Language：English   Publisher：Cancer Science  

Approximately 5%–10% of breast cancers are hereditary, caused by germline pathogenic variants (GPVs) in breast cancer predisposition genes. To date, most studies of the prevalence of GPVs and risk of breast cancer for each gene based on cases and noncancer controls have been conducted in Europe and the United States, and little information from Japanese populations is available. Furthermore, no studies considered confounding by established environmental factors and single-nucleotide polymorphisms (SNPs) identified in genome-wide association studies (GWAS) together in GPV evaluation. To evaluate the association between GPVs in nine established breast cancer predisposition genes including BRCA1/2 and breast cancer risk in Japanese women comprehensively, we conducted a case-control study within the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (629 cases and 1153 controls). The associations between GPVs and the risk of breast cancer were assessed by odds ratios (OR) and 95% confidence intervals (CI) using logistic regression models adjusted for potential confounders. A total of 25 GPVs were detected among all cases (4.0%: 95% CI: 2.6–5.9), whereas four individuals carried GPVs in all controls (0.4%). The OR for breast cancer by all GPVs and by GPVs in BRCA1/2 was 12.2 (4.4–34.0, p = 1.74E-06) and 16.0 (4.2–60.9, p = 5.03E-0.5), respectively. A potential confounding with GPVs was observed for the GWAS-identified SNPs, whereas not for established environmental risk factors. In conclusion, GPVs increase the risk of breast cancer in Japanese women regardless of environmental factors and GWAS-identified SNPs. Future studies investigating interactions with environment and SNPs are warranted.

DOI： 10.1111/cas.15312

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Language：Japanese   Publisher：Japan Association of Breast Cancer Screening  

BACKGROUND: Breast awareness is an efficient and effective behavioral pattern against breast cancer, however, its popularity is not yet sufficient. Thus, an effort to raise breast awareness is required. We have established a system for providing breast cancer information through videos on YouTube, and have posted videos on breast awareness. In this study, we compared our videos for breast awareness information in order to clarify the effective way of providing breast awareness information to public.
METHODS: Multiple breast clinicians collaborated to create the videos. We ensured scientific validity by using a peer-review system by independent group of breast clinicians. Patients and public are involved in confirming to ensure explicitness and expression appropriateness. The videos were posted on the YouTube channel “Breast Cancer Encyclopedia”. Among 6 videos for breast awareness information, we compared the number of views and retention rates of these videos from July 2020 to June 2021.
RESULTS: The most frequently viewed video was “A Short Summary of Breast Cancer Symptoms” with 29,000 views and a higher retention rate than the other videos at 47.2%. The video explaining breast awareness itself had 5,000 views and a retention rate of 37.2%.
CONCLUSIONS: The more concise video about the symptoms was viewed more than the video explaining breast awareness. As breast awareness refers to “the process of raising awareness of one's own breasts,” it is essential to establish a concise and accessible platform for viewers to “Think of it as a personal matter” and “Being familiar with the normal consistency of your breasts” so that they understand what's normal and promptly report changes. In addition, it is necessary to continue to improve the contents and methods of providing information in accordance with the times

DOI： 10.3804/jjabcs.31.31

CiNii Research

Language：Japanese   Publisher：Japanese Journal of Clinical Oncology  

Background: Physicians recommend adjuvant therapy to patients based on baseline risk. A common recognition for baseline risk between patients and physicians is critical for successful adjuvant therapy. We prospectively investigated the differences in estimated baseline risk between physicians and patients with early breast cancer. Methods: This analysis was performed at a single institution in Japan. Early breast cancer patients over 18 years old were enrolled after surgery. After explaining the pathological results, physicians asked each patient about an estimated baseline risk. Differences in estimated baseline risk were defined as the baseline risk estimated by patients minus the baseline risk estimated by physicians. The primary endpoint was that the number of patients who estimate baseline risk higher than physicians was higher than those who estimate a lower baseline risk. The secondary endpoints were differences in estimated baseline risk by stage, subtype and the influence of patient factors to differences in estimated baseline risk. Results: From July 2017 to December 2018, 262 patients were enrolled. Among the 262 patients, 190 estimated a higher baseline risk than physicians, 53 estimated a lower baseline risk and 19 estimated the same. Overall, patients estimated a significantly higher baseline risk than physicians (P < 0.001). Differences in estimated baseline risk was significantly smaller in patients who knew the term 'baseline risk' than patients who did not (P = 0.0037). Differences in estimated baseline risk were also significantly smaller in patients with stage II breast cancer than patients with stage I (P = 0.0239). However, there were no statistically significant differences of differences in estimated baseline risk according to other factors. Conclusions: Patients with early breast cancer estimated a significantly higher baseline risk than physicians. Physicians should accurately explain baseline risk to patients for shared decision making.

DOI： 10.1093/jjco/hyab152

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Language：English  

DOI： 10.1097/SLA.0000000000005185

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Language：English  

DOI： 10.1002/ijc.33478

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Language：English   Publisher：Japan Epidemiological Association  

<p><b>Background:</b> Obesity is a reported risk factor for various health problems. Genome-wide association studies (GWASs) have identified numerous independent loci associated with body mass index (BMI). However, most of these have been focused on Europeans, and little evidence is available on the genetic effects across the life course of other ethnicities.</p><p><b>Methods:</b> We conducted a cross-sectional study to examine the associations of 282 GWAS-identified single nucleotide polymorphisms with three BMI-related traits, current BMI, BMI at 20 years old (BMI at 20), and change in BMI (BMI change), among 11,586 Japanese individuals enrolled in the Japan Multi-Institutional Collaborative Cohort study. Associations were examined using multivariable linear regression models.</p><p><b>Results:</b> We found a significant association (<i>P</i> < 0.05/282 = 1.77 × 10⁻⁴) between BMI and 11 polymorphisms in or near <i>FTO</i>, <i>BDNF</i>, <i>TMEM18</i>, <i>HS6ST3</i>, and <i>BORCS7</i>. The trend was similar between current BMI and BMI change, but differed from that of the BMI at 20. Among the significant variants, those on <i>FTO</i> were associated with all BMI traits, whereas those on <i>TMEM18</i> and <i>HS6SR3</i> were only associated with BMI at 20. The association of <i>FTO</i> loci with BMI remained, even after additional adjustment for dietary energy intake.</p><p><b>Conclusions:</b> Previously reported BMI-associated loci discovered in Europeans were also identified in the Japanese population. Additionally, our results suggest that the effects of each loci on BMI may vary across the life course and that this variation may be caused by the differential effects of individual genes on BMI via different pathways.</p>

DOI： 10.2188/jea.je20190296

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CiNii Research

Language：English  

DOI： 10.1007/s12282-020-01065-4

PubMed

Language：English   Publisher：Cancer Research  

A genetic variant on aldehyde dehydrogenase 2 (ALDH2 rs671, Glu504Lys) contributes to carcinogenesis after alcohol consumption. Somewhat conversely, the ALDH2 Lys allele also confers a protective effect against alcohol-induced carcinogenesis by decreasing alcohol consumption due to acetaldehyde-related adverse effects. Here, we applied a mediation analysis to five case–control studies for head and neck, esophageal, stomach, small intestine, and colorectal cancers, with 4,099 cases and 6,065 controls, and explored the potentially heterogeneous impact of alcohol drinking on digestive tract carcinogenesis by decomposing the total effect of the ALDH2 Lys allele on digestive tract cancer risk into the two opposing effects of the carcinogenic effect (direct effect) and the protective effect (indirect effect mediated by drinking behavior). Alcohol was associated with an increased risk of most digestive tract cancers, but significant direct effects were observed only for upper gastrointestinal tract cancer risk, and varied substantially by site, with ORs (95% confidence interval) of 1.83 (1.43–2.36) for head and neck cancer, 21.15 (9.11–49.12) for esophageal cancer, and 1.65 (1.38–1.96) for stomach cancer. In contrast, a significant protective indirect effect was observed on risk for all cancers, except small intestine cancer. These findings suggest that alcohol is a major risk factor for digestive tract cancers, but its impact as a surrogate for acetaldehyde exposure appears heterogeneous by site. Meanwhile, the behavior-related effect of the ALDH2 Lys allele results in a decreased risk of most digestive tract cancers.

DOI： 10.1158/0008-5472.CAN-19-2685

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Language：English  

DOI： 10.1007/s10549-020-05580-y

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Language：Japanese   Publisher：Breast Cancer Research and Treatment  

Purpose: Lymphedema (LE) decreases the quality of life of breast cancer patients. Objective quantification of PRO may improve the discordance between patient-reported outcomes (PROs) and objective assessments of LE by establishing a standard follow-up for LE. This study determined the prevalence of subjective and objective LE and evaluated the correlation between objective assessment and PRO of LE in primary breast cancer patients undergoing breast and axilla surgery. Methods: Breast cancer patients who underwent sentinel lymph node biopsy (SN) or axillary lymph node dissection (ALND) more than 1 year after surgery were enrolled. We prospectively evaluated LE using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) and two objective assessments (arm circumference and bioimpedance) and analyzed their correlations. Results: Between November 2018 and January 2019, 631 patients (SN; n = 415, ALND; n = 216) were enrolled. The median age, body mass index, and duration from surgery was 56 years, 21.9 kg/m2, and 3.8 years, respectively. The prevalences of subjective and objective LE were 4.1% and 1.4% in the SN group and 51.8% and 24.1% in the ALND group, respectively. The objective assessments were weakly positively correlated with PRO-CTCAE. Arm circumference measurement correlated better than bioimpedance overall and was most strongly correlated with “frequency” (r = 0.485, p < 0.01). Conclusions: LE occurred in few SN patients. The prevalence of subjective LE was higher than that of objective LE. Arm circumference measurements better reflected PRO than did bioimpedance. These results underscore the limitation of LE detection by subjective or objective methods alone.

DOI： 10.1007/s10549-019-05443-1

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DOI： 10.1038/s41598-019-54839-y

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DOI： 10.1111/tbj.13473

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DOI： 10.1007/s00595-019-01775-z

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Language：English  

DOI： 10.1186/s40792-019-0635-4

PubMed

Language：Japanese   Publisher：Breast Journal  

Skin-sparing mastectomy (SSM) with immediate reconstruction is standard surgical treatment for early breast cancer with widespread ductal carcinoma in situ (DCIS). The local recurrence rate after SSM is up to 7.0%. We investigated prediction of the pathological margin using contrast-enhanced MRI, and evaluated the cut-off point to obtain the safety margin. We performed SSM with immediate reconstruction in 216 early breast cancer patients with widespread DCIS and/or invasive cancer from January 2014 to December 2015. Forty cases were retrospectively reviewed after excluding those with >15 mm between skin and tumor, determined by preoperative contrast-enhanced MRI, or involving reconstructive surgery for local recurrence, immeasurable lesion by preoperative contrast-enhanced MRI, or neoadjuvant chemotherapy. We defined a positive pathological margin as <1 mm from the cancer nest. We reviewed the distance between skin and tumor by MRI and pathological examination. To identify the cut-off for predicting a positive pathological margin, we performed sensitivity analysis using an ROC curve. The margin-positive rate by pathological examination was 27.5% (n = 11/40), with a moderate correlation of MRI margin and pathological margin (r = 0.44). The best cut-off point for margin positivity was 5 mm of MRI margin, with sensitivity and specificity of 54% and 86%, respectively (P = 0.009). This is the first prediction of pathological margin by preoperative contrast-enhanced MRI in early breast cancer patients with SSM. Care is required for SSM if the MRI margin is less than 5 mm due to pathological margin positivity.

DOI： 10.1111/tbj.13194

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DOI： 10.1007/s10549-018-4898-4

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Authorship：Lead author  

DOI： 10.1007/s12282-018-0856-6

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DOI： 10.1007/s12282-018-0852-x

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DOI： 10.1007/s12282-018-0850-z

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DOI： 10.1093/jjco/hyy088

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Language：English  

DOI： 10.1007/s12282-016-0742-z

PubMed