Day 1 :
- Prevention Of Breast cancer
Guangzhou University, China
XIAO-XIA YIN received the Ph.D. degree in electronics engineering from The University of Adelaide, Australia. She was a Visiting Scholar with the University of Reading, Reading, U.K., under the supervision of S. Hadjiloucas, and with the University of Cambridge, Cambridge, U.K., under the supervision of L. F. Gladden. She involved in tumor detection via DCE-MRI with The University of Melbourne, Australia, under the supervision of Prof. Kotagiri. She has an existing collaboration with Prof. M.-Y. Su with the Center for Functional Onco Imaging, University of California at Irvine, USA, and with Prof. T. Kron with the Peter MacCallum Cancer Centre, Australia. She is currently a professor in University of Guangzhou, China and her major is in high-dimensional medical image analysis. Her research interests include multiresolution analysis, segmentation, image reconstruction and classifification, and their applications to high-dimensional medical imaging. She received the Postdoctoral Research Fellowship from the Australian Research Council, in 2009.
We present Focal Boundary Dice, a new segmentation evaluation measure focused on boundary quality and class imbalance. We perform an extensive analysis across different error types and object sizes of imaged tumors from MRI scan and show that Focal Boundary Dice is significantly more sensitive than the standard Focal and Dice measures to boundary errors for imaged tumors from MRI scans and does not over-penalize errors on division of the boundary, including smaller imaged objects. The new quality measure displays several desirable characteristics, like higher accuracy in the selection of hard samples, prediction/ground truth pairs, and balanced responsiveness across scales, which makes it more suitable for segmentation evaluation than other classification focused measures such as combined IoU and BCE loss, Boundary BCE loss and Shape-aware Loss.
- Breast Cancer
Dr. Nandini N. M, Professor, JSS Medical College, Mysore, is attached as a teaching faculty from the past 25 years in the department of pathology.she has finished her MBBS from JNMC BELGAVI, MD from Mysore Medical College and Research Institute. She has worked in the field of cytology of cervix and breast. She has attended and given talks at many national and international conferences in countries like U.K, USA, Singapore and Netherland. She has worked on liquid based cytology, cell block technique and has come up with indegenious methods. She has severeal publications and books to her credit written on cervical and breast cancer.
Statement of the problem
Breast cancer is the most diagnosed cancer globally.. In 2020, there were an estimated 684,996 deaths from breast cancer, with a disproportionate number of these deaths occurring in low-resource settings.
Fine needle aspiration cytology(FNAC) has been established as an important tool in the evaluation of breast lesions in low resource settings. Manual liquid based cytology (MLBC) is designed to improve conventional smears (CS) by avoiding limiting factors such as obscuring material, air-drying and smearing artifacts.. the residual sample, for ancillary techniques, such as immunocytochemistry (ICC), flow cytometry and molecular biology.
Cell blocks are microbiopsy which employs retrieval of small tissue fragments from FNA specimen and is then fixed and processed with standard histopathology technique. It offers high diagnostic accuracy, cost-effectiveness, and rapidity of results.
There are several biomarkers which play a role in diagnosis, treatment and prognosis of breast lesions. ER PR are nuclear markers, HER2 and KI67 which proliferation markers with
ECADHERIN, and CD 34 are important for diagnosing metastasis , which can be tested on FNAC, MLBC and cell block of breast
Methodology & Theoretical Orientation:
The various cost effective methods are studied and their advantages and limitations are studied . it was found that based on the condition of the breast any one or all the method were studied and the diagnosis was confirmed by histopathology wherever possible .
Conclusion & Significance:
It was found that FNAC of breast is still a good cost effective method for diagnosis of breast lesions ,(MLBC) was found to be useful in breast lesions where the cytological and nuclear features were clearly made out.ICC was possible on both FNAC and MLBC.
Cell block , has helped in confirming the diagnosis in grey zone breast lesions as it almost represents histopathology , it can be used for panel of biomarkers .
Centre National d’Oncologie, Mauritania
Selma MOHAMED BRAHIM is a Mauritanian PhD in genetics and molecular biology. She have a research on BRCA1 and BRCA2 genes of the cancer in Mauritania and she had done numerous training programs in Mauritania and abroad, she had developed a strong skill set in biomedical, molecular bioinformatics sciences. She has master in biology and health Sciences at HASSEN II University/Morocco.
Selma also has been the coordinator of the research and education unit at the National Center of Oncology since 2020 in Mauritania
Breast cancer (BC) is the leading cause of death in African women. The aim of this cross –sectional study was to assess the incidence, clinico-pathological characteristics, risk factors and outcome of breast cancer in Mauritania. BC of women under the age of 40 is a complex disease because more than 90% of young patients with BC are symptomatic. Data on BC in young women breast cancer is limited and the cancer characteristics mutation BRCA1/A2 genes are less well studied.
This study was aimed to provide the first data on young women in BC the incidence, clinico-pathological characteristics, risk factors and related gene mutations in Mauritania.
Materials and methods Thirty-three percent young women were referred to the Centre National d’Oncologie (CNO) in Mauritania between January 2009 and December 2020.we evaluated clinical characteristic, treatment selection and screening mutation BRCA1/A2 genes.
Results The Thirty-three percent young women with BC recruited in this study were aged between 21 and 39 years. Infiltrating ductal carcinoma was the predominant histological type in 90% of cases. Multimodal treatment was based on mastectomy followed by adjuvant therapy including chemotherapy, radiation therapy and/or hormonal therapy, depending on tumor stage and its histological features. Metastases mainly occurred in the bones (59%).
We identified five predominant BRCA1/2 variants: (c.815_824insAGCTATGTGG,c.2612C>T,c.813_814insTAGCCATGTG, c.201-18del) and (c.4986+6T>C). We also found one BRCA2 missense variants (c.10247A>G). Interestingly, we identified two novel BRCA DNA variants in of which 1 were predicted as pathogenic
Conclusion Further research is needed to address gaps in knowledge pertaining to care of young women breast cancer patients and survivors.
Venkateshwara Mint products, India
Dr Rakhee is currently working as Research scientist in Venkateshwara Mint Products, Pvt. Ltd. Company and Savory Aroma India Pvt. Ltd. company in India. She is expertise in synthesis of natural products, API intermediates in industrial level such as Cis-3-hexenol, Cis-3-hexyn-1-ol, Benzyl alcohol etc. She manage the manufacturing of flavors, fragrances, essential oil, perfume, aromatic compounds, natural extract etc.
This research is intended to be a narrative review of the relevant academic literature as well as the work we have work done in our industry. Leaf alcohol (green aroma) is well known for having a potent, distinctive aroma of fresh grass. Inhaling green aromas such as Trans-3-hexenol, Cis-3-hexenol, Trans-2-hexenol and Cis-2-hexenol, can benefit the airways by acting as an antioxidant and an anti-inflammatory1. Pharmacological activity of these leaf alcohols absorbed through inhalation may be also beneficial to promote brain functions by decreasing mental fatigue, inducing relaxation, and improving cognitive performance and mood. It is frequently used in industries including beverages, confectionery, flavoring, personal care products, perfumery, oral care, nutraceuticals, and pharmaceuticals (to reduce schizoid tendencies, antifungal activity, anticancer, antistress and antimicrobial activity)2. Its esters are frequently used as flavoring and fragrance ingredients. Currently, there are two ways to prepare cis-3-hexenol in industrial production: biosynthetic and synthetic. But due to the market's inability to keep up with the increase in demand, leaf alcohol is frequently in short supply. The difficulty and shortcomings of the current techniques for producing leaf alcohol are the cause of the shortage. A high yield method is developed for leaf alcohol to prepare"Trans-3-hexenol and Cis-3-hexenol" in our industry. The photoreactor technique is used in the presence of UV light and is easy, practical, affordable, and environmentally friendly. These findings may have beneficial ramifications for landscape design, public wellness, and personal happiness on bigger scales. This abstract discusses the industrial production of natural products, the productivity-boosting effects of new technologies, and the positive effects on psychological and physiological health.
Auckland University of Technology, New Zealand
Jiawei (Stacey) Li obtained her MD in Clinical Medicine in 2016 and a Master’s Degree in 2018 from Jilin University, one of the key universities in China under the Chinese Government’s Building World-class University schemes of the “Project 985” and "Project 211". She is now a PhD candidate at the AUT under the supervision of A/Prof Dong-Xu Liu. Her research project is to delineate the mechanism of the SHON breast cancer biomarker using the CRISPR-Cas9 gene editing technique.
Endocrine therapies currently remain the most effective form of treatment for ER-positive (ER+) breast cancer. However, not all patients will benefit from these treatments. Up to 50% the patients with ER+ tumours are resistant to the therapies either from onset of therapy or soon after therapy, with devastating consequences. SHON, a novel secreted hominoid-specific oncogene, promotes cell proliferation and tumour growth and has also been shown to be a promising biomarker that can accurately predict the response of patients to endocrine treatment in breast cancer. SHON is an estrogen-regulated gene, and the expression of SHON is strongly associated with ER expression in breast cancer. However, the molecular mechanism about how SHON drives breast cancer progression and metastasis and mediates endocrine resistance in breast cancer is still not clear. In this project, we utilized the CRISPR-Cas9 gene editing technology to investigate the mechanism of action. Two ER+ breast cancer cell lines MCF-7 and T47D, and two ER- breast cancer cell lines MDA-MB-231 and BT549, were used to generate SHON-knockout (+/-, -/-) cells. For comparison, SHON-overexpressing stable cells were also created from these cell lines. The status of SHON gene in single-cell clones was confirmed by both genomic PCR and DNA sequencing. SHON-overexpressing cell clones were confirmed by RT-PCR at the RNA level and Western Blotting at the protein level. We have obtained monoallelic SHON+/- knockout single-cell clones and SHON-overexpressing MCF-7 cell clones. We are still screening for biallelic SHON-/- knockout cell clones. Once all the cell lines are established, a variety of in vivo and in vitro functional assays to delineate the signaling cascades in these cells in the presence and absence of SHON gene. This will improve our understanding of the role of SHON in breast cancer cells.
- Breast Cancer Surgery
South China University of Technology, China
Dr. Chengcai Yao is the director and academic leader of the Department of Breast Surgery at the Sixth Affiliated Hospital of South China University of Technology, PRC. He is also a member of the breast disease branch of the Guangdong Medical Association, the breast surgery branch of the Guangdong Medical Association and the breast cancer branch of the Guangdong Anticancer Association. He is also a youthful and middle-aged editorial member of the "Chinese Journal of Breast Diseases (electronic edition)" and the "Chinese Journal of General Surgery". He is primarily engaged in basic and clinical breast cancer research, with a particular focus on minimally invasive laparoscopic surgery for early-stage breast cancer and mechanisms of drug resistance to chemotherapy.
The quest for beauty is never-ending for women with breast cancer, so to ensure a successful treatment of the tumour, traceless surgical incisions are a consideration for surgeons. Endoscopic or robotic minimally invasive surgery may be the perfect solution to this problem, but currently endoscopic surgery is rarely performed in breast surgery for a variety of reasons, such as lack of natural space in the breast, immature technology, and excessive length of operation.
The objective of this study was to investigate the efficacy of transthoracic lateral single-hole non-liposuction endoscopy in nipple sparing mastectomy (NSM) with immediate prosthesis breast reconstruction (IPBR). Methodology：The clinicopathologic data of 42 patients with EBC who underwent endoscopic NSM and IPBR in the Department of Breast Surgery of our hospital from February 2020 to July 2022 were collected, and the success rate of surgery, operation time, intraoperative conditions, postoperative complications, aesthetic effect of breast reconstruction and short-term oncology safety were analyzed.
Finding: All the 42 patients successfully completed the operation, with a success rate of 100%. 12 patients were completed operation with (210.17±9.87) minutes in the first year after the original procedure began, and 30 patients with (155.36±2.42) minutes after the first year, and there was a difference between the two groups. There were also differences in intraoperative blood loss and postoperative drainage volume between the two groups, but no difference in extubation time. The postoperative complications and the aesthetic effect of breast reconstruction were not different. The 42 patients were average follow-up of 18.8 months. None of the patients had a recurrence or distant metastasis.
Conclusions:Transthoracic lateral single-hole non-liposuction endoscopy technique for IBPR of EBC: (1) high success rate of surgery, fewer postoperative complications, good aesthetic effect and high safety of oncology; (2) Skillful practice can shorten the operation time, improve intraoperative conditions and improve surgical efficiency.
Dr Khan is a Consultant Breast and General surgeon who specialises in breast cancer. She is a Fellow of the American College of Surgeons and College of Physicians and Surgeons of Pakistan. She is a Member of the Royal College of Surgeons, Glasgow, UK. Dr. Rabbia, after completing her basic education in Pakistan, went to Glasgow, France and Hungary for higher studies. Her length of experience in the field of surgery is over 10 years.
Dr Khan has a fellowship in oncoplastic and reconstructive breast surgery from the National Institute of Oncology, Budapest, Hungary. She is skilled in the oncoplastic techniques involved in breast conserving surgery as well as reconstructing the breast. Breast reduction and augmentation for cosmetic purpose is also one of her areas of expertise.
Dr Rabbia takes active participation in research work, and has had multiple publications throughout her career. Her research work has been published in multiple international journals. She is associated with Mohammad bin Rashid University of Medical Sciences and is involved in teaching medical students and interns.
Being a female surgeon, she is also capable of dealing with anal issues of females.
Her main interests are breast cancer surgery with oncoplastic techniques. She can also perform minor anal surgeries.
Dr Rabbia Khan is part of our Breast Unit in the Comprehensive Cancer Centre, which offers complete and advanced treatment and prevention of breast cancer, including general and high risk screening, treatment for not only cancer but also high risk lesions and benign lumps.
She is an active member of multidisciplinary tumour board meetings and has annual participation in international congresses of the American College of Surgeons.
Recent progress in understanding the genetic basis of breast cancer and widely publicized reports of celebrities undergoing risk-reducing mastectomy (RRM) have increased interest in RRM as a method of preventing breast cancer.
A generalized concern has been raised regarding the trend toward an over-aggressive surgical approach to breast cancer because even if RRM is nowadays a routine operation, it still remains a major intervention, with potentially protracted recovery, risk for serious complications, and long-term sequelae. It is therefore very important for physicians to be aware of this tendency, its drivers, and the evidence-based data.
We looked at our data from Mediclinic cancer comprehensive center and determined the rate of risk reducing mastectomy, prophylactic mastectomy (ipsilateral and contralateral) and their relation with genetic mutation or family history.
We excluded the survival benefit and rate of recurrence as we still need to observe these patients for at least 5 years to determine that.
Majority of the decisions were made out of fear for not having the cancer back. Aesthetics reasons were rare. However fewer patients opted due to genetic mutation as well.
- Breast Cancer Therapies
Pennsylvania Cancer and Regenerative Medicine Center, USA
Richard Pestell, AO, MD, PhD, MB, BS, MBA, FRACP, FACP is President Pennsylvania Cancer and Regenerative Medicine Center, Philadelphia, USA. He is a clinician scientist who was appointed Officer of the Order of Australia in the 2019 Queen's Birthday Honors for distinguished service to medicine, in the fields of endocrinology and oncology. He has >700 published works (>89,000 citations, H index 153) and holds patents in cancer diagnostics and treatment. He was previously Executive Vice President Thomas Jefferson University, Philadelphia, USA. He received MD and PhD degrees from Melbourne University, his MBA from NYU and was the Winthrop Fellow at Harvard Medical School and was Clinical Fellow at Massachusetts General Hospital. He identified key genetic target for cancer stem cells governing the onset and progression of cancer, with issued patents that have led to a current clinical trial.
We previously showed that the G-protein coupled receptor CCR5 is expressed on both immune and epithelial cells of ~50% of human Breast Cancers (BCa), thereby inducing cancer “stemness”, cell survival and DNA repair and a pro-metastatic phenotype. CCR5 inhibition by small molecules (Maraviroc) or a humanized monoclonal antibody (Leronlimab) reduced the breast cancer metastatic burden in murine models, with distinct impact on secretomes and promising results in a Phase 1B/2 study. With cancer survivors estimated at 19 million in the USA by 2025, DOX-induced cardio-toxicity is considered part of the “cardio-oncology epidemic”.
Herein, we show that:
- CCR5 inhibitors (CCR5i) enhanced DOX-induced cell death of breast cancer cells.
- CCR5 and its ligand CCl5 were induced by DOX in cardiac myocytes in both the hearts of patients undergoing cardiac transplantation for DOX-induced cardiomyopathy and in a murine model of DOX-cardiac toxicity.
- CCR5i protected human iPSC-derived cardiomyocytes and isolated canine cardiomyocytes from DOX- induced cell death.
- CCR5i substantially reduced (>90%) DOX-induced cardiac dysfunction in mice.
We conclude that CCR5 inhibitors (CCR5i) are “dual function” compounds that provide both cardiac protection and enhanced breast cancer cell killing in the presence of DNA damaging chemotherapy agents. Our studies may have a broad impact by identifying a novel approach to both enhancing therapeutic efficacy and providing cardio-protection from DNA damaging agents that are widely used in cancer treatment.