Clinical and Diagnostic Study of Breast Cancer in Women and its Relation with Periodontal Disease BC in relation to periodontal disease
Abstract
Background: Breast cancer (BC) is a common type of malignancy in females in Iraq. This study investigated BC's clinical and diagnostic features in 30 women and displayed its relationship with periodontal disease.
Methods: This cross-sectional study comprised 30 BC patients diagnosed in 2023. The clinical signs, ultrasound, biopsy, histopathology and Immunohistochemistry, treatment modules, and clinical signs of periodontal disease were reported and analyzed.
Results: The mean and standard deviation of patients’ age was 51.73± 11.41. The location of Breast Cancer lesions was on the left and right sides in 11 (36.66%) and 19 (63.33%) patients, respectively. All patients showed various sizes of non-painful lumps with well-defined masses in different areas of the breast tissue with regular or irregular borders in ultrasound and MRI. The gross and histopathological changes of cancerous tumors differed according to conditions, stage, and interaction with the cancer receptors in Immunohistochemistry. The percentage of metastases was 100% (in 30 cases) for the lymph nodes and 66.66% (in 20 cases) for the rest of the other organs. Different treatment modules were used, including chemotherapy, surgery, radiation, and hormonal therapy. The cases suffering from mild, moderate, and severe periodontal disease were 7 (23.33 %), 2 (6.66%), and 21 (70%), respectively.
Conclusion: The clinical signs, histopathological, IHC, and occurrence of periodontal disease in 30 women with breast cancer were documented in this study. The authors recommend further studies on breast cancer to support its early diagnosis and prevention strategies.
References
https://gco.iarc.who.int/media/globocan/factsheets/populations/368-iraq-fact-sheet.pdf
Kamińska M, Ciszewski T, Łopacka-Szatan K, Miotła P, Starosławska E. (2015). Breast cancer risk factors. Prz Menopauzalny. 14(3): 196-202.
Xiong X, Bueken P, Vastardis S, Pridjian G. Periodontal disease and gestational diabetes mellitus. Am J Obstet Gynecol. 2006;195:1086–9.
Kinane DF. Causation and pathogenesis of periodontal disease. Periodontal 2000. 2001;25:8–20.
Wang K, Zhang Z, Wang Z. 2022. Assessment of the association between periodontal disease and total cancer in- cidence and mortality: a meta-analysis. PeerJ 10:e14320 http://doi.org/10.7717/peerj.14320
Genco RJ, Borgnakke WS. 2020. Diabetes as a potential risk for periodontitis: association studies. Periodontology 2000 83(1):40–45 DOI 10.1111/prd.12270
(Molon RS, Rossa Jr C, Thurlings RM, Cirelli JA, Koenders MI. 2019. Linkage of periodontitis and rheumatoid arthritis: current evidence and potential bio- logical interactions. International Journal of Molecular Sciences 20(18):4541 DOI 10.3390/ijms20184541.),
Sanz M, Del Castillo AM, Jepsen S, Gonzalez-Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. 2020. Periodontitis and cardiovascular diseases, consensus report. Global Heart 15(1):1 DOI 10.5334/gh.400
Nascimento GG, Gastal MT, Leite FRM, Quevedo LA, Peres KG, Peres MA, Horta BL, Barros FC, Demarco FF. 2019. Is there an association between depression and periodontitis? A birth cohort study. Journal of Clinical Periodontology 46(1):31–39.
Takeuchi K, Matsumoto K, Furuta M, Fukuyama S, Takeshita T, Ogata H, Suma S, Shibata Y, Shimazaki Y, Hata J, Ninomiya T, Nakanishi Y, Inoue H, Yamashita Y. 2019. Periodontitis is associated with chronic obstructive pulmonary disease. Journal of Dental Research 98(5):534–540 DOI 10.1177/0022034519833630.
Liccardo D, Marzano F, Carraturo F, Guida M, Femminella GD, Bencivenga L, Agrimi J, Addonizio A, Melino I, Valletta A, Rengo C, Ferrara N, Rengo G, Cannavo A. 2020. Potential bidirectional relationship between periodontitis and Alzheimer’s disease. Frontiers in Physiology 11:683 DOI 10.3389/fphys.2020.00683.
Gopinath D, Kunnath Menon R, Veettil SK, George Botelho M, Johnson NW. 2020. Periodontal diseases as putative risk factors for head and neck cancer: systematic review and meta-analysis. Cancers 12(7):1893 DOI 10.3390/cancers12071893.
Republic of Iraq Ministry of Health and Environment Iraqi Cancer Board: Annual Report Iraqi Cancer Registry 2020. Baghdad, Iraq, Republic of Iraq Ministry of Health and Environment, 2021.
National Health Service 2021. https://digital.nhs.uk/data-and-information/publications/statistical/can. Cancer Registration Statistics, England 2019, NHS Digital.
Unger-Saldaña K. Challenges to the early diagnosis and treatment of breast cancer in developing countries. World J Clin Oncol. 2014;5:465–477. - PMC – PubMed
Balogun OD, Formenti SC. Locally advanced breast cancer—Strategies for developing nations. Front Oncol. 2015;5:89.
Namiq KS, Sulaiman LR. Neoadjuvant Therapy in Nonmetastatic Breast Cancer in Kurdistan, Iraq. JCO Glob Oncol. 2023 May;9:e2200276. doi: 10.1200/GO.22.00276. PMID: 37216625; PMCID: PMC10497289
Alwan NAS. Breast cancer among Iraqi women: Preliminary findings from a regional comparative breast cancer research project. J Glob Oncol. 2016;2:255–258. - PMC – PubMed
Mutar MT, Goyani MS, Had AM, et al. Pattern of presentation of patients with breast cancer in Iraq in 2018: A cross-sectional study. J Glob Oncol. 2019;5:1–6. - PMC – PubMed
Ahmed A, Sheikha A, Abdulla H, et al. Breast cancer in young women: A clinicopathological hospital-based descriptive study from Kurdistan, Iraq. Middle East J Cancer. 2021;12:137–142.
Raghdah Naser Mohsin, Ban Jasim Mohamad (2024). Clinical and Histopathological Features of Breast Cancer in Iraqi Patients between 2018-2021. Iraqi Journal of Science. 65, No. xx, pp: xx- xx DOI: 10.24996/ijs.2024.65.1.9.
Huda Hamed Al Abodi, Nada AbdulSahab Al Alwan, Waffa Mohmmed Atof, Beda Riyad Bedan. (2017). Evaluation of Women's Knowledge about Risk Factors and Early Detection of Breast Cancer at Ibn Rushd College of Education in Baghdad University. Iraqi National Journal of Nursing Specialties. 30; (1):117-123.
Odongo J, Makumbi T, Kalungi S, et al. Patient delay factors in women presenting with breast cancer in a low income country. BMC Res Notes. 2015;8:467. - PMC – PubMed
Birnbaum JK, Duggan C, Anderson BO, et al. Early detection and treatment strategies for breast cancer in low-income and upper middle-income countries: A modelling study. Lancet Glob Health. 2018;6:e885–e893. - PMC – PubMed
Haileamlak A. The impact of COVID-19 on health and health systems. Ethiop J Health Sci. 2021 Nov;31(6):1073-1074. doi: 10.4314/ejhs.v31i6.1. PMID: 35392335; PMCID: PMC8968362.
Ashraf MA. Hussain and Riyadh K. Lafta. (2021). Cancer Trends in Iraq 2000–2016. Oman Medical Journal. 36;1: e219.
Abdel-Razeq H, Abdel Rahman F, Almasri H, et al. Tumor characteristics and treatment outcomes of older patients with breast cancer in Jordan. BMC Women's Health. 2020;20:118. - PMC – PubMed
Trabulsi NH, Shabkah AA, Ujaimi R, et al. Locally advanced breast cancer: Treatment patterns and predictors of survival in a Saudi tertiary center. Cureus. 2021;13:e15526. - PMC – PubMed
Saadeh S, Abdel-Razeq H. Breast cancer in the Arab world. In: Al-Shamsi HO, Abu-Gheida IH, Iqbal F, et al., editors. Cancer in the Arab World. Singapore: Springer Singapore; 2022. pp. 353–362.
Nuha Salih Falgoos, Satar Abood Faris (2016). Diagnostic and Histological study of breast cancer diseases and knowledge of role steroid hormones (estrogen and progesterone) in the disease progression in Thi-Qar province. Journal of College of Education for pure sciences(JCEPS). 6; (1):1-14.
Hajer SH. Hamed, Rasheed M. Rasheed, Hameed H. Al-Janabi. ( 2015). A study of some antioxidants levels in blood serum of women with breast cancer in anbar governorate. Journal of University of Anbar for Pure science. (1 ):32-37
Sarah Ali Abed, Rana Dakhil Nafea, Suha Suhiel Hussein, Dergham Majeed Hameed, Ihab Abbas Taher. (2021). Types of Cancer Prevalence in Al Muthanna Province for Two Years’ Duration (2018-2019).Medico-legal Update. 21;1:1448-1456.
Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. (2021). Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers (Basel). Aug 25;13(17):4287. doi: 10.3390/cancers13174287.
Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. (2021). Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers (Basel). Aug 25;13(17):4287. doi: 10.3390/cancers13174287.
Golshan M, Loibl S, Wong SM, et al. Breast conservation after neoadjuvant chemotherapy for triple-negative breast cancer: Surgical results from the BrighTNess randomized clinical trial. JAMA Surg. 2020;155:e195410. - PMC – PubMed
Petruolo O, Sevilimedu V, Montagna G, et al. How often does modern neoadjuvant chemotherapy downstage patients to breast-conserving surgery? Ann Surg Oncol. 2021;28:287–294. - PMC – PubMed
Mo H, Kim Y, Rhu J, et al. Actual conversion rate from total mastectomy to breast conservation after neoadjuvant chemotherapy for stages II-III breast cancer patients. Eur J Cancer. 2018;92:S80.
Spronk PER, Volders JH, van den Tol P, et al. Breast conserving therapy after neoadjuvant chemotherapy; data from the Dutch Breast Cancer Audit. Eur J Surg Oncol. 2019;45:110–117. -PubMed
Patiniott PD, Wong GYM, Lam YH, et al. Neoadjuvant chemotherapy rates for breast cancer in Australia—“Are we there yet?”. Ann Breast Surg. 2019;3 DOI 10.21037/abs.2019.04.01
Murphy BL, Day CN, Hoskin TL, et al. Neoadjuvant chemotherapy use in breast cancer is greatest in excellent responders: Triple-negative and HER2+ subtypes. Ann Surg Oncol. 2018;25:2241–2248. – PubMed
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) Eur J Cancer. 2009;45:228–247. – PubMed
Donker M, van Tienhoven G, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): A randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15:1303–1310.
Amódio J, Palioto DB, Carrara HH, Tiezzi DG, Andrade JM, Reis FJ. Oral health after breast cancer treatment in postmenopausal women. Clinics (Sao Paulo). 2014 Dec;69(10):706-8. doi: 10.6061/clinics/2014(10)10. PMID: 25518024; PMCID: PMC4221315.
Wang K, Zhang Z, Wang Z. 2022. Assessment of the association between periodontal disease and total cancer in- cidence and mortality: a meta-analysis. PeerJ 10:e14320 http://doi.org/10.7717/peerj.14320
Hrysanthakopoulos NA, Vryzaki E (2022). Assessment of Periodontal Disease Indices in Breast Cancer Patients: A Case-Control Study Cases. 1(1):6. DOI : https://doi.org/10.35702/cases.10006
Jia M, Wu Z, Vogtmann E, O'Brien KM, Weinberg CR, Sandler DP, Gierach GL. The Association Between Periodontal Disease and Breast Cancer in a Prospective Cohort Study. Cancer Prev Res (Phila). 2020 Dec;13(12):1007-1016. doi: 10.1158/1940-6207.CAPR-20-0018. Epub 2020 Jul 29. PMID: 32727823; PMCID: PMC7718282.
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