Background
Inflammatory breast cancer (IBC) is a lethal form of breast cancer with unknown etiology. A higher frequency of IBC and a more aggressive IBC phenotype was reported in Egypt than in the ...United States. This difference in disease frequency and presentation might be related to molecular epidemiologic factors.
Methods
We used tumor blocks and demographic, epidemiologic, and clinical data of 48 IBC patients from Egypt and 12 patients from the United States. We counted tumor emboli in tumors before and after immunohistochemical staining with lymphatic vessel endothelial receptor-1 (LYVE-1), and measured the expression of RhoC GTPase protein in the two groups.
Results
Erythema, edema, and peau d’orange were found in 77% of the Egyptian patients as compared with 29% found in the US patients (
P
= 0.02). The number of tumor emboli was significantly higher in tumors from Egypt (mean ± SD, 14.1 ± 14.0) than in the tumors from the United States (5.0 ± 4.0,
P
= 0.01). The number of tumor emboli in LYVE-1 positive vessels was higher in tumors from Egypt (3.5 ± 2.8) than tumors from the United States (1.6 ± 0.5,
P
= 0.15). We detected a high level of RhoC in 87% of the tumors from Egypt and 14% of the tumors from the United States (
P
= 0.0003).
Conclusion
Patients from Egypt have a more aggressive form of IBC than those in the United States. Our analysis of IBC patients shows that distinct molecular phenotypes can be found when these two study populations are compared. Future studies should explore the epidemiologic and environmental exposures and the genetic factors that might lead to the different clinical and molecular features of IBC in patients from these two countries.
The diagnosis of inflammatory breast cancer (IBC) is largely clinical and therefore inherently somewhat subjective. The objective of this study was to evaluate the diagnosis of IBC at two centers in ...North Africa where a higher proportion of breast cancer is diagnosed as IBC than in the United States (U.S.). Physicians prospectively enrolled suspected IBC cases at the National Cancer Institute (NCI) – Cairo, Egypt, and the Institut Salah Azaiz (ISA), Tunisia, recorded extent and duration of signs/symptoms of IBC on standardized forms, and took digital photographs of the breast. After second‐level review at study hospitals, photographs and clinical information for confirmed IBC cases were reviewed by two U.S. oncologists. We calculated percent agreement between study hospital and U.S. oncologist diagnoses. Among cases confirmed by at least one U.S. oncologist, we calculated median extent and duration of signs and Spearman correlations. At least one U.S. oncologist confirmed the IBC diagnosis for 69% (39/50) of cases with photographs at the NCI‐Cairo and 88% (21/24) of cases at the ISA. All confirmed cases had at least one sign of IBC (erythema, edema, peau d'orange) that covered at least one‐third of the breast. The median duration of signs ranged from 1 to 3 months; extent and duration of signs were not statistically significantly correlated. From the above‐mentioned outcomes, it can be concluded that the diagnosis of a substantial proportion of IBC cases is unambiguous, but a subset is difficult to distinguish from other types of locally advanced breast cancer. Among confirmed cases, the extent of signs was not related to delay in diagnosis.
The diagnosis of inflammatory breast cancer (IBC) is largely clinical and therefore inherently somewhat subjective. The objective of this pilot study was to evaluate the diagnosis of IBC at two centers in North Africa, where a higher proportion of breast cancer is diagnosed as IBC than in the United States (U.S.). The diagnosis of a substantial proportion of IBC cases at the study centers was unambiguous, but a subset was difficult to distinguish from other types of locally advanced breast cancer.
Abstract Understanding the molecular factors that distinguish inflammatory breast cancer (IBC) from non-IBC is important for IBC diagnosis. We reviewed the records of 48 IBC patients and 64 non-IBC ...patients from Egypt. We determined RhoC expression and tumor emboli and their relationship to demographic and reproductive characteristics. Compared with non-IBC patients, IBC patients had significantly lower parity ( P = 0.018) and fewer palpable tumors ( P < 0.0001). IBC tumors showed RhoC overexpression more frequently than non-IBC tumors (87% vs. 17%, respectively) ( P < 0.0001). Tumor emboli were significantly more frequent in IBC tumors than non-IBC tumors (Mean ± SD: 14.1 ± 14.0 vs. 7.0 ± 12.9, respectively) ( P < 0.0001). This study illustrates that RhoC overexpression and tumor emboli are more frequent in tumors of IBC relative to non-IBC from Egypt. Future studies should focus on relating epidemiologic factors to molecular features of IBC in this population.
Gentamicin is an effective widely used antibiotic, but the risk of nephrotoxicity and oxidative damage limit its long-term use. Hence, the current study aims to elucidate such hazardous effects. To ...achieve the study aim male Wistar albino rats (
Rattus norvegicus) were exposed to gentamicin to investigate the resultant blood chemical changes and renal histological alterations. In comparison with control rats, gentamicin produced outstanding tubular, glomerular and interstitial alterations that included degeneration, necrosis, cytolysis and cortical tubular desquamation together with mesangial hypercellularity, endothelial cell proliferation and blood capillary congestion. Compared with control animals significant blood chemical changes (
P
<
0.05) including free radicals, ALT, AST, ALP, serum creatinine and serum urea were recorded in gentamicin-injected animals. The findings revealed that exposure to gentamicin can induce significant histological alterations in the kidney as well as remarkable blood chemical changes that might indicate marked renal failure.
Many students with ADHD have emotional dysregulation which is increasingly recognized as a core feature of attention-deficit/hyperactivity disorder (ADHD). Functional Model for Emotional Information ...Processing is supposed to be a useful tool to be used when observing, explaining, and predicting a human being while responding to emotional scenarios. It is a promising model to support social competence of students with ADHD. While research on this model is still in its infancy, it borrowed much of its theoretical base from both Crick and Dodge’s SIP model and Mayer and Salovey’s ability EI. It is a useful to improve social competence of children with ADHD.
We conducted a study in Egypt to assess the determinants of organochlorine serum levels among premenopausal women and the risk of premenopausal breast cancer for women with high organochlorine serum ...levels. We included 69 breast cancer patients and 53 controls consisting of visitors to the hospitals of the cancer patients. We found low levels of dichlorodiphenyldichloroethylene (DDE), total dichlorodiphenyltrichloroethane, and
β-hexacholorhexane (
β-HCH) in most subjects. Mean DDE levels were 12.7±20.3
ppb for cases and 16.6±30.1
ppb for controls (
P=0.60);
β-HCH levels were 2.1±3.8
ppb for patients and 2.1±3.9
ppb for controls (
P=0.71). Interestingly, subjects with low levels had breast fed their children for an average period of 18 months. Women with no lactation history had much higher organochlorine levels than women who breast fed (
P=0.002 for DDE). Younger age, older age at first childbirth, and shorter duration of breast feeding were significant predictors of higher levels of serum DDE levels. Younger age, older age at first childbirth, and higher body mass index were significant predictors of higher
β-HCH levels. This study suggests that organochlorine serum levels in Egyptian women are quite low, but indicates an effect of breast feeding in eliminating organochlorines, which would imply exposure to children. Organochlorine serum level was not a risk factor of breast cancer in this population.
Abstract
The diagnosis of inflammatory breast cancer (
IBC
) is largely clinical and therefore inherently somewhat subjective. The objective of this study was to evaluate the diagnosis of
IBC
at two ...centers in
N
orth
A
frica where a higher proportion of breast cancer is diagnosed as
IBC
than in the
U
nited
S
tates (
U
.
S
.). Physicians prospectively enrolled suspected
IBC
cases at the National Cancer Institute (
NCI
) –
C
airo,
E
gypt, and the
I
nstitut
S
alah
A
zaiz (
ISA
),
T
unisia, recorded extent and duration of signs/symptoms of
IBC
on standardized forms, and took digital photographs of the breast. After second‐level review at study hospitals, photographs and clinical information for confirmed
IBC
cases were reviewed by two
U
.
S
. oncologists. We calculated percent agreement between study hospital and
U
.
S
. oncologist diagnoses. Among cases confirmed by at least one
U
.
S
. oncologist, we calculated median extent and duration of signs and
S
pearman correlations. At least one
U
.
S
. oncologist confirmed the
IBC
diagnosis for 69% (39/50) of cases with photographs at the
NCI
‐
C
airo and 88% (21/24) of cases at the
ISA
. All confirmed cases had at least one sign of
IBC
(erythema, edema, peau d'orange) that covered at least one‐third of the breast. The median duration of signs ranged from 1 to 3 months; extent and duration of signs were not statistically significantly correlated. From the above‐mentioned outcomes, it can be concluded that the diagnosis of a substantial proportion of
IBC
cases is unambiguous, but a subset is difficult to distinguish from other types of locally advanced breast cancer. Among confirmed cases, the extent of signs was not related to delay in diagnosis.
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