Browsing by Subject "Breast cancer"

Now showing 1 - 7 of 7
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    A survey of knowledge and attitudes relating to cervical and breast cancer among women in Ethiopia
    (BioMed Central, 2018-08-29) Chaka, Bekele; Sayed, Abdul-Rauf; Goeieman, Bridgette; Rayne, Sarah
    Background Breast cancer and cervical cancer are the two leading cancers among women in Ethiopia. This study investigated knowledge and attitudes related to these two types of cancer among women in 4 zones of Ethiopia. This is the first study employing a validated questionnaire to investigate knowledge and attitudes relating to breast and cervical cancer in Ethiopia. Methods A community based cross-sectional study was conducted from September to November 2015 in the North Shewa zone (Amhara region), Gamo Gofa zone (Southern Nations, Nationalities and Peoples’ region) and zones 1 and 3 (Afar region) of Ethiopia. A total of 799 women aged 18 years and older participated in the survey. Multiple logistic regression analysis was used to investigate the association of possible predictors with breast and cervical cancer knowledge. Results A total of 799 women aged 18 years and older participated in the survey. Of the women interviewed, 63.0% had heard of breast cancer and 42.2% had heard of cervical cancer. Among those who had heard of breast cancer, 21.3% (107/503) had heard of breast cancer screening and 1.4% of women aged 40 years and older had undergone at least one breast screening examination. Fewer than half of the participants provided the correct response to questions related to risk factors for breast and cervical cancer. Among those who had heard of cervical cancer, 41.5% (140/337) had heard of cervical cancer screening and 3.3% had undergone at least one cervical cancer screening examination. Women with primary and higher levels of education were more likely to have heard of breast cancers (OR = 3.0; 95% CI: 2.1–4.2; p < 0.001) and cervical cancer (OR = 1.9; 95% CI: 1.4–2.6; p < 0.001). From the overall attitude score, the majority of the women were found to have negative attitudes towards breast cancer (67.4%) and cervical cancer (70.6%). Conclusions This study found that the overall knowledge of risk factors for breast cancer and cervical cancer among women was low. Lack of cancer awareness, and lack of education in general, are the most potent barriers to access and care, and should be addressed through multi-faceted strategies including peer-education, mass media and other community-based interventions.
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    Open Access
    Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study
    (2020-10-06) Harries, Jane; Constant, Deborah; Cairncross, Lydia; Moodley, Jennifer
    Background: No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18–49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa. Methods Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient-provider communication and counseling could address knowledge gaps.
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    Coping with breast cancer and mastectomy : a prospective study of the process
    (1999) Hudson, Jane Elizabeth; Schomer, Helga
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    Exploring the association between gene sequence polymorphisms within the angiogenesis and extracellular matrix regulatory pathways and shoulder pain and disability following breast cancer treatment
    (2025) Mafu, Trevor; Shamley, Delva; September, Alison
    Shoulder pain and disability are common sequelae of breast cancer treatment in women, with an understated negative impact on the quality of life of affected individuals and a poorly characterised aetiology. A better understanding of the aetiology of shoulder pain and disability in breast cancer survivors is urgent to develop and/or integrate effective treatments to mitigate the related reduction in quality of life– this is especially important given the increasing cancer survivorship in societies such as in South Africa where a high percentage of households are female-headed and a resource-based public healthcare system is used by the majority. Previous studies have explored treatment-related and patient-related factors that modulate risk of upper-limb impairments in breast cancer survivors, including shoulder pain and disability. However, there is a paucity of relevant studies on key genetic factors. Genetic factors within angiogenesis-related signalling and extracellular matrix (ECM) regulating pathways have been implicated in non-cancer-related studies of soft tissue conditions of the shoulder that are associated with pain and display movement dysfunction similar to that seen in breast cancer post-treatment shoulder morbidity. It is largely unknown whether or not key factors within the angiogenesis-related and ECM-regulating signalling pathways may modulate risk of shoulder pain and disability in breast cancer survivors.
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    From symptom discovery to treatment - women's pathways to breast cancer care: a cross-sectional study
    (BioMed Central, 2018-03-21) Moodley, Jennifer; Cairncross, Lydia; Naiker, Thurandrie; Constant, Deborah
    Background Typically, women in South Africa (SA) are diagnosed with breast cancer when they self-present with symptoms to health facilities. The aim of this study was to determine the pathway that women follow to breast cancer care and factors associated with this journey. Methods A cross-sectional study was conducted at a tertiary hospital in the Western Cape Province, SA, between May 2015 and May 2016. Newly diagnosed breast cancer patients were interviewed to determine their socio-demographic profile; knowledge of risk factors, signs and symptoms; appraisal of breast changes; clinical profile and; key time events in the journey to care. The Model of Pathways to Treatment Framework underpinned the analysis. The total time (TT) between a woman noticing the first breast change and the date of scheduled treatment was divided into 3 intervals: the patient interval (PI); the diagnostic interval (DI) and the pre-treatment interval (PTI). For the PI, DI and PTI a bivariate comparison of median time intervals by various characteristics was conducted using Wilcoxon rank-sum and Kruskal-Wallis tests. Cox Proportional-Hazards models were used to identify factors independently associated with the PI, DI and PTI. Results The median age of the 201 participants was 54 years, and 22% presented with late stage disease. The median TT was 110 days, with median patient, diagnostic and pre-treatment intervals of 23, 28 and 37 days respectively. Factors associated with the PI were: older age (Hazard ratio (HR) 0.59, 95% CI 0.40–0.86), initial symptom denial (HR 0.43, 95% CI 0.19–0.97) and waiting for a lump to increase in size before seeking care (HR 0.51, 95% CI 0.33–0.77). Women with co-morbidities had a significantly longer DI (HR 0.67, 95% CI 0.47–0.96) as did women who mentioned denial of initial breast symptoms (HR 4.61, 95% CI 1.80–11.78). The PTI was associated with late stage disease at presentation (HR 1.78, 95% CI 1.15–2.76). Conclusion The Model of Pathways to Treatment provides a useful framework to explore patient’s journeys to care and identified opportunities for targeted interventions.
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    Next-Generation version of pseudomonas exotoxin a based immunotoxins with reduced immunogenicity for triple negative breast cancer (TNBC) treatment
    (2025) Mthethwa, Jabulisile; Barth, Stefan
    Breast cancer continues to have the highest mortality rate in comparison to other cancer types, with approximately 19.4 million women aged 15 years and older living at risk of being diagnosed with breast cancer in South Africa. Triple-negative breast cancer (TNBC) subtype, which is mainly characterized by a lack of expression of the oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), patients do not benefit from current standard treatments since they are based on these absent biomarkers leading to off-targets which results to an adverse side effects in TNBC patients. TNBC subtypes tend to be more common in women younger than age 40, who are Black, or who have a Breast Cancer gene 1 (BRCA1) mutation. The five-year survival rate for TNBC in South Africa is approximately 19.26% and the major causes of this include the late diagnosis of disease, highly aggressive tumor growth, and the early formation of metastases. Therefore, it is crucial than ever to use a multi-targeted precision medicine approach exploiting the differential overexpression of TNBC-specific cell surface receptors. As part of this effort, tumors should be screened and evaluated for therapeutic and prognostic biomarkers that can precisely show the clinicians which treatment plan will work best for their patients. Combining novel immunotherapies with conventional treatment approaches has demonstrated significant promise for improving cancer quality of the patient's life and survival. Although, when it comes to TNBC, these immunotherapies are frequently used as a last option after more traditional treatments have failed such as chemotherapy. Overexpression of zinc transporter (LIV-1) and trophoblast cell surface antigen-2 (trop2) has been implicated in the oncogenesis of TNBC and associated with an unfavorable prognosis. Consequently, the LIV-1 and TROP-2 biomarkers represent a specific target antigen suitable for immunotherapy. In this study, we successfully developed recombinant immunotoxins by fusing an anti- hliv22 and anti-trop2 single chain variable fragment (scFv) antibody to a truncated mutant of Pseudomonas Exotoxin A (ETA') and deimmunized version of (ETA') RG7787, herewith termed (dETA') introducing a cysteine in position R456. Using the bacterial expression vector pMT, functional (scFv)-ETA' and scFv-dETA' were periplasmically expressed under osmotic stress conditions in the presence of compatible solutes. The 72 kDa, His10-tagged fusion proteins were purified using a two- step Immobilised Metal-ion Affinity Chromatography (IMAC). Specific binding of these recombinant immunotoxins to LIV-1- and TROP2-positive breast cancer cell line MCF-7 were confirmed by confocal microscopy in comparison to an antigen-negative control. The introduction of the new mutation in the RG7787 rIT indicates a partial recovery of enzymatic activity with trop2-targeting rITs showing a 1.4-fold reduction in cytotoxic activity, which is a significant improvement when compared with the 4 to13-fold reductions in IC50 values reported for RG7787 in the Alewine study. This is the first report documenting the specific cytotoxicity of a RG7787 recombinant immunotoxins with cysteine (C) mutation in position R456 introduced towards triple- negative breast carcinoma cells, suggesting that liv-1 and trop-2 specific antibody toxins may become valuable therapeutic reagents for the treatment of triple-negative breast cancer in the future.
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    Tumour cells down-regulate CCN2 gene expression in co-cultured fibroblasts in a Smad7- and ERK-dependent manner
    (BioMed Central Ltd, 2013) van Rooyen, Beverley; Schafer, Georgia; Leaner, Virna; Parker, M
    BACKGROUND: Recent studies have revealed that interactions between tumour cells and the surrounding stroma play an important role in facilitating tumour growth and invasion. Stromal fibroblasts produce most of the extracellular matrix components found in the stroma. The aim of this study was to investigate mechanisms involved in tumour cell-mediated regulation of extracellular matrix and adhesion molecules in co-cultured fibroblasts. To this end, microarray analysis was performed on CCD-1068SK human fibroblast cells after direct co-culture with MDA-MB-231 human breast tumour cells. RESULTS: We found that the expression of both connective tissue growth factor (CTGF/CCN2) and type I collagen was negatively regulated in CCD-1068SK fibroblast cells under direct co-culture conditions. Further analysis revealed that Smad7, a known negative regulator of the Smad signalling pathway involved in CCN2 promoter regulation, was increased in directly co-cultured fibroblasts. Inhibition of Smad7 expression in CCD-1068SK fibroblasts resulted in increased CCN2 expression, while Smad7 overexpression had the opposite effect. Silencing CCN2 gene expression in fibroblasts led, in turn, to a decrease in type I collagen mRNA and protein levels. ERK signalling was also shown to be impaired in CCD-1068SK fibroblasts after direct co-culture with MDA-MB-231 tumour cells, with Smad7 overexpression in fibroblasts leading to a similar decrease in ERK activity. These effects were not, however, seen in fibroblasts that were indirectly co-cultured with tumour cells. CONCLUSION: We therefore conclude that breast cancer cells require close contact with fibroblasts in order to upregulate Smad7 which, in turn, leads to decreased ERK signalling resulting in diminished expression of the stromal proteins CCN2 and type I collagen.