Microcalcifications in breast cancer: novel insights into the molecular mechanism and functional consequence of mammary mineralisation.

BACKGROUND: Mammographic microcalcifications represent one of the most reliable features of nonpalpable breast cancer yet remain largely unexplored and poorly understood. METHODS: We report a novel model to investigate the in vitro mineralisation potential of a panel of mammary cell lines. Primary mammary tumours were produced by implanting tumourigenic cells into the mammary fat pads of female BALB/c mice. RESULTS: Hydroxyapatite (HA) was deposited only by the tumourigenic cell lines, indicating mineralisation potential may be associated with cell phenotype in this in vitro model. We propose a mechanism for mammary mineralisation, which suggests that the balance between enhancers and inhibitors of physiological mineralisation are disrupted. Inhibition of alkaline phosphatase and phosphate transport prevented mineralisation, demonstrating that mineralisation is an active cell-mediated process. Hydroxyapatite was found to enhance in vitro tumour cell migration, while calcium oxalate had no effect, highlighting potential consequences of calcium deposition. In addition, HA was also deposited in primary mammary tumours produced by implanting the tumourigenic cells into the mammary fat pads of female BALB/c mice. CONCLUSION: This work indicates that formation of mammary HA is a cell-specific regulated process, which creates an osteomimetic niche potentially enhancing breast tumour progression. Our findings point to the cells mineralisation potential and the microenvironment regulating it, as a significant feature of breast tumour development

Time-trend of melanoma screening practice by primary care physicians: A meta-regression analysis

Objective. To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time. Methods. Meta-regression analyses of available data. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials. Results. Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%\u201382% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were 120.68% (P =0.494), 122.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines. Conclusions. Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon

What's the message? Interpretation of an uninformative BRCA1/2 test result for women at risk of familial breast cancer

To test the "false-reassurance hypothesis," which suggests that women who receive an uninformative BRCA1/2 test result may incorrectly conclude that they no longer have an elevated risk, with possible harmful consequences for adherence to breast surveillance guidelines. A prospective questionnaire design was used to compare 183 women with an uninformative BRCA test result (94 affected and 89 unaffected) with 41 proven BRCA mutation-carriers and 49 true negatives before and after BRCA1/2 test disclosure. After DNA-test disclosure, test applicants differed from each other with regard to their perception of the likelihood of carrying a deleterious gene (P <0.0001). The BRCA mutation carriers reported the highest perceived likelihood and the true negatives reported the lowest. Compared to the predisclosure measures, women who received an uninformative DNA test result reported a lower perceived risk after disclosure (P <0.0001), suggesting a relatively high level of reassurance because of the test result. However, after DNA-test disclosure, only 12 women concluded that the risk of carrying a mutation was nonexistent, and perceived likelihood was significantly associated with the pedigree-based risk assessment (P = 0.0001). Moreover, despite the significant decrease in perceived likelihood for uninformative women, intention to obtain mammograms did not change (P = 0.71); it remained at the same almost optimal level as for BRCA mutation carriers. No support was found for the suggestion that the nature of uninformative test results is often misunderstood. Moreover, an uninformative test result did not affect the positive mammography intentions of both affected and unaffected wome

Beyond a Paycheck: The Influence of Workforce Participation on Women’s Cancer Screening in Turkey

WOS: 000390049300006The present study investigates the influence of workforce participation on women's cancer screening behaviors in Turkey. In cultures with predominantly Muslim populations like Turkey, emphasis is typically placed on a woman's traditional role as a child bearer. Although the impact of workforce participation on women's welfare has been studied in various contexts, the relationship between workforce participation and health protective behavior has received scant attention. Using quantitative data from a survey of women aged 40 and above from 33 urban cities in Turkey (N = 483), we examine the influence of workforce participation on breast and cervical cancer screening behaviors. Homemakers were less likely than working/retired women to be up-to-date on screenings. Women with lower income and education screened less; however, workforce participation seemed to have a positive effect on screening among these women. Additionally, working/retired women and homemakers differed from each other in terms of their perceptions regarding their risk of developing cancer (perceived susceptibility). In addition, both perceived susceptibility and women's perceptions regarding their ability to get cancer screening (self-efficacy) were significant predictors of intention to engage in screening in future. In Turkey, homemakers are in a vulnerable position due to lower rates of cancer screening. Furthermore, targeting homemakers for interventions may be easier than trying to identify other low screening groups of women such as those with lower education or income. Interventions raising perceptions of susceptibility to cancer, possibly by targeting neighborhoods during working hours, could be useful in increasing screening rates at risk women.Scientific and Technological Research Council of Turkey (TUBITAK) [3501, 111K197]This research study has been funded by The Scientific and Technological Research Council of Turkey (TUBITAK), Support Program 3501, Project No: 111K197