Germline pathogenic variants among high hereditary risk patients with breast and ovarian cancer and unaffected subjects in Lebanese Arab women

BACKGROUND The prevalence of germline pathogenic variants in high hereditary risk breast and/or ovarian cancer patients and unaffected subjects referred for testing is an unmet need in low and middle-income countries.AIM To determine the prevalence of germline pathogenic variants in high hereditary risk patients with breast and/or ovarian cancer and unaffected individuals.METHODS We retrospectively reviewed records of patients and unaffected subjects referred for germline pathogenic variant testing due to high hereditary risk between 2010-2020.Data was collected and analyzed on Excel sheet.RESULTS In total,358 individuals were included,including 257 patients and 101 unaffected individuals with relatives with breast or ovarian cancer.The prevalence of breast cancer susceptibility gene(BRCA)1/2 pathogenic variants was 8.63%(19/220)in patients with breast cancer,and 15.1%(5/33)in those with ovarian cancer.Among the 25 of 220 patients with breast cancer tested by next-generation sequencing,3 patients had pathogenic variants other than BRCA1/2.The highest risk was observed in those aged 40 years with breast cancer and a positive family history,where the BRCA1/2 prevalence was 20.1%(9/43).Among the unaffected subjects,31.1%(14/45)had the same BRCA1/2 pathogenic variants in their corresponding relatives.Among the subjects referred because of a positive family history of cancer without known hereditary factors,5.35%(3/56)had pathogenic variants of BRCA1 and BRCA2.The c.131G>T nucleotide change was noted in one patient and two unrelated unaffected subjects with a BRCA1 pathogenic variant.CONCLUSION This study showed a 8.63%prevalence of pathogenic variants in patients with breast cancer and a 15.1%prevalence in patients with ovarian cancer.Among the relatives of patients with BRCA1/2 pathogenic variants,31%tested positive for the same variant,while 5.3%of subjects who tested positive due to a family history of breast cancer had a BRCA pathogenic variant.

Primary Screening for Breast Diseases among 17618 Women in Wufeng Area, a Region with High Incidence of Cervical Cancer in China

In this study, the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated. From March to August, 2009, 17618 women, from Wufeng area of Hubei province, China, were recruited to screen breast diseases by using breast infrared diagnostic apparatus. Other diagnostic methods, such as B-mode ultrasound, X-ray mammography, needle biopsy and pathological examination were, if necessary, used to further confirm the diagnosis. The screening showed that 5990 of 17618 cases (34.00%) had breast diseases, 5843 (33.16%) had mammary gland hyperplasia, 48 (0.27%) had breast fibroadenoma, 11 (0.06%) had breast carcinoma, and 88 (0.50%) had other breast diseases. The peak morbidity of breast cancer was found in the women aged 50–60 ages. The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8, 0.157%) in comparison with that in the subjects younger than 50 years old (n=3, 0.024%) (u=2.327, P<0.05). It was shown that the occurrence of breast diseases was concentrated in women aged 20–40 years, while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40. Compared with the patients elder than or equal to 40 years old (n=3289, 27.46%), the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases, 47.18%; P<0.001). However, there was no significant difference in the morbidity of breast diseases between the age group of 20–29 years and that of 30–39 years (P=0.453), and both of them were high. There was no significant association between the morbidity of breast diseases and cervical cancer. Since the morbidity of breast diseases was higher among young women, more attention should be paid to the screening of breast diseases among young women for early diagnosis.

BRCA mutation rate and characteristics of prostate tumor in breast and ovarian cancer families:analysis of 6,591 Italian pedigrees

Objective:As prostate cancer(Pr C)shows a BRCA mutation rate as high as 30%,it becomes crucial to find the optimal selection criteria for genetic testing.The primary objective of this study was to evaluate the BRCA mutation rate in families with Pr C associated with breast and/or ovarian cancers;secondary aims were to compare the characteristics of families and BRCA-related Pr C outcome among BRCA1 and BRCA2 carriers.Methods:Following the Modena criteria for the BRCA test,we evaluated the mutation rate in families with breast and/or ovarian cancer with a Gleason score≥7 Pr Cs,by testing breast or ovarian cases and inferring the mutation in the prostate cases.The characteristics of families and BRCA-related Pr C outcomes were measured using the chi-square(χ^(2))test and Kaplan–Meier methods,respectively.Results:Among 6,591 families,580(8.8%)with a Gleason score≥7 Pr Cs were identified,of which 332(57.2%)met the Modena selection criteria for BRCA testing.Overall,215 breast or ovarian cancer probands(64.8%)were tested,of which 41 resulted positive for BRCA and one for CHEK2 genes(19.5%).No statistically significant differences were found in BRCA-related Pr C prognosis and in the characteristics of families among BRCA1,BRCA2 and non-tested patients.Ten of 23(44%)mutations in the BRCA2 gene fell in the prostate cancer cluster region(PCCR)at the 3′terminal of the 7914 codon.Conclusions:It appears the Modena criteria are very useful for BRCA testing selection in families with breast and/or ovarian cancer and Pr C.A trend toward a worse prognosis has been found in BRCA2 carriers.

CHARACTERISTICS OF MORTALITY RATES FROM BREAST AND OVARIAN CANCER IN JAPAN

Objective: Breast and ovarian cancer is rare in Japan compared with other developed countries but their mortality rates are increasing. It is necessary to examine the experience of Japan as a guide to further prevent breast and ovarian cancer in our country. Methods: We conducted an epidemiological study of breast and ovarian cancer in the past 50 years to investigate the trends and characteristics of the mortality rates in Japan. The numbers of age-specific death from breast and ovarian cancer and the population of 5-year groups were obtained from the Vital Statistics of Japan. The truncated age specific mortality rates were calculated according to the patterns of age specific mortality rates from both cancers. Age adjustments were made to the standard world population. Results: In the past 50 years, mortality rates of breast and ovarian cancer increased about 2 or 6 fold, respectively. This increase was most marked over 50 years old. The death pattern of breast cancer was same as that of ovarian cancer, but that of ovarian cancer changed greatly with time. The birth cohort study had some interesting findings. Common to breast and ovarian cancer, the later the year of birth, the higher the mortality rates from both malignancies in later life. Conclusion: The increase of the yearly mortality rates from breast and ovarian cancer might be due to changes in lifestyle and environmental factors. We are very concerned about dietary practices. Further investigation is needed to clarify the possible causes of animal food.

Double Ribbons campaign: How to reduce the incidence of breast cancerand cervical cancer in Chinese women

The Double Ribbons campaign is a combination of the pink ribbon and the blue ribbon.China has launched the"Double Ribbon Campaign,"which includes free screening for both breast and cervical cancers.In this paper,by briefly describing the characteristics of breast cancer and cervical cancer,this paper summarizes the screening data of Changle County People's Hospital in Shandong Province in the past ten years,clarifies the importance of early screening,early diagnosis and early treatment of diseases,summarizes experience,defines goals,and promotes the long-term development of China's health cause.

Impact of Olaparib for Maintenance Monotherapy on Survival in Breast and Ovarian Cancer: A Systematic Review and Pooled Analysis of Published Trials

Purpose: To assess the efficacy and safety of Olaparib, a PARP inhibitor on progression-free survival (PFS), objective response rate (ORR) and overall survival (OS) in patients with breast and ovarian cancer. Methods: Research data from clinical trials through PubMed, Science Citation Index, Elsevier Science Direct and Cochrane Library of all published studies exploring the PFS, ORR or OS of Olaparib for maintenance monotherapy on survival in breast and ovarian cancer were analysed. Pooled estimates of the ORR, weighted medians of PFS and OS from all Olaparib were calculated. Assessment of quality and level of evidence was assigned by Cochrane guidelines and guidelines of Oxford Centre for Evidence-Based Medicine. Results: Data of 893 patients (731 olaparib;162 control) from 6 trials, 2 randomised controlled trials and 4 non-randomised trials, were included. The overall median weighted PFS and OS in patients treated with Olaparib were 5.9 and 19.1 months, respectively. The pooled ORR was 25%. Olaparib showed a greater effect on PFS in patients with both wild-type BRCA and BRCA mutant gene. The most common toxicity were nausea and vomiting. Conclusions: Olaparib as maintenance monotherapy for breast and ovarian cancer is associated with promising outcomes including increased response rate and improved PFS. Its potential in clinical application is needed for further investigation in phase III trials.

Breast and Ovarian Cancer in Young Women of the Arabian Gulf Region: Relationship to Age

It is widely known that cancer is a disease of “old-age”. However available data show that this is not the case for many types of cancers. Incidences of breast and ovarian cancers have varying rates of change with age. Breast cancer data of Arabian-gulf women, show that the incidence rates increase with age and reach a maximum at 39 year. It then declines linearly with age to about 55 years. The rate of increase and its changes with age are similar to those of many other countries. In the premenopausal phase the relationship between incidence and age could be adequately modeled using a linear model for the logarithmic transformations of age and incidence. Similar observations are made for the ovarian cancer incidences. Results: It is shown that the rate of increase in breast and ovarian cancer incidence with respect to age is increasing in the premenopausal ages. Moreover, the burden of the disease with respect to mortality and “Disability Adjusted Life Years” or DALY, varied considerably among the six gulf countries. Conclusions: We conclude, based on the age incidence relationship that the number of cancer cases may double in the next period that follows our study period (1998-2009). Moreover, if the six countries have identical relationship between age and the two types of cancer, there should be an integrated and unified effort to have a common strategy for prevention and control.

Effect of Ovarian Transposition Therapy on Ovarian Function, Ovarian Blood Flow and Sexual Life Quality in Patients with Cervical Cancer

Objective To study the ovarian function,blood flow and quality of life in patients with cervical cancer after ovarian transposition.Methods 114 patients with cervical cancer during January 2015 to January 2016 were retrospectively analyzed,patients who don’t need ovarian transposition treatment were included in the control group(38 cases),and those who need ovarian transposition treatment were included in observation group,those who had accepted operation but not radiotherapy were in observation group 1(38 cases),and those who had accepted operation and radiotherapy were in observation group 2(38 cases).Then the ovarian function,ovarian blood flow and sexual life quality and complication were compared in each group.Results P,E2,LH and FSH indexes of all patients before operation showed no significant difference in statistical analysis(P>0.05),after 12 months of follow-up,ovarian function index changes were observed in 2 groups,and the other two groups had significant difference(P<0.05);preoperative blood group hemodynamic indexes were no significant difference(P<0.05),after treatment,2 groups’RI was observed and was higher than other groups,and the difference between groups was significant(P<0.05);The quality of sex life in the observation group was significantly higher than that in the control group,and the 2 groups had a statistically significant difference(p<0.05)compared to the 2 groups.In addition,the incidence rate of each group of complications was compared,observation 1 group and observation 2 group were higher than the control group,the statistical analysis of the group was significantly different(p<0.05).Conclusion Cervical cancer patients with ovarian shift after treatment,postoperative can still preserving ovarian function and sexual life quality also increased significantly,but the postoperative patients complicated with abdominal pain,without functional ovarian cysts;If ovarian shift line of postoperative radiation therapy,there are side effects on the ovarian function and sexual life.After the ovarian transposition treatment for patients with cervical cancer,they can still retain ovarian function,and the sexual life quality is also significantly improved,but abdominal pain and non-functional ovarian cyst may occur;if the radiation therapy was given after ovarian transposition,then side effects will appear in the ovarian function and sex life.

Awareness about Early Detection Methods, Symptoms and Risk Factors towards Breast and Cervical Cancer among the Female Students of Mawlana Bhashani Science and Technology University (MBSTU), Santosh, Tangail, Bangladesh

The study was conducted to ensure knowledge, attitude, awareness about breast and cervical cancer among the female students of Mawlana Bhashani Science and Technology University. This study was carried out from July to September, 2015 among the participants of university female halls, different female hostels and different faculty of the university by using a validated questionnaire which was developed for this study. A total 250 female students, at the age of (18 - 26) years were participated. Collected information was analyzed using SPSS, Graph-pad Prism and MS Excel. The results showed that about 87.6% participants were undergraduate. Most of them come from village (45.6%) and city (36.0%). About 90% were Muslims and the socioeconomic level of most of the participants was middle (90.4%). In case of food intake patterns, it was observed that 35.6% participants eat chips, soft drinks, popcorn everyday;40.4% eat meat regularly;24% eat sugar everyday;27.6% eat fruits and vegetables every day. Among them, 55.6% girls maintained daily 1 hour physical activity;37.2% did exercise rarely;34.8% participants rarely do strenuous exercise. About 84.4% respondents have not any family history of cancer;6% participants have sister or mother having breast tumor and 7.2% have at least more than one close relative who have cancer. Among the participants, only 0.8% drank alcohol;1.2% have addiction of smoking cigarette;15.6% girls wear tight bra;3.6% have benign breast disease and 2.8% participants have attended in breast or cervical cancer screening programs. The moderate numbers of girls have breast cancer screening practice. Among them, only 28.8% participants have ever heard about BSE (Breast self-examination) and 40.4% have not any knowledge about breast cancer treatment. About 50.8% respondents don’t have any knowledge about cervical cancer treatment. The village people are the most risky group. About 17.02% girls recognized weakened immune system as a risk factor of cervical cancer. It can be concluded that, knowledge of participants regarding breast and cervical cancer is poor. Targeted education should be implemented to improve the knowledge of respondents about early detection methods and symptoms of breast and cervical cancer.

Low testing rates and high BRCA prevalence: Poly (ADP-ribose) polymerase inhibitor use in Middle East BRCA/homologous recombination deficiency-positive cancer patients

BACKGROUND Poly(ADP-ribose)polymerase inhibitors(PARPis)are approved as first-line therapies for breast cancer gene(BRCA)-positive,human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer.They are also effective for new and recurrent ovarian cancers that are BRCA-or homologous recombination deficiency(HRD)-positive.However,data on these mutations and PARPi use in the Middle East are limited.AIM To assess BRCA/HRD prevalence and PARPi use in patients in the Middle East with breast/ovarian cancer.METHODS This was a single-center retrospective study of 57 of 472 breast cancer patients tested for BRCA mutations,and 25 of 65 ovarian cancer patients tested for HRD.These adult patients participated in at least four visits to the oncology service at our center between August 2021 and May 2023.Data were summarized using descriptive statistics and compared using counts and percentages.Response to treatment was assessed using Response Evaluation Criteria in Solid Tumors criteria.RESULTS Among the 472 breast cancer patients,12.1%underwent BRCA testing,and 38.5%of 65 ovarian cancer patients received HRD testing.Pathogenic mutations were found in 25.6%of the tested patients:26.3%breast cancers had germline BRCA(gBRCA)mutations and 24.0%ovarian cancers showed HRD.Notably,40.0%of gBRCA-positive breast cancers and 66.0%of HRD-positive ovarian cancers were Middle Eastern and Asian patients,respectively.PARPi treatment was used in 5(33.3%)gBRCA-positive breast cancer patients as first-line therapy(n=1;7-months progression-free),for maintenance(n=2;>15-months progression-free),or at later stages due to compliance issues(n=2).Four patients(66.6%)with HRD-positive ovarian cancer received PARPi and all remained progression-free.CONCLUSION Lower testing rates but higher BRCA mutations in breast cancer were found.Ethnicity reflected United Arab Emirates demographics,with breast cancer in Middle Eastern and ovarian cancer in Asian patients.

Current medical treatment of estrogen receptor-positive breast cancer

Approximately 80% of breast cancers(BC) are estrogen receptor(ER)-positive and thus endocrine therapy(ET) should be considered complementary to surgery in the majority of patients. The advantages of oophorectomy, adrenalectomy and hypophysectomy in women with advanced BC have been demonstrated many years ago, and currently ET consist of(1) ovarian function suppression(OFS), usually obtained using gonadotropinreleasing hormone agonists(Gn RHa);(2) selective estrogen receptor modulators or down-regulators(SERMs or SERDs); and(3) aromatase inhibitors(AIs), or a combination of two or more drugs. For patients aged less than 50 years and ER+ BC, there is no conclusive evidence that the combination of OFS and SERMs(i.e., tamoxifen) or chemotherapy is superior to OFS alone. Tamoxifen users exhibit a reduced risk of BC, both invasive and in situ, especially during the first 5 years of therapy, and extending the treatment to 10 years further reduced the risk of recurrences. SERDs(i.e., fulvestrant) are especially useful in the neoadjuvant treatment of advanced BC, alone or in combination with either cytotoxic agents or AIs. There are two types of AIs: type Ⅰ are permanent steroidal inhibitors of aromatase, while type Ⅱ are reversible nonsteroidal inhibitors. Several studies demonstrated the superiority of the third-generation AIs(i.e., anastrozole and letrozole) compared with tamoxifen, and adjuvant therapy with AIs reduces the recurrence risk especially in patients with advanced BC. Unfortunately, some cancers are or became ET-resistant, and thus other drugs have been suggested in combination with SERMs or AIs, including cyclin-dependent kinase 4/6 inhibitors(palbociclib) and mammalian target of rapamycin(m TOR) inhibitors, such as everolimus. Further studies are required to confirm their real usefulness.

Current state and controversies in fertility preservation in women with breast cancer

On average,over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States.Because an increasing number of young women delay childbearing to later life for various reasons,a growing population of women experience breast cancer before completing childbearing.In this context,preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care.In this review,we will outline the currently available fertility preservation options for women with breast cancer of reproductive age,discuss the controversy behind hormonal suppression for gonadal protection against chemotherapy and highlight the importance of timely referral by cancer care providers.

Epithelial ovarian cancer:An overview

Ovarian cancer is the second most common gyneco-logical cancer and the leading cause of death in the United States. In this article we review the diagnosis and current management of epithelial ovarian cancer which accounts for over 95 percent of the ovarian malignancies. We will present various theories about the potential origin of ovarian malignancies. We will discuss the genetic anomalies and syndromes that may cause ovarian cancers with emphasis on Breast cancer type 1/2 mutations. The pathology and pathogenesis of ovarian carcinoma will also be presented. Lastly, we provide a comprehensive overview of treatment strategies and staging of ovarian cancer, conclusions and future directions.

Metastasis to the thyroid gland from primary breast cancer presenting as diffuse goiter:A case report and review of literature

BACKGROUND Metastasis to the thyroid gland(TM)from primary breast cancer is uncommon and usually presents as thyroid nodules;however,diffuse goiter without thyroid nodules is the first sign of TM in rare cases.Skip metastases(SMs)to the lymph nodes in breast cancer,defined as discontiguous higher-level metastases in the absence of lower levels of contiguous metastases,have been reported in the contralateral cervical area of the primary tumor site in rare cases.CASE SUMMARY A 49-year-old previously healthy Chinese woman was diagnosed with right lateral invasive ductal carcinoma and underwent neoadjuvant chemotherapy treatment and bilateral mastectomy with axillary lymph node dissection.No malignancy of the left breast or axillary or distant metastases were identified preoperatively.However,enlarged left cervical lymph nodes were detected 36 mo after surgery,and rapidly enlarging thyroid glands without nodules were detected 42 mo after surgery.Fine-needle aspiration cytology was performed on the left cervical lymph nodes and left lobe of the thyroid,which were both revealed to contain metastases from the primary breast cancer.Additionally,the immunostaining profiles changed in the process of metastases.The patient was discharged with the NP(vinorelbine and cisplatin)regimen for subsequent treatment,and stable disease was determined when the curative effect was evaluated.CONCLUSION Diffuse goiter may be the first sign of TM,and enlarged lymph nodes in the contralateral cervical area may be SMs of primary breast cancer.

Common non-synonymous polymorphisms in the BRCA1 Associated RING Domain (BARD1) gene are associated with breast cancer susceptibility:a case-control analysis

The BRCA1 Associated RING Domain(BARD1) gene has been identified as a high penetrance gene for breast cancer, whose germline and somatic mutations were reported in both non-BRCA1/2 hereditary site-specific and sporadic breast cancer cases. BARD1 plays a crucial role in tumor repression, along with its heterodimeric partner BRCA1. In the current study, we tested the hypothesis that common non-synonymous polymorphisms in BARD1 are associated with breast cancer susceptibility in a case-control study of 507 patients with incident breast cancer and 539 frequency-matched cancer-free controls in Chinese women. We genotyped all three common(minor allele frequency (MAF) > 0.10) non-synonymous polymorphisms(Pro24Ser, Arg378Ser, and Val507Met) in BARD1. We found that the BARD1 Pro24Ser variant genotypes(24Pro/Ser and 24Ser/Ser) and Arg378Ser variant homozygote 378Ser/Ser were associated with a significantly decreased breast cancer risk, compared with their wild-type homozygotes, respectively. Furthermore, a significant locus-locus interaction was evident between Pro24Ser and Arg378Ser (P-int = 0.032). Among the 378Ser variant allele carriers, the 24Pro/Pro wild-type homozygote was associated with a significantly increased breast cancer risk (adjusted OR = 1.81, 95% CI = 1.11-2.95), but the subjects having 24Pro/Ser or Ser/Ser variant genotypes had a significantly decreased risk(adjusted OR = 0.74, 95% CI = 0.56-0.99). In stratified analysis, this locus-locus interaction was more evident among subjects without family cancer history, those with positive estrogen receptor (ER) and individuals with negative progesterone receptor(PR). These findings indicate that the potentially functional polymorphisms Pro24Ser and Arg378Ser in BARD1 may jointly contribute to the susceptibility of breast cancer.

Cervix and breast cancers in Oujda city in Eastern Morocco: Determinants and risk factors

A retrospective study was conducted in 2008 on 681 in Eastern Morocco in order to estimate the incidence of cervical and breast cancer, and to determine the social determinants and risk factors associated with these two types of cancer. Another goal of the study was to give health decision makers evidence of the necessity for early diagnosis and treatment. A questionnaire was used before the clinical gynecological examination and sampling cell for the Pap smear. Any woman with a Pap smear suspect had to do a biopsy at the reference centre. Physicians, obstetricians and midwives in the consultation process did gynecological examination and breast palpation. Patients with a suspicious nodule underwent ultrasound and mammography by radiologists on site. Gynecological samples were carried out systematically to all ever-married women to detect cancer of the cervix. Software Excel and SPSS 17 were used for data processing. Patients with high social status were more susceptible to develop breast cancer whereas women with cervical cancer were poor, belonging to a class with a low marital status of widowed or divorced having been married at an early age. The majority of women were married (81%), poor (80%) and illiterate (66%). Breastfeeding women were less affected by breast cancer than women not breastfeeding. For cervical cancer, the difference was not statistically significant. Women using contraceptives were vulnerable to both breast and cervical cancer. For cervical cancer, over 15% of women with a family history were screened positive. No relationship was found between breast cancer and family history. Taking into account regional particularities, we stress the importance of social determinants and risk factors and show that our results are consistent with those published by other researchers. Breast and cervical cancers constitute a real challenge in Morocco. Their socioeconomic burden can be reduced by early detection and treatment. The delayed diagnosis complicates the task both in terms of survival and cost of treatment. Consequently, Moroccan health authorities are urged to adopt preventive and cost effective strategies.

Provision of Fertility Preservation for Young Women with Early-Stage Breast Cancer

Breast cancer is the most common cancer in women worldwide, constituting 25% of all cancer diagnoses. Even though it is only affecting 4% - 6% of women under the age of 40, it remains the most common malignancy among younger patients. Advancement in the treatment and earlier detection gives excellent 5 years of survival. However, the standard treatment that comprises surgical-chemo radiation therapy or hormonal treatment often results in an increased incidence of treatment-induced infertility. Therefore, adding fertility preservation to primary cancer treatment may offer the best opportunity for future fertility. However, despite advancements in Assisted Reproductive Technology (ART), the uptake of fertility services in this group remains low. In this review, we highlighted the effect of all breast cancer treatments on women’s fertility, the effectiveness and safety of ART in breast cancer patients as well as the safety of pregnancy in breast cancer survivors. Our aim is to improve awareness of fertility preservation for breast cancer to ensure all women diagnosed with breast cancer have multidisciplinary approaches with early referral to fertility specialists to discuss regarding potential risks and benefits of fertility preservation to improve the uptake of fertility preservation among this group of patients.

At-home cancer screening:a solution for China and other developing countries with a large population and limited number of healthcare practitioners

Five-year survival rate for patients with all cancers combined, in China, is only 30.9%, which is much lower than those in developed countries. The three main reasons for the low cancer curative rates in China include differences in the spectrum of cancer types, in early detection rates, and in the percentage of cancer patients receiving standardized treatment between China and developed countries.The most important mechanism for improving the curative rate is to improve early detection rates of major cancers in China using novel and affordable technologies that can be operated at home by the patients themselves.This attempt could be helpful in setting up a practical example for other developing countries with limited medical resources and a limited number of healthcare practitioners.

Clinical signification on the expressions of metallothionein in three types cancer of woman

Objective： To study the expressions and significations of metallothionein （MT） in cervical squamous cell cancer （CSC）, bladder transitional cell cancer （BTC） and breast cancer （BC） of woman. Methods： Immunohistochemical method was used to examine the expresses rate of MT in three types of woman cancer tissue. Results： The expressions rates of MT were 54.35% （29146） in BTC, 67.05% （59188） in BC and 57.14% （40/70） in CSC. The positive rate of MT expression was higher in low differentiation group than well differentiation group in BTC and CSC （P 〈 0.05）. Positive of MT in lobular cancer was significance higher than medullary and duct cancers （P 〈 0.05）. Conclusion： The expression of MT is related to differentiation degree, and it is a guidance for clinical choice of chemotherapy project.