Vascular Invasion as an Independent Prognostic Factor in Lymph Node Negative Invasive Breast Cancer

Rezaianzadeh, Abbas,Talei, Abdolrasoul,Rajaeefard, Abdereza,Hasanzadeh, Jafar,Tabatabai, Hamidreza,Tahmasebi, Sedigheh,Mousavizadeh, Ali Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.11

Introduction: Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients. Methods: in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant. Results: Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion. Discussion: The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer.

Pathological Profile of Patients with Breast Diseases in Shiraz

Rezaianzadeh, Abbas,Sepandi, Mojtaba,Akrami, Majid,Tabatabaee, Hamidreza,Rajaeefard, Abdolreza,Tahmasebi, Sedigheh,Talei, Abdolrasoul Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.19

Background: Around 200,000 breast disorders are annually diagnosed all over the world. Fibrocystic changes are the most common breast disorder and fibroadenoma is the most prevalent benign breast tumor. The present study aimed to determine the spectrum, type and prevalence of breast masses in women referred to Shiraz University of Medical Sciences between 2004 and 2012. Materials and Methods: A cross-sectional study was conducted on the diagnostic reports data. Results: A total of 640 samples were studied. Most 57.3% of masses were detected in the left breast, 65%, 28.2% and 6.1% of cases presenting with benign, malignant, and inflammatory lesions, respectively. Among all the samples the most prevalent diagnosis (37.7%) was fibroadenoma and fibrocystic lesions (17%). 174 samples (96% of the malignant cases) were invasive. 6.5% of the benign, and 37% of the malignant cases occurred in post menopause women and the differences were statistically significant. Among those with malignant tumors lymph nodes were involved in 25.6% of menopausal women and 44.2% of non-menopausal ones, and the difference was statistically significant. Conclusions: Regular clinical breast examination beside mammographic follow-ups, especially during menopause, should be carried out as a priority and a national organized program should be designed for screening breast disorders.

Assessment of Breast Cancer Risk in an Iranian Female Population Using Bayesian Networks with Varying Node Number

Rezaianzadeh, Abbas,Sepandi, Mojtaba,Rahimikazerooni, Salar Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.11

Objective: As a source of information, medical data can feature hidden relationships. However, the high volume of datasets and complexity of decision-making in medicine introduce difficulties for analysis and interpretation and processing steps may be needed before the data can be used by clinicians in their work. This study focused on the use of Bayesian models with different numbers of nodes to aid clinicians in breast cancer risk estimation. Methods: Bayesian networks (BNs) with a retrospectively collected dataset including mammographic details, risk factor exposure, and clinical findings was assessed for prediction of the probability of breast cancer in individual patients. Area under the receiver-operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive values were used to evaluate discriminative performance. Result: A network incorporating selected features performed better (AUC = 0.94) than that incorporating all the features (AUC = 0.93). The results revealed no significant difference among 3 models regarding performance indices at the 5% significance level. Conclusion: BNs could effectively discriminate malignant from benign abnormalities and accurately predict the risk of breast cancer in individuals. Moreover, the overall performance of the 9-node BN was better, and due to the lower number of nodes it might be more readily be applied in clinical settings.

Colorectal Cancer Mortality in Shiraz, Iran

Dianatinasab, Mostafa,Ghaem, Haleh,Rezaianzadeh, Abbas,Hosseini, Seysd Vahid,Khazraei, Hajar Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.8

Background: Mortality among Iranian patients with colorectal cancer has not been fully examined and the factors associated with their survival are still controversial. This study aimed to determine the mortality rate and its related factors among the patients with colorectal cancer in southwestern regions in Iran. Materials and Methods: This prospective cohort study was conducted on 220 patients with colorectal cancer referred to Fahighi Hospital, Shiraz, Iran from 2009 to 2014. Data were collected from the patients' medical records and were analyzed using Cox regression analysis. Results: Over a median follow-up of 29.3 months, 56 out of the 220 patients (25.5%) died, 32 (14.5%) aged below 40 years, and 45.5% were female. Based on the results of multiple Cox regression analysis, family history of gastrointestinal cancer, stage III, former smoking, type of lesion (fungative and polypoid), and opium use were associated with a greater risk of colorectal cancer mortality (all P<0.05). Conclusions: This cohort study found that the mortality rate of colorectal cancer in Iran is lower than that in European countries. In addition, behavioral and clinical factors were significantly associated with the survival rate. Addressing the related factors would help healthcare providers and physicians provide the best care and improve the survival rate.

Modeling of Breast Cancer Prognostic Factors Using a Parametric Log-Logistic Model in Fars Province, Southern Iran

Zare, Najaf,Doostfatemeh, Marzieh,Rezaianzadeh, Abass Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4

In general, breast cancer is the most common malignancy among women in developed as well as some developing countries, often being the second leading cause of cancer mortality after lung cancer. Using a parametric log-logistic model to consider the effects of prognostic factors, the present study focused on the 5-year survival of women with the diagnosis of breast cancer in Southern Iran. A total of 1,148 women who were diagnosed with primary invasive breast cancer from January 2001 to January 2005 were included and divided into three prognosis groups: poor, medium, and good. The survival times as well as the hazard rates of the three different groups were compared. The log-logistic model was employed as the best parametric model which could explain survival times. The hazard rates of the poor and the medium prognosis groups were respectively 13 and 3 times greater than in the good prognosis group. Also, the difference between the overall survival rates of the poor and the medium prognosis groups was highly significant in comparison to the good prognosis group. Use of the parametric log-logistic model - also a proportional odds model - allowed assessment of the natural process of the disease based on hazard and identification of trends.

Comparing Recurrence and Complications After Laparoscopy and Laparotomy Surgery among Patients Suffering from Colorectal Cancer, Shiraz, Iran

Ghaem, Haleh,Amiri, Zahra,Kianpour, Fatemeh,Rezaianzadeh, Abbas,Hosseini, Seyed Vahid,Khazraei, Hajar Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7

Background: The goal of this study was to compare the rate of recurrence and occurrence of complications in colorectal cancer patients after two kinds of laparoscopy and laparotomy. Materials and Methods: A follow-up study was carried out among 358 patients who suffered from colorectal cancer from 2012-2014. The data were gathered from colorectal research center in Shiraz, Shahid Faghihi hospital, and analyzed using the chi-square test, logistic regression, and multinomial regression. Results: The average age of these patients was $56.3{\pm}14.6$, 55.0% being men. Moreover, 57.8% of them underwent laparoscopy surgery and 42.2% of the patients underwent laparotomysurgery and the conversion rate was 58.0% which ultimately was put under the category of laparotomy surgery. After biennial median follow-up, differences in the occurrence of complications such as bleeding (hemorrhage), fever, intestine blockage and wound infection in these two kinds of surgery werestatistically significant (P<0.05). However, the rate of recurrence and the patients' ultimate status (alive without disease, alive with disease, and death) did not significantly differ between these two surgery groups. Conclusions: Post-operation complications were laparoscopy surgery were less than those in laparotomy. However, the outcomes such as patients' ultimate status and recurrence were similar between the two groups.

The relationship between maternal mental health and communication skills in children in Shiraz, Iran

Najmeh Maharlouei,Hossein Alibeigi,Abbas Rezaianzadeh,Pedram Keshavarz,Hadi Raeisi Shahraki,Hamid Nemati,Kamran B,Lankarani 한국역학회 2019 Epidemiology and Health Vol.41 No.-

OBJECTIVES: Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children. METHODS: This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children. RESULTS: The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01). CONCLUSIONS: The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-year-old children.

Breast Cancer Risk Factors in Women Participating in a Breast Screening Program: a Study on 11,850 Iranian Females

Sepandi, Mojtaba,Akrami, Majid,Tabatabaee, Hamidreza,Rajaeefard, Abdolreza,Tahmasebi, Sedigheh,Angali, Kambiz Ahmadi,Rezaianzadeh, Abbas,Talei, Abdolrasoul Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.19

The incidence rate of breast cancer in developed countries is almost three-fold higher than in developing countries. Iran has had one of the lowest incidence rates for breast cancer in the world, but during the recent decades a marked increase has been seen. The purpose of this study was to investigate some established risk factors of breast cancer in Iranian women. A study of 11,850 women participating in abreast screening program was conducted. The 197 women diagnosed with breast cancer and 11,653 healthy women were compared. Logistic regression was performed to investigate associations of reproductive and anthropometric factors with breast cancer risk. Family history of breast cancer (OR=1.94, 95%CI=1.35-2.78), occupation (OR= 1.65,95%CI=1.20-2.25), education level (OR=0.50,95%CI=0.28-0.91), parity (OR=0.27, 95%CI=0.12-0.59), menopausal status (OR=3.15, 95%CI=2.35-4.21), age at menarche (OR=0.33, 95%CI=0.15-0.70), and age at the first pregnancy (OR=4.10, 95%CI=1.13-14.77) were related to the risk of breast cancer. Decrease in parity may to some extent explain the rising trend of incidence of breast cancer incidence in Iranian women.