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Background & Objective: The breast cancer is the most common malignancy in women. MDM2 expression is determined in some carcinomas, sarcomas, leukemias,and breast cancer. The purpose of this study was to determine the expression of MDM2 gene in primary breast cancer and it’s relationship with grade, stage and axillary lymph node involvement. Materials & Methods: the study was the cross-sectional one, that was performed on 75 samples of patients with breast cancer admitted in Mostafa Khomeini hospital Tehran, Iran (2000-05). After preparing the samples, a tissue section from each samples was obtained. One of the tumoral sections and one of the lymph node sections were stained by H&E. We determined the type of the tumor, the number of lymph nodes, the stage and the grade of the tumor. We studied MDM2 with polyclonal antibody by IHC. Results: The meanSD of patients were 5412.5 years old. 69.3% of patients had lymphoid involvement. 32% of samples were positive for MDM2. 58.7% of samples were in stage II and the most of patients (42.7%) were in grade III. In this study, there was not any relationship between MDM2 and tumor grade, but there was a relationship between stage of tumor and lymph node involvement with MDM2 gene (P<0.05). Conclusion: This study showed that MDM2 gene is a prognostic factor in breast cancer.

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Background and Objective: Child obesity is increased in developing countries. This study assessed the prevalence of obesity on children which are exclusively on breast feeding and its duration among children aged 24-59 months in Bandar Turkmen district Northern, Iran.

Materials and Methods: In this descriptive- analytical study, 343 in children aged 24-59 months were selected with stratified random sampling. Obesity was defined as >+2SD NCHS (National Center for Health Surveys) reference. Data were collected by questionnaire, interview with mothers and were analyzed with Chi-Square and Fisher tests and multiple regression logistic models.

Results: In this study, 6.4% of children were obese. Prevalence of obesity was not significantly different between boys and girls (5.4% and 7.4% respectively). Breast feeding duration<18 months (P<0.005) and formula or cow’s milk plus breast feeding up to 6 months old (P<0.01) was significantly correlated with children’s obesity. Breast feeding duration more than 18 months reduced the obesity risk factor with 64%.

Conclusion: This study demonestrated that exclusively breast feeding in the first 6 months of life and breast feeding duration more than 18 months reduce the child obesity.

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Background and Objective: Breast cancer is one of the most important malignant tumors world -wide and the second common cancer in the females. Breast cancer is associated with a number of environmental factors and genetic damages. Ki67 is a proto-oncogene which is activated in cell proliferation process. Ki67 is important in prognosis and response to chemotherapy. The aim of this study was to investigate the Ki67 gene expression in patients with breast cancer by immunohistochemistry method. Materials and Methods: This descriptive laboratory study was conducted on 80 breast cancer specimens from patients admitted to the hospitals in Sabzevar, Iran during 2005-09. Samples were fixed in formalin, the tissue processing was done and sections were stained by Hematoxilin and Eosin method. The malignancy was diagnosed by two pathologists blindly. Over expression of ki67 was determined with the immunohistochemistry method. Slides were scored into negative, weak, average and strong based on percentage of cells which were stained. The Data were analyzed by SPSS-11.5, Chi-Square and Fisher’s exact tests. Results: Ki67 proliferative marker was observed in 37 (46.3%) specimens with breast cancer. Sensivity of staining was one positive (+) in 15 cases, two positive (++) in 14 cases and three positive (+++) in 8 cases. There was a significant relationship between Ki67 gene expression and tumor type and tumor staging (P<0.05), but there was no significant relationship between Ki67 gene expression and tumor grade. Conclusion: It is concluded that, ki67 is expressed mostly in invasive and developed breast cancer.

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Both fibrocystic change and phyllodes tumor are classified as fibroepithelial tumors of breast which are composed of epithelial and stromal components. Although as the most common benign breast lump fibrocystic lesions are known by symptom such as pain, nipple discharge, heaviness, usually in women’s third decade of life, mammographic and sonographic features often render them almost indistinguishable from phyllodes tumor. In view of the essential differences in terms of therapeutic planning which exist between these two tumors, their early and precise distinction is crucial to avoid problem such as patients’ anxiety and unwarranted tumors operation. In this article a case of fibrocystic change in a 24 year old woman is reviewed in which clinical signs and symptoms and mammographic changes are indication of phyllodes tumor.

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Background and Objective: Breast cancer is one of the most frequent malignancies among women. This study was done to determine the BRCA1 gene expression in 7,12-Dimethylbenz(a)anthracene (DMBA) induced breast cancer in rats. Materials and Methods: In this experimental study, the breast cancer was induced by DMBA in Sprague dawley rats. After tumors arise, cell cultures were prepared and G-banding staining was performed on metaphase chromosomal smear. According to databases, genes in the affected area were collected and after comparing genome of the rats and human in changed chromosomal segments, a gene list was prepared. FISH technique was performed on BRCA1 gene to prove accuracy of chromosomal banding results. Results: Structural changes such as deletion occurred in chromosomes 10, which BRCA1 is located on. 24.7% of cells showed evidence of physical deletion in both copy of BRCA1 gene and 23.8% of cells showed deletion in one copy. Conclusion: Induced DMBA Breast cancer cells showed deletion in BRCA1 copy numbers. This gene may be involved in animal breast tumor model.

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Background and Objective: Dissection of the axillary lymph nodes is considered as one of the common measures in management of breast cancer. Edema and limitation in hand movement are accompanied with dissection of axillary lymph nodes. Sentinel lymph node biopsy can be used to evaluate axillary metastasis. This study was carried out to evaluate the diagnostic value of sentinel lymph node biopsy in patients with breast cancer. Materials and Methods: This descriptive study was performed on 30 selected patients with breast cancer less than 5 cm without any involvement of axillary lymph nodes in Ghaem Hospital in Mashhad, North-East of Iran during 2009 -10. Initially, the lymphoscintigraphy was performed. Subsequently, prior, to the surgery, the blue dye as a marker was injected for detecting sentinel lymph node and with the use of probe gamma counter and observing blue color on lymph nodes, the sentinel node was determined and separated. Finally, axillary dissection was performed for removing the lymph nodes of I and II level in all patients. Results: Among 30 patients who were evaluated for sentinel lymph nodes and axillary dissection, false negative were observed only in two cases (6.6 %). The sensitivity rate was determined to be 84.6%. Conclusion: Considering the high success rate of detection of sentinel lymph node and limited false negative cases, sentinel lymph node biopsy is recommended in cases of breast cancer without axillary involvement.

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Background and Objective: Glycodelin expression in normal and cancerous human breast tissue and its relation with age, tumor type, microscopic grade and metastasis to axillary lymph nodes recently were noticed. This study was done to evaluate the glycodelin expression in breast cancer. Methods: In this descriptive study, 96 Paraffin-embedded blocks of malignant breast cancer by immunohistochemistry method were considered to evaluate the expression of glycodelin. Patients age,tumor size, tumor type, microscopic grade and metastasis to axillary lymph nodes were recorded for each subject. Results: Glycodelin was found in 30.45% of invasive carcinoma of the breast with axillary lymph node metastasis. Glycodelin was expressed in 72.7% of carcinoma of the breast without lymph nodes metastasis (P<0.05). There was a significant relation between glycodelin expression with microscopic grade 1 of tumor and metastasis to less than 4 of lymph nodes (P<0.05). Conclusion: Glycodelin expression can be evidence for lack of axillary lymph node metastasis of breast cancer.

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Background and Objective: Valproic acid is used in the epilepsy, bipolar and migraine therapy. As a histone deacetylase inhibitor, Valproic acid has been recently under investigation in cancer treatment, either alone or in combination with either chemotherapy or radiotherapy. This study was done to determine the effect of Valproic acid and radiotherapy on viability of MCF-7 breast cancer cell line. Methods: In this descriptive - analytic study, MCF-7 cell line was obtained from the Iranian Pasteur Institute. The cells were treated and incubated by different concentrations of Valproic acid (1, 2, 4, 8, 16, 32, 64 and 128 mM) either alone or in combination with various dosages (0 .5, 2, 4, 6 and 8 Gray) of radiotherapy. After cell viability assay, using the Neutral red staining, the most nearest results to LD50 were selected. Cell viability was evaluated with trypan blue staining. Results: The most nearest concentrations of LD50 was doses of 2, 8 and 16 mM of valproic acid and dosage of Gray 4 of radiation. There was a significant dose-dependent correlation between reduction of cell viability with valproic acid concentration (P<0.05). Conclusion: Valproic acid, either alone or combination with radiotherapy caused a significant decline in the cell viability of MCF-7 breast cancer cell line.

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Background and Objective: Breast cancer is a cancer in women with high prevalancy worldwide. Vascular endothelial growth factor (VEGF) is one of the most important Pro-angiogenic factors. +405C/G is one of the common VEGF polymorphism which may have an impact on the level of gene expression and over loading of gene products. This study was done to evaluate the association between VEGF +405C/G gene polymorphism and breast cancer risk in north of Iran.

Methods: This case-control study was carried out on 50 patients with breast cancer and 50 normal aged-matched controls in north of Iran. Genomic DNA was extracted from peripheral blood cells. To determine the genotype of +405 C/G VEGF gene polymorphism, PCR-RFLP method was used.

Results: The prevalence of genotypic frequencies of GG, GC and CC in controls were 42%, 48% and 10%, respectively  and in patients were 22%, 46% and 32%, respectively (P<0.05). The +405C allele was considered as a risk factor in breast cancer (P<0.05).

Conclusion: It seems +405 C/G VEGF gene polymorphism may be associated with the breast cancer in northern Iran.

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Background and Objective: Spirituality refers to considering the cultural-religious beliefs of the people in the therapeutic process and taking into account the transcendental dimension of the clients who lead them to the transcendental source. This study was conducted to determine the effect of spirituality therapy on the resilience of women with breast cancer in Tehran, Iran.
Methods: This quasi-experimental study was performed on 30 women with breast cancer referred to the oncology and chemotherapy clinic in Tehran, Iran during 2016. Subjects were selected by available sampling method and then non-randomly divided into two groups of 15 intervention and control groups. The intervention group was subjected to psychological intervention during 11 sessions of 60 minutes and the control group did not receive intervention. Patients completed the Conner and Davidson resiliency questionnaire (2003) before and after the end of the treatment period.
Results: The mean and standard deviation of the resiliency score of the intervention and control groups in the beginning of the study were 3.64±0.22 and 3.77±1.13, respectively. This rate was 4.30±0.41 and 3.68±0.1 in patients in intervention and control groups, respectively (P<0.05).
Conclusion: Spiritual therapy intervention increased the resiliency of women with breast cancer.

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Background and Objective: Breast cancer and related treatments induce various physical symptoms. One of suggested method for preventing or reducing physical symptoms is exercise training. This study was done to evaluate the effect of 8 weeks Pilates exercises physical fitness indices in breast cancer patients.
Methods: In this randomized clinical trial study 30 female breast cancer patients were divided into intervention (n=15) and control (n=15) groups by block randomization method. Pilates exercise for 8 weeks, 3 days a week for 60 min in every session was performed in Patients in interventional group but patients in control group did not participate in any regular physical activity. Flexibility, coordination, back and hand strength and muscular strength were determined using Wells, alternate hand wall toss, one leg –stance, back and handgrip dynamometer, sit up tests, respectively.
Results: Pilates exercises significantly increased flexibility, balance, coordination, back and hand strength, muscular endurance and sit up in interventional group in compared to controls (P<0.05).
Conclusion: Pilates exercise improves physical fitness indices in women with breast cancer.

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Background and Objective: Angiogenesis and expression of angiogenic factors in tumor are associated with increased risk of metastasis and reduction of treatment outcomes. This study was performed to evaluate the effect of endurance training on the angiogenic factors (VEGFR-2, VEGF) of tumor in breast cancer bearing mice.
Methods: In this experimental study, 20 BALB/c mice following breast cancer induction were randomly allocated into two groups of experimental (n=10) and control (n=10). Breast cancer tumors were induced by MC4-L2 cell infusion. Animals in the experimental group were received endurance training for 6 weeks, 5 days a week with gradual increase in intensity from 12 to 20 (m.min-1) and duration from 25 to 55 minutes. Tumor volume was measured weekly with digital caliper. Expression of two angiogenic proteins of VEGFR-2 and VEGF were measured by ELISA method.
Results: Endurance training significantly reduced VEGFR-2 protein in training group (1.524±0.324 ng ml^-1) compared to the control group (2.686±0.815 ng ml^-1) (p<0.05), whereas, there was no significant difference in the VEGF protein in the training group (734.633±110.131 pg ml^-1) compared to the control group (756.317±72.32 pg ml^-1). The tumor volume significantly decreased in the training group compared to the control group (p<0.05).
Conclusion: Regular endurance training induces anti-angiogenic effects in tumor tissue of breast cancer bearing mice.

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Background and Objective: Breast cancer is one of the most common types of cancer among women. HER-2 molecule as the receptor of tyrosine kinase from the family of epithermal growth factor is a major cause of cancer. The Herceptin protein molecule, which is an anti-HER-2 antibody, can play an important role in the diagnosis and treatment of breast cancer. This study was done to subcloning of Herceptin gene, expression in the prokaryotic system (E.coli) and produce Herceptin recombinant protein for use in the treatment of breast cancer.

Methods: In this descriptive – laboratory study, Herceptin gene from synthesized construct was isolated by enzyme digestion, and then subcloned to the expression vector pET28a. Subcloning of the gene was confirmed using PCR and enzyme digestion. After transferring the vector into E.coli BL21 DE3, expression of the recombinant Herceptin gene was induced by IPTG. The recombinant protein was evaluated by SDS-PAGE and purified with Ni-NTA column chromatography and finally verified by western blotting using anti-histidine antibody. The survival of cells adjacent to recombinant Hercaptin by MTT was investigated.

Results: Following the subcloning of the Herceptin gene, PCR and enzyme digestion, the 741 fragment of the Herceptin gene was confirmed. Confirmation of Herceptin's recombinant protein and its evaluation on SDS-PAGE gel about 27 kDa was done. The recombinant protein was also confirmed with anti-histidine tag. The purified protein adjacent to the SKBR3 cell line was able to block the growth of cancer cells.

Conclusion: Regarding the expersion of HER2 antigen on surface of breast cancer cells, Herceptin can act as antibody blocker and it arrests the growth of breast cancer cells.

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Background and Objective: The mental health of cancer patients impaired by suffering, future worriness, and fear of death. This study was conducted to determine the effect of acceptance and commitment based training on the difficulty of emotion regulation and mental health in women with breast cancer.
Methods: In this clinical trial study, 30 female patients with breast cancer were randomly divided into control and intervention groups (n=15). The intervention group received 8 sessions of 90 minutes of acceptance and commitment procedures. Before and after the treatment and two months there after, all participants were evaluated and compared with the Gratz-Romer 2004 and General Health Questionnaire (GHQ-28).
Results: Emotion regulation score in the intervention group was singnificantly reduced from 113.52±4.16 to 104.67±3.96 (P<0.05). Emotion regulation score remained low in the intervention group in the follow up period (104.17±3.58); but the mean in the control group did not show any significant reduction. In the intervention group after the treatment, the total score of mental health reduced from (46.81±4.21) to (33.18±3.39) (P<0.05). This score was 33.12±3.33 in the follow-up period in the intervention group; but no significant reduction was observed in the control group.
Conclusion: Acceptance and commitment technique training can improves mental health and emotion regulation in women with breast cancer.

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Background and Objective: Breast cancer is the most common type of cancer in women. This study was conducted to investigate the relationship between nutritional status and breast cancer.
Methods: This case-control study was conducted on 210 women (105 breast cancer patients and 105 healthy individuals) aged 20-89 years in Azadshahr (Iran) in 2019. Nutritional status was assessed using a researcher-made checklist.
Results: The majority of cancer patients were in the 40-54 years age group (49.5%). There was a significant difference between the case and control groups in terms of consumption of solid oil (49.5% vs. 31.4%), hot food (19% vs. 9.5%), carbonated drinks (29.5% vs. 21%) and the average number of servings of fried foods per week (3.2±1.79 vs. 2.3±1.73) (P<0.05). There was no significant difference between the two groups in terms of consumption of vegetables, type and amount of meat, animal oil, legumes, salt and tea.
Conclusion: The consumption of solid oil, hot food, carbonated drinks and fried foods could be associated with the risk of developing breast cancer.
 

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Background and Objective: Breast cancer is the most common cancer among women and ranks second in terms of mortality rate. This study was conducted in order to determine the personal, clinical, and laboratory characteristics of women with breast lesions referred to the Dr. Beski Hospital in Gonbad-e Kavus, Iran.
Methods: This descriptive-analytical study was conducted on 130 women with breast lesions (benign and malignant) who were operated on in the Dr. Beski Hospital from March 2019 to March 2020. Demographic data (age, family history, and ethnicity) and pathology results (grade, lesion type, surgery type, location, and tumor size) were recorded.
Results: Breast lesions were malignant in 51.53% of the patients. The most common malignant tumor was invasive ductal carcinoma (71.64%), and the most common benign tumor was fibroadenoma (69.84%). Most malignant cases were observed in patients aged 41-50 years (43.28%). Almost half of the studied population (49.15%) had no positive family history, and about a quarter of the patients had at least one first or second-degree relative with breast cancer. Most patients (44.78%) had grade II malignant tumors. In addition, 78.51% of the subjects had not undergone chemotherapy before breast surgery. About half of the patients (49.57%) did not undergo any adjuvant treatment after surgery; however, chemotherapy was the most common type of adjuvant treatment (13.68%) after surgery. Simultaneous chemotherapy and radiotherapy were performed for 24.78% of the patients after surgery. There were statistically significant relationships between age and type of lesion and adjuvant treatments after the operation, and involvement of lymph nodes was observed (P<0.05). There was a statistically significant relationship between age, tumor size, family history, and tumor malignancy (P<0.05). There was a significant correlation between age and tumor malignancy (P=0.02, F (2.48) = 4.19) so the degree of malignancy was higher in younger individuals.
Conclusion: The results of this study showed the young age of developing malignant breast lesions in the study area. Most malignant lesions are invasive ductal carcinoma and grade II. There is a positive relationship between a family history of cancer and the classification of breast tumors.
 

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Background and Objective: Breast milk has significant benefits for both mothers and babies. Counseling is a beneficial method for the continuity of exclusive breastfeeding. Remote counseling methods are currently being developed. This study was conducted to determine the effects of telephone counseling on the continuity and duration of exclusive breastfeeding among mothers who have had a cesarean section.
Methods: In this clinical trial, 154 mothers who have had cesarean section delivery were randomly divided into an experimental and a control group. The intervention group received seven sessions of telephone counseling for 1-3 months postpartum in addition to the routine breastfeeding training program. The control group only received the routine breastfeeding training program.
Results: After 4 months postpartum, the average duration of exclusive breastfeeding in the intervention group (15.51±0.88 weeks) was longer than that in the control group (10.74±5.33 weeks) (P<0.05). At 3 months postpartum, exclusive breastfeeding in the intervention group was 10.45 times longer than in the control group (OR=10.455, CI=2.547-42.912, P<0.001).
Conclusion: Telephone counseling is effective in increasing the continuity and duration of exclusive breastfeeding in mothers who undergo a cesarean section.
 

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Background and Objective: Breast cancer has a high prevalence and mortality rate in the world and also in Iran. Neoadjuvant chemotherapy (NAC) is one of the treatment methods to improve patient survival. This study aimed to determine the response rate to NAC in patients with locally advanced breast cancer based on common molecular receptors.
Methods: This descriptive-analytical study was conducted on 100 patients with breast cancer (mean age= 41.14±10.06 years) referring to the surgical clinic of the Fifth Azar Educational and Therapeutic Center in Gorgan, Iran during 2013-18. Patients without distant metastasis underwent NAC treatment regimen followed by surgery. Demographic characteristics, types of drugs, and molecular receptor characteristics, and their response to treatment were recorded in a checklist. Treatment response and overall patient survival were evaluated.
Results: The mean tumor size before NAC was 3.01±2.47 cm (range= 0-8, median= 2) and 16% were determined to be grade one, 52% were determined to be grade 2, and 32% were determined to be grade 3. Thirty-six percent of patients had a positive family history. Forty-six percent were estrogen receptor (ER) positive, 40% were PR positive, 22% were human epidermal growth factor receptor 2 (Her-2) positive, and 78% were Her-2 negative. Thirty-six percent had a Ki-67 index greater than 30%. Eighteen percent of patients had a complete pathological response, and 82% had a partial or negative response. In terms of family history of breast cancer, Her2, ER, progestrone receptor (PR), Ki-67 receptor status, histological grade, tumor size, and axillary lymph nodes, there was a significant statistical difference between the two groups with and without complete pathological response (P<0.05).
Conclusion: The rate of complete pathological response to NAC in patients with locally advanced breast cancer was 18%.

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Background and Objective: Breast cancer is the most common cancer among women, causing the death of many worldwide each year. Given the importance of determining prognosis and the role of biomarkers, this study aimed to determine the expression level Ki-67 biomarker and its relationship with metastasis time and location in breast cancer patients.
Methods: This descriptive-analytical study was conducted on 154 breast cancer women admitted to the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, during 2009-2019. Upon admission, Ki-67 expression levels in tissue were determined using immunohistochemistry (IHC). Other required information, including demographic characteristics, disease stage, time interval from diagnosis to metastasis, and metastasis location, were identified and evaluated.
Results: Most of the patients (63%) were in the 40-60 age group. Ki-67 levels were determined to be below 15% in 45 patients (29.2%) and above 15% in 109 patients (70.8%). A statistically significant relationship was observed between Ki-67 expression levels and the time interval from diagnosis to metastasis (P<0.05). No statistically significant relationship was found between Ki-67 expression levels and age group, metastasis location, or disease stage.
Conclusion: The results of this study demonstrated that individuals with tissue Ki-67 levels above 15% experienced metastasis within a shorter period of time.
 

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Background and Objective: Breast cancer is one of the most common diseases worldwide and the second leading cause of death among women. Immune responses play a critical role in inhibiting the onset and progression of this disease. Given the important role of T lymphocytes in identifying and preventing the spread of breast cancer tumor cells, this study was conducted to simultaneously evaluate the regulatory molecules CXC chemokine receptor 3 (CXCR3), programmed cell death protein 1 (PD-1), natural killer group 2 member D (NKG2D), and transforming growth factor beta 1 receptor II (TGF-βRII) on T lymphocytes of newly diagnosed breast cancer patients.
Methods: This case-control study was performed on 26 newly diagnosed breast cancer patients (mean age = 46.2±9.5 years) admitted to the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, and 12 non-breast cancer individuals (mean age = 42.9±9.9 years) selected from the staff and students of Golestan University of Medical Sciences during 2018-2019. First, blood sampling was performed and peripheral blood mononuclear cells (PBMCs) were isolated. Then, using flow cytometry, different cell populations were evaluated for the expression of CXCR3, PD-1, NKG2D, and TGF-βRII. Plasma levels of interferon gamma (IFN-γ) and major histocompatibility complex class I chain related gene-A (MIC-A) were measured by enzyme-linked immunosorbent assay (ELISA).
Results: The mean percentage of T lymphocyte population in newly diagnosed breast cancer patients was significantly lower compared to healthy individuals (P<0.05). Also, the mean percentage of T lymphocytes expressing PD-1 and TGF-βRII was higher in the case group compared to the control group, while the expression of NKG2D and CXCR3 showed lower levels (P<0.05). The results of comparing plasma concentrations of IFN-γ and MIC-A indicated that the case group had higher levels of MIC-A than the control group (P<0.05); however, no statistically significant difference was found regarding IFN-γ.
Conclusion: It seems that the increased expression of TGF-βRII and PD-1 along with the decreased expression of NKG2D and CXCR3 and the reduced level of MIC-A in newly diagnosed breast cancer patients may be related to upregulation and potent suppression of T lymphocyte immunity and their dysfunction in breast cancer disease.