Breast cancer detection using volatile compound profiles in exhaled breath via selected ion-flow tube mass spectrometry.

This study aimed to evaluate volatile compounds in exhaled breath as a non-invasive screening method to detect breast neoplasms. Exhaled breath samples were collected from patients with breast cancer (BC;n= 45) and non-breast cancer (NBC;n= 51) controls. Selected ion-flow tube mass spectrometry was used to quantify the volatile compounds. A multiple logistic regression (MLR) model was developed by combining multiple compounds to discriminate between BC and NBC samples. Amongst the 672 quantified peaks, 17 showed significant differences between BC and NBC samples (P< 0.05 corrected by false discovery rate). Pathway analysis revealed a significant difference in glycerophospholipid metabolism. The MLR model showed an area under the receiver operating characteristic curve (AUC) of 0.719 (95% confidence interval: 0.615-0.822,P< 0.0002). Cross-validation under various conditions resulted in a slight fluctuation in the AUC values, indicating the high generalizability of the MLR model. The model showed a higher BC probability for advanced-stage subjects and higher Ki67 (⩾30) for BC subjects. This study suggests the potential of volatile compounds in exhaled breath as a noninvasive screening method for BC.

Vascular branching point counts using photoacoustic imaging in the superficial layer of the breast: A potential biomarker for breast cancer.

This study aimed to identify the characteristics of the vascular network in the superficial subcutaneous layer of the breast and to analyze differences between breasts with cancer and contralateral unaffected breasts using vessel branching points (VBPs) detected by three-dimensional photoacoustic imaging with a hemispherical detector array. In 22 patients with unilateral breast cancer, the average VBP counts to a depth of 7 mm below the skin surface were significantly greater in breasts with cancer than in the contralateral unaffected breasts (p < 0.01). The ratio of the VBP count in the breasts with cancer to that in the contralateral breasts was significantly increased in patients with a high histologic grade (p = 0.03), those with estrogen receptor-negative disease (p < 0.01), and those with highly proliferative disease (p < 0.01). These preliminary findings indicate that a higher number of VBPs in the superficial subcutaneous layer of the breast might be a biomarker for primary breast cancer.

Omission of dexamethasone from antiemetic treatment for highly emetogenic chemotherapy in breast cancer patients with hepatitis B infection or diabetes mellitus.

BACKGROUND: Chemotherapy with anthracycline- and cyclophosphamide-containing regimens are classified as highly emetogenic. Combinatory treatments of aprepitant (Apr), palonosetron (Pal), or granisetron (Gra) with dexamethasone are recommended as antiemetic treatments for such emetogenic chemotherapy. We retrospectively examined whether omission of dexamethasone is tolerable for patients with hepatitis B virus (HBV) and diabetes mellitus (DM), for whom it is recommended not receive dexamethasone. PATIENTS AND METHODS: During August 2009 and September 2007, we reviewed the medical records of patients with breast cancer who were HBV carriers or had been diagnosed with DM. 97 patients were treated with anthracycline- and cyclophosphamide- containing regimens with omission of dexamethasone in antiemetic treatment because of their HBV or DM status. RESULTS: Results The number of patients treated with Gra only, Apr and Gra, Apr and Pal, were 29, 29, and 39, respectively. Complete response (CR) in the acute phase (0-<24 hours after chemotherapy) or delayed phase (24-120 hours after chemotherapy) for Gra only, Apr-Gra, and Apr-Pal was 44.8% and 44.8%, 72.4% and 72.4%, and 76.9% and 74.4%, respectively. Complete control (CC) in the acute or delayed phase in each regimen for Gra only, Apr-Gra, and Apr-Pal was 31.0% and 27.6%, 48.2% and 51.7%, and 46.2% and 46.2%, respectively. Apr-Gra or Apr-Pal tended to be superior to Gra only in CR and CC in both the acute and delayed phases. HBV reactivation or aggravation of DM control was not observed in any of the 3 therapy options. CR and CC were about 20% higher for the dexamethasone-containing regimen than for the non-dexamethasone regimen in both the acute and delayed phases. CONCLUSION: Omission of dexamethasone in antiemetic treatment is tolerable when anthracycline- and cyclophosphamide-containing chemotherapy is administered to patients with breast cancer who have comorbidities of being HBV carriers or of DM.

A combination of aprepitant, palonosetron, and dexamethasone prevents emesis associated with anthracycline-containing regimens for patients with breast cancer. A retrospective study.

BACKGROUND: Chemotherapy regimens for breast cancer containing anthracycline and cyclophosphamide are classified as highly emetogenic. Aprepitant (A), palonosetron (P), granisetron (G), or dexamethasone (D) are recommended antiemetic drugs. However, it is uncertain which combination is most effective. We retrospectively examined the efficacy of these antiemetic drugs. PATIENTS AND METHODS: We reviewed the medical records of 454 patients with breast cancer treated in our facility with regimens containing anthracycline and cyclophosphamide between August 2009 and September 2010. RESULT: The number of patients treated with GD, AGD, and APD was 147, 150, and 157, respectively. Complete response (CR) in the acute (0-24 h) and delayed (24-120 h) phases was 68.7 and 76.2 %, respectively, for GD, 90.0 and 92.7 %, respectively, for AGD, and 89.8 and 90.4 %, respectively, for APD. Complete control (CC) in the acute and delayed phases for each regimen was 60.5 and 64.6 %, respectively, for GD, 62.7 and 88.7 %, respectively, for AGD, and 84.1 and 87.3 %, respectively, for APD. In the acute and delayed phases CR for AGD or APD was significantly superior to that for GD (P < 0.01). It worth noting that CC for APD in the acute phase was significantly superior to that for AGD (P < 0.01). In the delayed phase CC for AGD or APD was significantly superior to that for GD. CONCLUSION: A combination of aprepitant, palonosetron, and dexamethasone is an antiemetic treatment of choice for patients treated with regimens containing anthracycline and cyclophosphamide.

Diverticular Bleeding of the Colon during Combination Chemotherapy with Bevacizumab and Paclitaxel for Recurrent Breast Cancer.

BACKGROUND: Bevacizumab has been increasingly used in combination chemotherapy with paclitaxel for treatment of metastatic or recurrent breast cancer. The aim of this report is to underline possible risks associated with the new combination chemotherapy. CASE PRESENTATION: A 39-year-old woman with recurrent breast cancer was treated with bevacizumab and paclitaxel. Positron emission tomography revealed breast cancer metastasis to the left supraclavicular lymph nodes and right axillary lymph nodes, with no distant metastasis. RESULTS: After the third cycle of bevacizumab and paclitaxel, the patient developed a bloody bowel discharge. Emergent colonoscopy demonstrated diverticular bleeding on one of the multiple diverticula in the ascending colon. The bleeding point was successfully clipped colonoscopically. CONCLUSION: The factors for diverticular bleeding are believed to be non-steroidal anti-inflammatory drugs, constipation, and bevacizumab. We recommend reviewing anamneses for diverticulitis, multiple prior abdominal surgeries, peritoneal carcinomatosis, and regular use of certain drugs.

Detection of circulating tumor cells in peripheral blood of heavily treated metastatic breast cancer patients.

BACKGROUND: Circulating tumor cells (CTCs) are detected in peripheral blood of breast cancer patients, and they may play an important role as a prognostic and predictive marker. We conducted this study to determine the presence of CTCs with the CellSearch System™ and the clinical significance in treatment of metastatic breast cancer (MBC). METHOD: Twenty-eight MBC patients were enrolled. These patients were followed by assessing CTCs, imaging studies, and serum tumor markers. Blood samples were collected before starting a new treatment and at the treatment evaluation period (2-3 months after starting chemotherapy). The cutoff for CTC level was 5. RESULTS: At baseline, 9 of 28 patients (32%) had ≥5 CTCs per 7.5 mL of blood. At the evaluation period, 5 of 23 patients (22%) had ≥5 CTCs. The baseline CTC number did not contribute to determine their overall survival (OS); however, CTCs at the evaluation period were available to predict their OS (p < 0.001). In two cases, both CTCs and tumor markers were available as predictors of treatment efficacy. In two other cases, although alterations of tumor markers might not reflect disease condition, CTC alteration corresponded to their condition. One patient who had multiple skeletal metastasis only, experienced a decrease in her CTCs in spite of tumor marker alteration. CONCLUSIONS: We suggest that monitoring the number of CTCs may be helpful in predicting the efficacy of the treatment and the prognosis. CTCs might be especially useful with patients whose lesions are difficult to assess.