A cost-benefit analysis of genetic screening test for breast cancer in Iran.

BACKGROUND: This study aimed to evaluate the implementation of the population- and family history (FH) -based screening for BReast CAncer (BRCA) in Iran, a country where less than 10% of breast cancer cases are attributable to a gene mutation. METHODS: This was an economic evaluation study. The Benefit-Cost Ratio (BCR) for genetic screening test strategies in Iranian women older than 30 was calculated. To this end, the monetary value of the test was estimated using the willingness-to-pay (WTP) approach using the contingent valuation method (CVM) by payment card. From a healthcare perspective, direct medical and non-medical costs were considered and a decision model for the strategies was developed to simulate the costs. A one-way sensitivity analysis assessed the robustness of the analysis. The data were analyzed using Excel 2010. RESULTS: 660 women were included for estimating WTP and 2,176,919 women were considered in the costing model. The cost per genetic screening test for population- and FH-based strategies was $167 and $8, respectively. The monetary value of a genetic screening test was $20 and it was $27 for women with a family history or gene mutation in breast cancer. The BCR for population-based and FH-based screening strategies was 0.12 and 3.37, respectively. Sensitivity analyses confirmed the robustness of the results. CONCLUSIONS: This study recommends the implementation of a FH-based strategy instead of a population-based genetic screening strategy in Iran, although a cascade genetic screening test strategy should be evaluated in future studies.

Investigation of miR-133a, miR-637 and miR-944 genes expression and their relationship with PI3K/AKT signaling in women with breast cancer.

PURPOSE: MicroRNAs (miRNAs) are regulatory molecules capable of positively or negatively regulating signaling pathways, and are involved in tumorigenesis as well as various aspects of cancer. The purpose of this study was to investigate the expression levels of miR-133a, miR-637, and miR-944 in serum and tumor tissues as well as their relationship with the expression level of phosphatidylinositol-3-kinase (PI3K) and protein kinase-B (AKT) genes and proteins along with their clinical significance in breast cancer. METHODS: The expressions of miR-133a, miR-637, miR-944, PI3K, and AKT genes were examined in the tumor and tumor margin tissues of 40 patients with breast cancer, as well as the serum levels of miR-133a, miR-637, and miR-944 in these patients and 40 healthy groups by quantitative real-time PCR (qRT-PCR). PI3K and AKT proteins expression in tumor and tumor margin tissues were detected using immunohistochemistry (IHC). RESULTS: The expression levels of miR-133a and miR-637 in the tumor tissue and serum of patients were lower than those in the tumor margin tissue and serum of the healthy group, respectively. In addition, the expression level of miR-944 in the tumor tissue was lower than that in the tumor margin tissue, but its expression increased in the serum of cancer patients compared to that in the healthy group. The expression of miR-637 was correlated with tumor location and Her2 receptors, and the expression of miR-944 was correlated with tumor location and family history. PI3K and AKT mRNA and protein levels were higher in the tumor tissues than in the tumor margin tissues (p < 0.05). CONCLUSION: The results of our study revealed that miR-637 has a better diagnostic value in breast cancer than miR-133a and miR-944.

Assessment of Tissue Oxidative Stress, Antioxidant Parameters, and Zinc and Copper Levels in Patients with Breast Cancer.

Breast cancer is a multifactorial disease, and among the many factors which are involved in the onset, progression, and invasion of the disease, oxidative stress plays a significant role. The concentration and activity of enzymatic antioxidants are proportional to the concentration of trace elements, and the concentration of trace elements is often deficient in malignancies. Therefore, in the present study, we studied the tissue levels of oxidative stress, antioxidant status, zinc (Zn), and copper (Cu) in breast cancer patients. Tissue samples were collected from 40 patients with breast cancer and 40 tumor margin tissue as a control group. All subjects gave their informed consent. The tissue samples were measured for superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), total antioxidants capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA), Zn, and Cu. Data of all biochemical parameters of two groups were statistically analyzed by SPSS software, t test, and GraphPad Prism. Concentrations of MDA, TOS, and OSI in tumor tissue were significantly higher than tumor margin tissue, but the level of TAC and CAT, SOD, and GPX activities was significantly reduced in tumor tissue (p<0.05). It was found that the concentrations of Zn and Cu in breast cancer patients were higher than tumor margin tissue. Patients with breast cancer have a rise in oxidative stress indicators and a decrease in antioxidant stress markers. Since oxidative stress is a significant contributor to the development and progression of breast cancer, more research might lead to a more effective method of breast cancer treatment. Considering the dual role of oxidative stress in cancer, which can both cause survival and adaptation, and the death of cancer cells, and with more information, it can be used to manage the treatment and destruction of cancer cells.