consequently greatly reduce the death rate from the breast cancer. Screening mammography should be performed every year for women age 45-54, and every two years for women age 55 and older who are in good health. A mammogram is read by a radiologist to diagnose cancer.
To assist radiologists in reading mammograms, computer-aided detection (CAD) systems have been developed which can identify suspicious lesions on mammograms. CADs can improve the accuracy and confidence level of radiologists in decision making and have been approved by FDA for clinical use. Traditional CAD systems work based on conventional machine learning (ML) and image processing algorithms. With recent advances in software and hardware resources, a great breakthrough in deep learning (DL) algorithms was followed, which revolutionized various engineering areas including medical technologies. Recently, DL models have been applied in CAD systems in mammograms and achieved outstanding performance. In contrast to conventional ML, DL algorithms eliminate the need for the tedious task of human-designed feature engineering, as they are capable of learning useful features automatically from the raw data (mammogram). One of the most common DL frameworks is the convolutional neural network (CNN). To localize lesions in a mammogram, a CNN should be applied in region‑based algorithms such as R‑CNN, Fast R‑CNN, Faster R‑CNN, and YOLO.
Proper training of a DL‑based CAD requires a large amount of annotated mammogram data, where cancerous lesions have been marked by an experienced radiologist. This highlights the importance of establishing a large, annotated mammogram dataset for the development of a reliable CAD system. This article provides a brief review of the state‑of‑the‑art techniques for DL‑based CAD in mammography.

The prediction of lymphedema via the combination of the selected data mining algorithms
Anaram Yaghoobi Notash , Peiman Bayat, Shahpar Haghighat, Ali Yaghoobi Notash ,
Volume 79, Issue 11 (2-2022)
Abstract
Background: Breast cancer is the second leading cause of cancer death in women, after lung cancer. Due to the importance of predicting this disease, the use of data mining methods in medical research is more significant than before. Data mining algorithms can be a great help in preventing the development of lymphedema in patients. The aim Of this study was to create a diagnosis system that can predict the probability of lymphedema in breast cancer patients.
Methods: In the present study, the factors of lymphedema in 1117 patients with breast cancer have been collected. The likelihood of developing lymphedema is predicted using ensemble learning via 5 heterogeneous classification algorithms, feature selection and the genetic algorithm (The Two-layer Ensemble Feature Selection method). After collecting the data of patients with breast cancer from 2009 to 2018, and data preprocessing using the optimized ensemble learning algorithm and feature selection, we will examine the likelihood of developing lymphedema for the new patient. Finally, the factors affecting the disease have been extracted. Excluding the time of collecting statistical data, the period of the study was from September 2019 to February 2021. This study is performed at Seyed Khandan Rehabilitation Center, Tehran, Iran.
Results: The results of algorithms showed that the accuracy of the ensemble learning method with selected classification algorithms (SVM with RBF kernel) is 87% and the accuracy of the ensemble learning with feature selection method is 90%. According to the final evaluation of the proposed method, the most effective risk factors for lymphedema have been extracted.
Conclusion: Unfortunately, treatment and diagnosis are not without complications, and one of the most important of these complications in breast cancer is lymphedema in the upper extremities, which can affect the quality of life in patients. It is essential to have a method that can accurately suggest to a specialist whether a new patient will develop lymphedema in the future or how likely it is to develop it, using patient’s own clinical and demographic characteristics.
 

Skin metastases in breast cancer: a review article
Behnaz Varaminian, Marzieh Ghalamkari , Tayeb Ramim, Masoumeh Roohaninasab ,
Volume 80, Issue 8 (11-2022)
Abstract
Skin metastases from breast cancer usually occur in more advanced stages of the disease, but can sometimes be the first clinical manifestation of breast cancer or the first evidence of a previous tumor recurrence. These demonstrations significantly reduce survival. Skin metastases from breast cancer have different manifestations. The most common manifestations are nodules. These nodules are soft, round or oval, mobile, firm, and elastic in texture and can be single or multiple, often flesh-colored, but can also be brown, bluish black, and pink to reddish brown. In the absence of a previous history of cancer, it can be difficult to diagnose the early location of metastatic cancers. However, metastases usually show histopathological similarities to the primary tumor. Soft tissue breast metastases usually have a better prognosis than breast or bone cancer metastases. Also, skin metastases from breast cancer do not necessarily have a poor prognosis as skin metastases from other malignancies. The relative risk of death from skin metastases to other malignancies is more than four times higher than skin metastases from breast cancer. Differential diagnosis includes cutaneous lymphoma, intracranial leukocyte infiltration, and cutaneous metastasis. Metastatic skin lesions are often mistaken for benign lesions. Recognizing them quickly is important to prevent long-term anti-inflammatory treatment that delays proper diagnosis. Therefore, to rule out metastasis, abnormal or nodular lesions should be considered for biopsy in patients with a history of systemic malignancy or suspected malignancy. Cutaneous metastases are usually a sign of widespread disease and may not be treatable in most cases. Treatment options include systemic and/or topical treatments. Extensive skin metastases require systemic treatment. For thicker skin metastases, radiation therapy, surgical or electrochemical resection is indicated as monotherapy or in combination. Oxygen in combination with topical 5% methotrexate (OFAMTX, 5% methotrexate in a carrier solution) is a recently described method that facilitates drug penetration into the epidermis. In the absence of visceral or lymph node metastases, OFAMTX is useful as a local skin treatment. This treatment is an effective and tolerable method for superficial skin metastases. Using local treatment in combination with systemic agents increases the overall effectiveness of treatment on skin metastases.

Recurrence and survival in early breast cancer subtypes
Ali Taghizadeh, Leila Pourali, Mona Joudi, Bahareh Makvandi , Elahe Hasanzadeh, Saeideh Ahmadi Simab , Golshid Nouri Hosseini , Mehrdad Gazanchian,
Volume 81, Issue 3 (6-2023)
Abstract
Background: Breast cancer is the most common type of cancer in many countries, accounting for over 18% of all cancers in females. There are more than one million new cases of breast cancer each year. Most women diagnosed with breast cancer are over the age of 50, but younger women can also get breast cancer. About one in seven women are diagnosed with breast cancer during their lifetime. There's a good chance of recovery if it's detected at an early stage. In Iran, breast cancer is the most common cancer among women, making up 21.4% of all female cancers. The mortality rate of this cancer is 4.33 for every 100,000 people. The purpose of this research is to see how often different kinds of early breast cancer come back and how long people live after being diagnosed.
Methods: This retrospective study evaluated the medical records of 500 breast cancer patients at two hospitals in Mashhad, Iran during April 2006 to March 2016. We used SPSS software, version 16 (SPSS Inc., Chicago, IL, USA) to analyze data. A P value less than 0.05 means that the results are considered statistically significant.
Results: We included 230 women with breast cancer. The average overall survival was 130.7 months, with 83.2% of people surviving for five years and 78.8% surviving for 10 years. The stage of the disease is strongly linked to the recurrence (P=0.000). Additionally, the specific type of disease is also strongly related to disease recurrence (P=0.01) or metastasis (P=0.01). Patients who have the triple-negative subtype had the highest chance of the cancer spreading and recurrence compared to patients with other subtypes.
Conclusion: The different types of breast cancer are strongly linked to the disease recurrence or metastasis. Patients with triple-negative subtypes had the most cases of cancer spreading to other parts of the body and coming back again, compared to other subtypes. Our findings also showed that patients with the triple-negative disease had the worst overall and disease-free survivals.

Microbiota and probiotics, a new approach in the prevention and treatment of breast cancer: a review article
Saeedeh Keyvani-Ghamsari , Kiana Nouri, Ali Khaleseh Nejad , Shokoufeh Hassani,
Volume 81, Issue 11 (2-2024)
Abstract
Today, despite vast advances in cancer diagnosis and treatment, breast cancer is still the leading cause of cancer-related deaths in women. Various factors such as race, age, family history, mutation in the BRCA1/2 gene, diet, inactivity, alcohol consumption, and estrogen levels have been identified as risk factors for breast cancer. In recent years, microbiota has also been recognized as a new risk factor in breast cancer. In fact, the change in the microbial balance that occurs due to many environmental and internal factors of the body can be effective in the spread of cancer by affecting the intracellular pathways and signals. Studies have shown that intestinal dysbiosis affects the spread of breast cancer by affecting the metabolism and production of estrogen, or mechanisms unrelated to estrogen, such as the production of microbial metabolites that affect the immune system and lead to chronic inflammation. In addition, it has been proven that the breast tissue also has its microbiota, the types of which are different in healthy people, patients, even in different stages of breast cancer, and its subgroups. In such a way that a large amount of Proteobacteria, Firmicutes, Lactobacillus, and Actinobacteria are observed in healthy breasts, while their ratio changes in cancerous tissues. Considering the relationship between microbiota and breast cancer, maintaining a healthy microbiota is a new and significant approach to reducing the risk of developing, spreading, and managing this cancer. In this regard, compounds such as probiotics that can affect the balance of intestinal microbiota are considered as an effective approach to prevent and treat breast cancer. Probiotics can stimulate the growth of beneficial bacteria and inhibit the growth of harmful bacteria by causing physicochemical changes and affecting the metabolism of the intestinal microbiota. Furthermore, the consumption of probiotics can prevent the proliferation of cancer cells and reduce the tumor size by balancing the immune system, reducing inflammation, and inducing apoptosis in the cancer cells. This study describes the importance of microbiota in breast cancer, the difference between microbiota in a healthy person and a sick person, and the role of probiotics in the treatment of breast cancer.

Investigating the role of ultrasound in diagnosing malignant axillary lymph nodes in patients with breast cancer in patients referred to Golestan Hospital in Ahvaz
Fatemeh Khaksarmadani, Azim Motamedfar, Mohammad Momen Gharibvand,
Volume 82, Issue 3 (6-2024)
Abstract
Background: Breast cancer ranks as one of the most prevalent cancers among women worldwide and remains a major cause of mortality. The axillary lymph node (ALN) status, especially in the absence of distant metastasis, is a significant prognostic indicator in breast cancer management. Non-invasive methods, such as ultrasound, have gained prominence in the diagnostic landscape, particularly for evaluating dense breast tissue where traditional imaging may have limitations. This study was conducted to assess the diagnostic accuracy of ultrasound in detecting malignant ALNs among breast cancer patients.
Methods: This descriptive-analytical study was conducted on 150 women diagnosed with breast cancer who visited Golestan Hospital in Ahvaz, Iran, between 2021 and 2022. Patients were initially examined clinically, and subsequently, ALN evaluations were performed using a GE S6 logic ultrasound machine. Key radiologic parameters including lymph node size, morphology, cortical thickness, and vascular distribution were assessed. Stata software was used for data analysis, and pathology results were considered the gold standard to determine ultrasound’s sensitivity and specificity in detecting malignancy.
Results: We found 77.7% of the 150 patients had metastatic ALNs, indicating a high rate of lymphatic spread in this population. Ultrasound showed a sensitivity of 86.09% and a specificity of 51.52% in detecting malignant nodes. Radiological signs of cancer, like abnormal morphology and increased cortical thickness, were strongly linked to positive pathological findings. This shows that ultrasound is a useful tool for diagnosis.
Conclusion: The results indicate that ultrasound, as a non-invasive and accessible modality, can serve as a valuable diagnostic tool for identifying malignant ALNs in breast cancer patients. Integrating ultrasound with physical examination could enhance diagnostic precision, potentially reducing the need for invasive procedures such as biopsies. However, more research is necessary to establish the role of ultrasound in clinical protocols and investigate its potential to guide customized treatment strategies. Such advancements could optimize patient outcomes, enhance resource allocation, and ultimately contribute to more effective breast cancer management.

Investigating the role of vitamin D deficiency as a risk factor and prognosis of breast cancer: a case-control study
Navid Kalani , Lohrasb Taheri , Fatemeh Eftekharian, Ali Talebi, Marzieh Haghbeen,
Volume 82, Issue 6 (9-2024)
Abstract
Background: Breast cancer is the most common cancer diagnosed in women. Epidemiological studies have led to the hypothesis that vitamin D may reduce the risk of breast cancer. This study aimed to investigate the association between vitamin D deficiency and breast cancer.
Methods: This case-control study was conducted on 59 patients referred to Khatam Al-Anbia Comprehensive Cancer Clinic in Jahrom city between May 2021 and March 2022. Thirty patients with pathologically confirmed ductal or lobular breast cancer in situ or invasive in one or both breasts, with no previous history of the disease and within two months of their breast cancer diagnosis, were considered as the case group. Thirty women without breast cancer who had been referred for breast screening examination were considered as the control group. Both groups were matched for demographic characteristics and age. The data collection tools in this study included demographic information and clinical history of the patients and serum vitamin D levels. Data analysis was performed using SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and descriptive statistics (mean, percentage, and standard deviation) and inferential statistical tests (logistic regression, Kolmogorov-Smirnov). The significance level was considered to be P<0.05.
Results: The mean age of the patients participating in the case group was 52.17±10.6 and in the control group was 51.24±9.7. There was no statistically significant difference in age (P=0.654). There was also no significant difference between the two groups in terms of body mass index and different body index classifications, menopause age, and age of onset of menstruation. The number of months of breastfeeding in the control group was significantly higher than the case group (P=0.001). The results of logistic regression showed that, on the other hand, there was no significant relationship between the type of pathology of the disease and serum vitamin D levels.
Conclusion: The results of the present study showed that vitamin D deficiency can be a poor prognostic factor in the course of breast cancer.

Investigating the effect of insect body extracts (their products) and some arthropods in inhibiting the growth of cancer cells or tumours (breast cancer cell line/MCF7)
Bahar Rostamizadeh, Alireza Jalali-Zand , Kamran Qhaedi, Rozita Nasiri,
Volume 82, Issue 8 (11-2024)
Abstract
Background: Insects and arthropods, along with their products, have been used as medicinal sources since ancient times, that is called entomotherapy. Cancer is one of the major problems in medical science, for which a drug has not yet been discovered to control it quickly and accurately. Arthropods have been medicinal sources since ancient times and they especially Insects have a high potential for insect therapy because of the biodiversity. This research investigates the effect of insect body extracts and arthropods in inhibiting the growth of cancer cells or tumours, specifically on the breast cancer cell line, MCF7002E
Methods: The basic and applied study was conducted in Isfahan from 2018 to 2023. In this research, six species of insects, namely Gryllotalpa sp., Polyrhachis sp., Dolichovespula sp., Apis mellifera, Periplaneta americana, Drosophila melanogaster, and one species of Chilopoda, Scolopendra sp., were used. The samples were washed with distilled water and 70% alcohol, then frozen and powdered and prepared in 1% DMSO at eight concentrations of 62.5, 125, 250, 500, 1000, 2000, 4000, 8000 μg/ml and were evaluated for the control of two lines of breast cancer cells MCF-7 by the MTT test was performed to check the effect of doses. The affected doses of insects and centipedes were performed in 6 replicates and three times to MCF-7 cells. IC50 and LD50 were calculated by Prism version six software to check the effect of concentrations determine the effective dose and choose the best extract to control the growth of MCF-7 breast cancer cells.
Results: Scolopendra sp., Drosophila melanogaster, Periplaneta americana, Polyrhachis sp., Apis mellifera, and Gryllotalpa sp. are the most effective species, respectively, in inducing apoptosis and cell death in MCF-7 cancer cell line. Dolichovespula sp. had the least effect. Scolopendra sp. at a concentration of 500 μg/litre induced cell death in more than 50% of MCF-7 cancer cells.
Conclusion: The results of the application of seven different genera of arthropods and insects showed that these genera have excellent therapeutic potential, particularly in the treatment of MCF-7 cancer cells.
 

Histopathological and immunohistochemical study of malignant breast tumors in Iran
Seyede Hakimeh Sajadi, Mohadeseh Karimi ,
Volume 82, Issue 12 (3-2025)
Abstract
Background: Approximately 16% of all female cancers. Due to its high prevalence and considerable impact on patient survival, comprehensive evaluation of histopathological and molecular features is crucial for improving disease management. This study aimed to analyze the histopathological spectrum and immunohistochemical (IHC) molecular subtypes of invasive breast tumors in an Iranian population, with the ultimate goal of guiding tailored therapeutic strategies.
Methods: This retrospective cross-sectional study was conducted between 2021 and 2023 at Shahid Mohammadi Hospital, Bandar Abbas, Iran. Initially, 110 female patients diagnosed with invasive breast carcinoma were evaluated. After applying exclusion criteria (bilateral breast cancer, in-situ carcinoma, prior neoadjuvant chemotherapy, or inadequate pathological specimens), 10 patients were excluded, leaving 100 cases for final analysis. Demographic and clinical data were collected from medical records, while histopathological assessment was performed using hematoxylin-eosin (H&E) staining. Immunohistochemistry was applied to evaluate estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 expression, enabling classification into molecular subtypes: Luminal A, Luminal B, HER2-enriched, and Basal-like. Tumor grade and stage were determined according to AJCC/UICC criteria. Statistical analysis was performed using SPSS v21, with significance set at P<0.05.
Results: The patients’ ages ranged from 26 to 73 years, with a mean age of 49.5 years. Histopathologically, invasive ductal carcinoma accounted for 89% of cases, followed by lobular (5%), medullary (3%), and other rare subtypes (3%). Molecular classification revealed 9% Luminal A, 65% Luminal B, 11% HER2-enriched, and 15% Basal-like. A significant association was found between tumor grade and molecular subtype (P=0.001). Luminal B tumors showed the highest frequency of grade III lesions, axillary lymph node metastasis, and advanced tumor stage (II-III), indicating more aggressive biological behavior compared to Luminal A.
Conclusion: This study confirmed that invasive ductal carcinoma is the predominant histological type of breast cancer, with Luminal B being the most prevalent molecular subtype in the studied population. The findings highlight the importance of molecular profiling for accurate prognostication and treatment planning. In particular, the aggressive features of Luminal B tumors emphasize the need for more intensive therapeutic approaches. Incorporating routine IHC-based subtyping into breast cancer management protocols could significantly enhance patient outcomes and support the implementation of precision oncology in Iran.

Exercise training and cardiovascular health in postmenopausal women with breast cancer: physiological perspectives, clinical evidence, and practical challenges
Babak Hooshmand-Moghadam , Abbas Ali Gaeini,
Volume 82, Issue 12 (3-2025)
Abstract
Background: As survival rates among breast cancer patients improve, cardiovascular disease (CVD) has emerged as a leading cause of long-term morbidity and mortality in postmenopausal survivors. This epidemiological transition from oncologic risk to cardiometabolic vulnerability reveals a critical yet underexplored dimension of survivorship care. Structured exercise training represents a promising intervention, and this narrative review-grounded in a systematic literature search investigates the effects of aerobic, resistance, and combined training modalities on cardiovascular health in postmenopausal women with breast cancer. The review synthesizes evidence across physiological mechanisms, clinical outcomes, and implementation challenges to provide a comprehensive perspective on exercise oncology in this underserved population.
Methods: A systematic search of reputable international databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar as well as Persian databases SID and Magiran was conducted to identify relevant human studies, clinical trials, and randomized controlled trials published between January 2000 and April 2025. Screening, selection, and synthesis of the studies were performed in Iran between October 2024 and January 2025.
Results: Accumulating evidence supports that structured exercise especially combined aerobic and resistance training exerts substantial cardioprotective effects through multiple mechanisms, including reductions in systemic inflammation, improvements in body composition, regulation of blood pressure, enhancement of cardiorespiratory fitness, and improved left ventricular function. Combined interventions consistently outperformed single-modality programs, underscoring the importance of integrative approaches in oncologic rehabilitation. Despite this promise, persistent barriers such as limited access to trained personnel, lack of individualized protocols, and weak institutional support impede translation into routine practice. Notably, few existing reviews have bridged mechanistic, clinical, and operational domains in this population, highlighting a significant gap in the literature.
Conclusion: Exercise training is not merely an adjunct to care it is a clinically potent, physiologically grounded, and policy-relevant strategy for mitigating cardiovascular risk in postmenopausal breast cancer survivors. Given the increasing burden of CVD in this group, integrating personalized, evidence-based exercise into oncologic care pathways is both urgent and essential for advancing survivorship standards and informing future clinical guidelines.

 
Study of the prevalence of thyroid disorders in patients with breast cancer
Tahereh Parsajam , Behnam Reza Makhsoosi, Ali Najafpour, Kimia Fathi,
Volume 83, Issue 1 (4-2025)
Abstract
Background: Thyroid hormones play a key role in the development of various organs of the body. The breast and thyroid are hormone-responsive organs that are closely related to changes in endocrine activity and glandular diseases. Breast cancer is the most common cancer in women and the second leading cause of cancer-related death. Due to the inconsistencies in the relationship between breast cancer and thyroid diseases and the lack of regional data, the present study was designed and conducted with the aim of investigating the prevalence of various thyroid disorders in patients with breast cancer and its relationship with the type of breast cancer and age.
Methods: In this prospective study, we examined 50 women with breast cancer who had undergone surgery after surgery. The location of this study was Imam Reza Hospital in Kermanshah and the duration of this study was 12 months from the beginning of March 2023 to the end of March 2024. Patient information included: age, histopathological type of cancer, and thyroid test results including serum TSH, FT4, and ATPO levels, were recorded and reviewed.
Results:  Based on the results obtained, it was shown that the average age of people with thyroid disorders in patients with breast cancer was 42.88 and the standard deviation was 11.313. Also, there was no significant difference between the age of people and thyroid disorders in patients with breast cancer (P-value < 0.89). In the study of thyroid disorders in patients with breast cancer, it was shown that there was a significant relationship between patients with breast cancer and the amount of TSH and the amount of FT4. This means that people with breast cancer had an increase in the amount of TSH and the amount of FT4. However, there was no significant relationship between patients with breast cancer and the amount of ATPO (P-value < 0.319).
Conclusion: Thyroid disorders are more prevalent in patients with breast cancer than in the normal population, and given the relationship between the types of thyroid disorders and the type of breast cancer histopathology, these results can be used and screening methods can be used more effectively in those who have risk factors for breast cancer for early diagnosis and treatment of the disease.

Diagnostic value of the long non-coding RNA KCNQ1OT1 in the detection of breast cancer
Mandana Pouladzadeh, Fatemeh Khazaei, Saeid Bitaraf, Hossein Karimpourian, Mahsa Mombeyni, Mohammad-Reza Mahmoudian-Sani ,
Volume 83, Issue 4 (7-2025)
Abstract
Background: Breast cancer is the most prevalent malignancy among women and remains a leading cause of cancer-related mortality worldwide. Early detection can markedly improve patient survival, yet existing screening methods often lack sufficient accuracy and sensitivity. lncRNA KCNQ1OT1 has been implicated in the initiation and progression of tumors in several cancers, including breast cancer. This study aimed to evaluate the diagnostic potential of serum lncRNA KCNQ1OT1 expression as a biomarker for early detection of breast cancer.
Methods: This case-control study was conducted at Ahvaz Jundishapur University of Medical Sciences, Shafa Hospital, Ahvaz, Iran, between September 2024 and March 2025. Serum samples were obtained from 30 patients with histologically confirmed breast cancer and 30 healthy women serving as controls. Total RNA was extracted from 500 µL of serum, and cDNA was synthesized using oligo (dT) primers. Real-Time PCR was performed in triplicate, with GAPDH as the internal control. Relative gene expression was calculated using the 2^-ΔΔCt method, and data were analyzed using the Mann-Whitney U test and ROC analysis.
Results: The patient and control groups were homogeneous for most demographic parameters, but showed significant differences in age (P=0.023) and ethnicity (P=0.004). Most patients were in stage I of the disease. The median expression of serum KCNQ1OT1 was significantly lower in patients (0.024, IQR 0.013-0.033) than in controls (0.039, IQR 0.027-0.051), indicating marked downregulation in the patient group (P=0.0003). The ROC analysis yielded an AUC of 0.82 (95% CI: 0.67-0.96, SE=0.07, P=0.0005). At an optimal cutoff value of >0.031, the sensitivity was 70%, the specificity was 95%, and the positive likelihood ratio (LR⁺) ≈ was approximately 14, demonstrating strong discriminative ability.
Conclusion: Serum KCNQ1OT1 exhibits promising diagnostic performance for identifying early-stage breast cancer and may serve as a reliable noninvasive biomarker. Larger multicenter studies incorporating molecular subtyping and tissue correlation are required to validate its clinical applicability and strengthen diagnostic accuracy.
 
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