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Scientific Program

Plenary Talks

Abstract

Biography

Aurelian Udristioiu, M.D,Primary Physician, EuSpLM,City Targu Jiu, Romania National Academy of Biochemical Chemistry (NACB) Member, Washington D.C, USA. Fellow PhD in Molecular Biology, Titu Maiorescu University, General Medicine Faculty, Bucharest, Romania. Man of Medical Year/2015 at the International Bibliographic Center, IBC, Cambridge, UK.

Speaker
Aurelian Udristioiu / Titu Maiorescu University
Romania

Abstract

Biography

Jacques Bernuau has completed his MD in Paris University. He served as an Assistant Professor in clinical hepatology in the Liver Unit, in Hôpital Beaujon, Clichy, France. He also worked as a hepatologist in the gynecology and obstetrics department of the same hospital. He has published several papers on the topic of liver disease in pregnancy in international journals.

Speaker
Jacques Bernuau / Beaujon Hospital
France

Sessions:

Women Health-2019

Abstract

Autophagy is a cellular process that maintains the homeostasis of the normal cell.Autophagy is an evolutionarily conserved intracellular catabolic process that is used by all cells to degrade dysfunctional or unnecessary cytoplasmic components through delivery to the lysosome. Increasing evidence reveals that autophagic dysfunction is associated with human diseases, such as cancer. In cancer, autophagy can be neutral, tumor-suppressive, or tumor-promoting in different contexts. Large-scale genomic analysis of human cancers indicates that the loss or mutation of core autophagy genes is uncommon, whereas oncogenic events that activate autophagy and lysosomal biogenesis have been identified.Thus, the role of autophagy in cancer is determined by nutrient availability, microenvironment stress, and the presence of an immune system.The interdependency of metabolism and cellular mechanisms such as autophagy are becoming more evident and important. The initial signal to form auto-phagosomes is by the class III phosphatidyl-inositol (PI) 3 kinase complex consisting of sequence genes, Beclin1/Atg6, p150hVSp35, and class III PI3K (Vps34). This process is negatively regulated by binding of Bcl-2 family members such as Bcl-xL to Beclin1 preventing Beclin1 binding to the PI3K-III complex and thereby reducing autophagy. Binding of Beclin 1 to Bcl-2 or Bcl-xL is much weaker than that of proapoptotic BH3-only proteins, such as Bid, Bad, Bak, and Bim. Upon nutrient deprivation, which is the most potent autophagy inducer, BH3-only proteins induce autophagy by competitively disrupting the interaction between Beclin 1 and Bcl-2 or Bcl-Xl. At this point, it is unclear whether the autophagy-inhibitory Beclin 1–Bcl-2 or Beclin 1–Bcl-xL interaction plays any role in the tumor promoting function of the anti-apoptotic Bcl-proteins, especially since only endoplasmic reticulum (ER)-targeted Bcl-2 binds Beclin 1 and the interaction between these two proteins is disrupted under conditions of metabolic stress, which is a frequent occurrence in tumors in vivo. Thus, autophagy may function in tumor suppression by mitigating metabolic stress and, in concert with apoptosis, by preventing tumor cell death by necrosis. However, the specific interactions between necrotic tumors, their microenvironment and the immune system, as well as the specific molecular pathways implicated in tumorigenesis under these conditions, have yet to be elucidated. Keywords: autophagy, apoptosis, Beclin1, Bcl-proteins, phosphatidyl-inositol (PI) 3 kinase complex.

Biography

Aurelian Udristioiu currently works at the Clinical Laboratory, Emergency County Hospital Targu Jiu. Aurelian does research in Internal Medicine (General Medicine), Cancer Research and Biochemistry. Their current project is 'The correlation between the cellular energy expressed in ATP and levels of mutant p53 protein in CLL”. Aurelian Udristioiu is the President of the Conference, "3rd International Conference on Women Health and Breast Cancer", during May 30-31, 2019 at Nice, France. Aurelian Udristioiu, M.D, PhD, Emergency County Hospital Targu Jiu, City Targu Jiu, Romania Associate Professor at UTM University, Medicine Faculty, Molecular Biology Department, Member in American Academy of Biochemical Chemistry AABC/AACC

Speaker
Aurelian Udristioiu / Titu Maiorescu University
Romania

Abstract

Genital infections constitute one of the most common reasons why a woman visits a gynecologist and natural therapies are increasingly popular among patients who suffer from those infections. In addition, current resistance to conventional antibiotics led to the search for new antimicrobial agents, namely those of botanical origin. Thus, the influence of phytochemicals in this area is quite marked, being a great proportion of drugs derived or extracted from plants. In the last years, special attention has been devoted to some classes and sub-classes of plant secondary metabolites, namely to tea polyphenols. In this lecture, we will be focused on the most relevant studies about the antimicrobial activity of phytochemicals and botanical extracts upon microorganisms usually involved in women’s genital infections, such as Candida spp., Gardnerella vaginalis, Trichomonas vaginalis and Human papillomavirus. The relationship between the phytochemical composition and the antimicrobial effects will be highlighted.

Biography

Branca M. Silva has completed her Ph.D in Pharmaceutical Sciences (Nutrition and Food Chemistry branch) from the Faculty of Pharmacy – University of Porto (Porto, Portugal) in 2005. Currently, she is an Associate Professor at the Faculty of Health Sciences – University of Beira Interior (Covilhã, Portugal). She is (co)author of about 100 scientific papers and book chapters, has more than 3650 citations and an h-index of 33. Her research interests are oriented to the Medicinal Phytochemistry, Food Chemistry and Nutrition areas. Currently, she is an Academic Editor of the Journal of Chemistry (Hindawi Publishing Corporation). She is also Editorial Board Member and reviewer of several international journals and co-editor of 2 books (Bentham Science Publishers).

Speaker
Branca M. Silva / University of Beira Interior
Portugal

Abstract

Context: On September 18, 2017, the consequences of Hurricane Maria resulted in the displacement of the Ross University School of Medicine (RUSM) from Dominica, to campuses in St. Kitts, West Indies and Knoxville, Tennessee, USA. This resulted in the suspension of the clinical outreach programs such as the Service Learning Project (SLP) where medical students gained insights into the healthcare needs of their local communities. From the Spring 2018 semester until present, due to the loss of the clinical outreach programs, there was a need to create a modified SLP which would make up for the continued absence of these programs at the RUSM campuses. The SLP is now a rigorous 1000 word essay on one public health issue in the local community. Objectives: To ensure that the SLP would robustly stand in the gap for the loss of the clinical outreach programs while fulfilling the basic tenet of identifying the healthcare needs and challenges of local communities. To ensure that medical students develop the practice of gaining knowledge of the healthcare needs and challenges facing the communities which they serve, particularly underserved or underinsured populations. Key Message: It is vital that Service Learning in any form reflect the geographic, social and cultural diversity of a medical school’s locale. Conclusion: SLP’s demonstrate the compassion of medical students while providing informative, educational and inspirational resources to physician colleagues. They may also serve as a therapeutic and educational support system for medically underserved and vulnerable populations.

Biography

Dr. Hedda Dyer is a graduate of the University of Edinburgh Medical School (MB CHB Ed), a Member of Royal College of Surgeons of Edinburgh (MRCS Ed), a Member of the Association of Surgeons of Great Britain and Ireland (ASGBI), a Member of the American Society of Breast Surgeons, a Member of the Dominica Medical Association. She is also registered with the Barbados Medical Board and the General Medical Council of the United Kingdom. She is a member of the Dominica cancer society advisory board. She possesses a Master of Business Administration (MBA) with a concentration in Health Services from the Keller Graduate School of Management.

Speaker
Hedda G. Dyer / Ross University School of Medicine
USA

Abstract

Pregnancy is a state in which complex physical and physiological changes are present, these have important effects on multiple organ systems. Some authors pointed out the possible connection between periodontal disease in pregnant women with the risk of preterm delivery, newborns of a low gestational age with low birth masses and possible cardiovascular disease. Cardiordiovascular disease atherosclerosis is now one of the leading causes of death in developed countries, it begins in childhood, and goes a long time without manifesting symptoms, increasing with age, it begins to seriously threaten health. Insufficient insight into the possible pathological implications of the oral health status of pregnant women with the premature expression of cardiovascular risk factors in children, initiated this research. The aim of the study is to investigate more prominent predictors of early cardiovascular risk factors: increased body mass index, high values of blood pressure and the thickening of the intima-media carotids complex in comparison to children whose mothers had good oral health during pregnancy. Regular dental therapy/care can decrease the frequency of the occurrence of caries and periodontal disease in pregnant women, the frequency of prematurity and low birth weight with all it’s potential complications, decreasing the financial costs of neonatal intensive care management and the cardiovascular repercussions on newborn’s health. Primary prevention of atherosclerosis should begin as early as possible, during pregnancy, in childhood, creating a healthy way of life, which will be able to prevent or at least slow the development of atherosclerosis.

Biography

Senka Mesihović-Dinarević paediatric cardiologist: Faculty of Medicine, University of Sarajevo 1982. 1982-2016. Paediatric Clinic. PhD 1991, 1992-1996: Royal Brompton Hospital London. Professor of Paediatrics 2006.1994. AEPC, 1995. BPCA.1995-2011: Lecturer London MRCP; 2014. Director of Discipline for health protection of women and children. Consultant: RCPCH 1997. 2003-2016. Director of Paediatric Clinic Sarajevo.2000 FESC, 2008. Full Member of Academy of Sciences and Arts of Bosnia and Herzegovina, Honorary Doctorate of Letters in Cambridge: 2014. 2016.Member of the European Academy of Science and Arts; 2017. Full Professor University for Peace-United Nations, over 498 papers, cited 218 times in the ICI Web of Science.

Speaker
Senka Mesihović-Dinarević / Eurofarm Policlinic
Bosnia and Herzegovina

Abstract

Presently pregnant women are monitored frequently to distinguish normal progress in gestation and to identifypotential problems and possible treatments. Observation of progress is particularly important during late gestation to detect the onset of labour by changes in uterine contractility and cervical dilation which are necessary for normal vaginal delivery of the fetus. However, present methods used to measure uterine contractility, cervical dilation and fetal well being are totally inadequate to make precise and quantitative measurements on the advances of labour. Cardiotocography, a noninvasive method, is used to estimate fetal heart rate and uterine activity in most pregnant patients but this method is of limitedvalue in determination of contraction parameters. Intrauterine pressure monitoring is more precise in terms of contractionamplitude, but this is an invasive procedure. Contractions of skeletal, cardiac and most smooth muscle tissues, such as the uterus, depend upon the electrical activity of the muscle. Thus, measurement of electrical activity of muscle using electromyographic methods offers more understanding of the dynamics which control contractions. Our studies, and many observations by others, have demonstrated that electrical events of the uterus control contractility. This lecture will briefly review the fundamental basis for electrical activity of the uterus and explain how this technology can be used effectively in a pregnant patient. The frequency, duration and amplitude of uterine contractions are all proportional to the frequency, duration and propagation of electrical events, usually arranged in bursts of electrical activity. Furthermore, the onset and progression of term and preterm labor can be predicted (positive predictive value = 100% and negative predictive value = 90%) from receiver operator characteristics curves with high accuracy using the characteristics of uterine EMG signals. In addition, artificial neural network processing demonstrates that EMG burst characteristics can identify animals in term and preterm labor. Recently we have completed studies to compare the association of uterine electrical events and cervical effacement and dilation in normal nulliparous pregnant patients and in patients with arrest of labor during the 1st stage of labor. These studies demonstrate that the EMG burst characteristics increase progressively during cervical dilation in patients proceeding normally in pregnancy. However, in patients with arrest of labor the EMG burst parameters are significantly lower but are increased with oxytocin treatment. We conclude from these studies that: 1. Electrical bursts directly dictate contraction patterns of the uterus and thereby indirectly regulate cervical effacement and cervical dilation; 2. Analysis of EMG can be used to monitor uterine contractions and cervical dilation, the two cardinal signs for the onset and progress of labour; 3. The onset of the active phase of labor occurs at the time of full cervical effacement; 4. EMG monitoring is useful for the diagnosis of secondary arrest of labor. In total these and other studies demonstrate the value of electromyography in evaluation of onset and progression of labour and inassessment of problems and treatments related to labour.

Biography

Robert E Garfield obtained his undergraduate training from the University of Wyoming (BSc in Biology and MSc in Physiology) and PhD degree in Pharmacology with Professor Edwin Daniel at the University of Alberta in Canada. Later he did postgraduate studies with Professor Andrew Somlyo at the University of Pennsylvania, Philadelphia, PA. He later returned to Canada for his first faculty appointment at McMaster University, Hamilton, Ontario in the Department of Biomedical Sciences and Obstetrics and Gynecology (Ob/Gyn). During this period, he worked with Professor Arpad Csapo (Washington University, St Louis, Mo), father of the progesterone withdrawal hypothesis and Etienne Baulieu (University of Paris, France), discoverer of antiprogestins. Seventeen years later he accepted an appointment as Director of Reproductive Sciences in the Department of Ob/Gyn at the University of Texas Medical Branch. Galveston, Texas. He then transferred to the Department of Ob/Gyn at St. Joseph’s Hospital in Phoenix, Arizona. During the past four years Dr. Garfield was visiting Professor at the Department of Ob/Gyn at the Women and Children’s Medical Center and Medical University in Guangzhou, China. Presently Dr. Garfield is Professor and Research Scientist in the Department of Ob/Gyn at Banner University Medical Center – Phoenix, Arizona, USA and the University of Arizona Medical College of Medicine – Phoenix. During his career he has been fortunate to work and mentor about 150 young medical and graduate students, post PhD and MD fellows, developing faculty, and midwifes. He continues to collaborate worldwide with outstanding clinical and basic science faculty. Professor Garfield has published over 500 peer reviewed papers, textbooks and about 1000 published abstracts at international meetings, and holds many patents on drugs and medical devices. He is most noted for his discoveries on the structure and function of the uterus and cervix, methods to diagnose true labor at term and preterm and treatment of premature labor.

Speaker
Robert E Garfield / University of Arizona
USA

Abstract

A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, Personalized and Precision Medicine (PPM). To achieve the implementation of PPM concept into the practice, it is necessary to create a fundamentally new strategy based upon the subclinical recognition of biomarkers long before the disease clinically manifests itself. Each decision-maker values the impact of their decision to use PPM on their own budget and well-being, which may not necessarily be optimal for society as a whole. It would be extremely useful to integrate data harvesting fromGENOMIC, PHENOMIC and EXPOSOMIC sources (including the microenvironment)different databanks for applications such as prediction, preventionand personalization of further management to thus provide more tailored measures for patients and/or persons-at-risk (including family members) resulting in improved outcomes, reduced adverse events, and more cost-effective use of healthcare resources. In particular, PPM is becoming crucial for women, kids and the families whist dictating the needs to get personalized health management and wellness programs outlined and developed A lack of medical guidelines has been identified by the majority of responders as the predominant barrier for adoption, indicating a need for the development of best practices and guidelines to support the implementation of PPM into the practice! The latter requires a lot before the current model “physician-patient” could be gradually displaced by a new model “medical advisor-healthy person-at-risk”. This is the reason for developing global scientific, clinical, social, and educational projects in the area of PPM to elicit the content of the new branch.

Biography

Sergey Suchkov was born in the City of Astrakhan, Russia. In 1980, graduated from Astrakhan State Medical University with MD. In 1985, maintained his PhD at the I.M. Sechenov Moscow Medical Academy and Inst of Med Enzymology. In 2001, his Doctor Degree at the Nat Inst of Immunology in Russia. From 1989 through 1995, was a Head of the Lab of Clin Immunology, Helmholtz Eye Research Inst in Moscow. From 1995 through 2004 - a Head of the Dept for Immunology, Moscow Clin Res Inst (MONIKI). In 1993-1996, was a Secretary-in-Chief of the Edit Board, Biomedical Science, an IntJ published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK. At present, Dr Sergey Suchkov, MD, PhD, is: ● Professor in Medicine, Director, Center for Personalized Medicine, Sechenov University and Professor in Immunology, Dept of Clinical Immunology, A.I.Evdokimov Moscow State Medical and Dental University; ● Professor in Medicine, Chair, Dept for Translational Medicine, Moscow Engineering Physical Institute (MEPhI), Russia ● Secretary General, United Cultural Convention (UCC), Cambridge, UK. DrSuchkov is a member of the:● New York Academy of Sciences, USAl; ● American Chemical Society (ACS), USA;● American Heart Association (AHA), USA;● European Association for Medical Education (AMEE), Dundee, UK;● EPMA (European Association for Predictive, Preventive and Personalized Medicine), Brussels, EU;● ARVO (American Association for Research in Vision and Ophthalmology);● ISER (International Society for Eye Research);● Personalized Medicine Coalition (PMC), Washington, DC, USA; DrSuchkov is a member of the Editorial Boards of EPMA J., American J. of Cardiovascular Research and “Personalized Medicine Universe”etc

Speaker
Sergey Suchkov / Sechenov University
Russian Federation

Abstract

Introduction: The presence of electrophysiological abnormalities of the atrial myocardium with increasing age could explain the differences in the genesis of atrial fibrillation in women with paroxysmal atrial fibrillation. Material and Methods: Right atrial endocardial mapping were performed in 54 female patients who had paroxysmal atrial fibrillation, idiopathic or associated to other arrhythmias. Results: A total of 648 right atrial endocardial electrograms were assessed and quantitatively measured. The number of abnormal atrial electrograms showed a significantly positive correlation with age (r=0.37; p<0.0005). Women with paroxysmal atrial fibrillation over 60 years of age had a significantly greater mean number of abnormal electrograms (2.722.01) than those younger than 60 years (1.412.05; p<0.004). The longest duration (r=0.38; p<0.0005) and the maximal number of fragmented deflections (r=0.32; p<0.005) of atrial electrograms among the 12 right atrial sites also showed a significantly positive correlation with age. Conclusions: There is a significantly greater predisposition to atrial fibrillation in aging women because they develop a significantly greater abnormally prolonged and fractionated atrial electrograms with increasing age.

Biography

Professor Osmar Antonio Centurión, is a cardiologist with expertise in Coronary Heart Diseases and Cardiac Arrhythmias, Hemodynamics and Electrophysiology and Arrhythmia Ablation. He is Professor of Medicine at the School of Medical Sciences from the Asuncion National University (UNA) in Asunción, Paraguay. He received is PhD degree in Cardiology, at the Nagasaki University School of Medicine, Nagasaki, Japan in 1994. He is the Founding Member of Sociedad Latinoamericana de Cardiología Intervencionista (SOLACI). Author of more than 200 medical articles published in peer-reviewed American, European and Japanese journals in cardiology. He is a Fellow of the American College of Cardiology, American Heart Association, and member of more than 10 International Cardiovascular Societies. He is currently chief of the Department of Cardiology, Hospital de Clinicas. In addition, he is the Director of the Department of Health Science Investigation at the Metropolitan Hospital. He is currently Member of the Editorial Board of more than 50 international scientific journals. He is Past-Editor-In-Chief of the Revista de la Sociedad Paraguaya de Cardiología, and current Editor-in-Chief of Mathews Journal of Cardiology, and Blood, Heart and Circulation Journal.

Speaker
Osmar Antonio Centurión / Asunción National University
Paraguay

Abstract

The vaginal microbiota of healthy reproductive-age women is generally dominated by Lactobacillus species, which preserve the genitourinary tract from the colonization and overgrowth of several infectious agents, including those responsible for sexually transmitted diseases. The protective effect of lactobacilli is exerted through multiple mechanisms, including the production of various antibacterial compounds (lactic acid, hydrogen peroxide, bacteriocins, and biosurfactants), the competitive exclusion for epithelium adhesion and the modulation of the immune system. Chlamydia trachomatis represents a leading cause of sexually transmitted disease worldwide, and, if left untreated, can induce severe sequelae in women, i.e. pelvic inflammatory disease, infertility and ectopic pregnancy. We investigated the possible interference of Lactobacillus species known to be dominant in the healthy vaginal microbiome, with the infection process of C. trachomatis. We therefore evaluated the ability of some vaginal L. crispatus, L. gasseri and L. vaginalis strains to reduce Chlamydia infectivity in human cervical cells (Hela cells). L. crispatus strains proved to be the most active, and Chlamydia inhibition involved lactic acid production and glucose depletion. Looking at the molecular level, coincubation of lactobacilli with cervical cells caused modification of the physical properties of the HeLa plasma membrane, by altering lipid composition and α5 integrin subunit exposure. The research highlighted the protective effect of lactobacilli against the sexually transmitted pathogen C. trachomatis infection and elucidated possible mechanisms, getting insights into the role of the cervico-vaginal microbiota for the woman’s health.

Biography

Carola Parolin graduated in Biotechnology at University of Milan-Bicocca, Italy, and completed her PhD at Bologna Univesity, Italy, where she currently works as a post-doc researcher. Her main interests concern human ecology, particularly the vaginal microbiome, and probiotics. She is co-author of 31 scientific publications, and serves as a reviewer for many reputed journals. This research was supported by Fondazione del Monte di Bologna e Ravenna, Italy.

Speaker
Carola Parolin / University of Bologna
Italy

Abstract

Introduction: Breast reconstruction after total mastectomy and irradiation is a real challenge for the surgical teams. And is a crucial step for the patient in the life after breast cancer. The effect of radiotherapy on the skin often leads to preferring the reconstructions by flaps. However, reconstructions by prosthesis carries a high risk of complications and unsatisfactory cosmetic results. The optimization of skin trophicity by lipofilling and its positive impact on the results of secondary prosthetic breast reconstruction led us to perform an autologous fat grafting prior to secondary implant breast reconstruction after mastectomy and radiotherapy. Patients and method: All patients were treated at the same center between 2012 and 2015. They all had a total mastectomy and irradiation. They all had one or more sessions of lipofilling prior to breast implant reconstruction. Patients were followed to collect this data: postoperative complications, prosthesis removal, cosmetic result, and tumor recurrences. Results: Fifty-four patients were included. The mean pre-pectoral lipofilling session was 1.1 (1-2). The average volume of fat injected is 150cc (80-250). The average time between the end of treatment and the first session of lipofilling is 20.4 months (3-60). The mean volume of the prosthesis is 400cc (290-620). The mean follow-up time is 22 months. No local tumor recurrence was reported. One patient had a cutaneous necrosis after lipofilling. Implant explantation was performed in three cases (5.5%). The mean cosmetic result is 4.7 (3.5-5). Conclusion: Pre-pectoral lipofilling prior to implant breast reconstruction improves the chances of success by optimizing the trophicity of the skin. It significantly reduces the risk of prosthesis explantation. Therefore, this protocol allows us to propose a minimal invasive breast reconstruction, with no additional scar and no additional pain.

Biography

Dr. Kais Razzouk-Breast Surgery-Breast Reconstruction-Gynecological surgery-Gynecological and mammary cancerology-Nice Santa Maria Breast Institute

Speaker
Kais Razzouk / Nice Breast Institute
France

Abstract

Preeclampsia/eclampsia are more prevalent in low- than in high-income countries and associate with immediate health risks to mothers and offspring. Further, preeclampsia, as well as gestational hypertension alone, associates with increased risk of developing maternal hypertension following pregnancy. Early observations of the low risk of preeclampsia in low-income countries where the diet contained high amounts of calcium stimulated research into calcium’s role in preeclampsia prevention. WHO currently recommends that 1.5-2.0 g of calcium be provided to pregnant women when dietary calcium intake is insufficient with particular focus on women with preeclampsia risk factors. However, the role of calcium in hypertension prevention is controversial and the role of calcium in hypertension prevention in women who had a hypertensive pregnancy is not known. We explored calcium intake in mid-pregnancy for it’s prediction of incident hypertension within 10 years post delivery in a Norwegian Mother and Child (MoBa) cohort of women. The lowest relative to highest calcium intake quartile associated with a 62% greater risk of subsequent hypertension among women who had gestational hypertension with weaker associations observed among women who were normotensive during pregnancy. A low calcium intake predisposes to salt-sensitive hypertension and women who have had gestational hypertension have a greater likelihood of salt-sensitive blood pressure after pregnancy than women who have had normotensive pregnancies. The study results with evidence from the prevailing literature (which will be presented) suggests the need for additional nutritional research of high-risk women for the development of risk reduction strategies.

Biography

Prof. Egeland has expertise in epidemiological methods and analyses of complex data in cross-disciplinary research involving cardio-metabolic diseases, reproduction, and nutritional health. She currently works as Senior Researcher at the Norwegian Institute of Public Health and is Adjunct Professor at the Dept. of Global Public Health and Primary Care, University of Bergen, Norway. She has over 135 publications including book chapters; is currently engaged in registry-based research, and leads several research projects spanning disciplines in life-course epidemiology.

Speaker
Grace M. Egeland / University of Bergen & Norwegian Institute of Public Health
Norway

Abstract

Background Many breast cancer patients suffer from hot flush and medical menopause as side effects of treatment. Some patients undergo acupuncture, rather than hormone therapy, to relieve these symptoms, but the efficacy of acupuncture is uncertain. This meta-analysis evaluated the efficacy of acupuncture on hot flush and menopause symptoms in women with breast cancer. Methods A literature search was performed, following the PRISMA Statement and without language restrictions, of 7 databases from inception through 2017. All selected studies were randomized clinical trials (RCTs) that examined the effect of needle acupuncture on hot flush and menopause symptoms in patients with breast cancer. The methodological quality of these trials was assessed using Cochrane criteria, and meta-analysis software (RevMan 5.2) was used to analyze the data. Results We examined 844 breast cancer patients (average age: 58 years-old) from 13 RCTs. The trials had medium-to-high quality, based on the modified Jadad scale. The meta-analysis showed that acupuncture had no significant effect on the frequency and the severity of hot flush (p = 0.34; p = 0.33), but significantly ameliorated menopause symptoms (p = 0.009). None of the studies reported severe adverse events. Conclusions Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer.

Biography

Dr. Tsai-Ju Chien is a Hemato-Oncologist as well as a TCM doctor. The unique character of her is that she practices both TCM and western medicine in the same time in clinical for years. She devotes herself in bridging the gap between TCM and main stream medicine. What she focused is not only clinical care but also the basic research. She therefore extends her interest and research from clinical trial to basic study; from TCM herb to acupuncture. She has the passion to coordinate oriental and western medicine by applying modern method and therefore to reconcile the holism and reductionism

Speaker
Chien Tsai-Ju / National Yang-Ming University
Taiwan

Abstract

Background: Although opioids are commonly used for postsurgical analgesia after cesarean section, they are associated with adverse events and the potential for chronic opioid use. These concerns drive the need for effective opioid-free analgesic regimens. Liposomal bupivacaine (LB) is a prolonged-release formulation of bupivacaine designed to provide sustained postsurgical analgesia after a single dose. Cases: Three case reports describe multimodal pain management after cesarean section using LB, non-steroidal anti-inflammatory drugs, and acetaminophen. All three women reported excellent pain control; early ambulation, resumption of food intake, and voiding. All three were entirely opioid free throughout their hospital care and post-partum, with rapid return to activities of daily living. Conclusion: Opioid-free cesarean section using LB provided improved analgesia and rapid recovery compared with traditional cesarean section pain management. Further studies of LB in cesarean section are warranted.

Biography

Speaker
Richard Chudacoff / Moore County Hospital
USA

Abstract

Iron metabolism was found implicated in breast cancer (BC). Although dietary iron showed inconsistencies regarding its possible associations with BC risk, its source might be important. We have reported that an animal/plant ratio of dietary iron was directly associated to this risk [http://dx.doi.org/10.16966/jbcra.102]. Based on estimates of heme and non-heme iron contents in representative foods, we carried out the present study, with the aim of more accurately reanalyze dietary iron and its role on BC risk. A case-control study, performed on 572 BC cases and 889 controls, used a specific multi-topic questionnaire including a food frequency questionnaire. Controls were age-frequency matched to cases. Food-derived nutrients were calculated from available databases. Total dietary iron was calculated according its heme or non-heme source, additionally adjusted by energy. Odds Ratios (ORs) were estimated by logistic regression, adjusting for potential confounders. Data were categorized into tertiles, for analyses purpose. Total iron intake was not associated with BC risk. Heme iron was positively associated among postmenopausal women and for the overall sample. Non-heme iron showed an inverse association among premenopausal women and among the overall sample. Regarding heme/non heme ratio, risks tended to increase in all analyzed groups: premenopausal (OR=2.07), postmenopausal (OR=1.99) and both groups together (OR=1.93). Therefore, source and proportions of available iron might be of importance as a link to breast carcinogenesis. Further studies are needed to clarify this point.

Biography

Dr. Alvaro Ronco (Montevideo, 1958) is a Uruguayan M.D. with large expertise in nutritional epidemiology of cancer, focused on breast cancer. He is Associated Professor of Cancer Epidemiology at the CLAEH University in Uruguay and has published 140 papers in international peer-reviewed specialized journals. Author of Nutritional Epidemiology of Breast Cancer (Springer, Dordrecht 2012), the first book published on this area. Distinguished by AACR as one of the 12 Latin American referent researchers in cancer. He is a Non-EU expert member in the database of the European Commission.

Speaker
Alvaro Ronco / Pereira Rossell Women Hospital
Uruguay

Abstract

Hormone receptor positive (HR+) breast cancer (BC) is the most commonly diagnosed molecular subset of BC. Modification of estrogen activity or synthesis represents the treatment of choice for HR+ BC. Resistance to existing endocrine therapies remains a major challenge, with recent advances in identifying molecular mechanisms of resistance including cross-talk between estrogen receptor and various growth factor receptor and/or intracellular signalling pathways. The activation of cyclin-dependent kinases(CDK) 4/6 is finely regulated by the cyclin family members and negative modulators including members of the INK4, CIP, and KIP family. Increased cyclin D1 expression, due to genetic abnormalities or increased transcription of CCND1 (e.g. hyper-activation of the ER signaling network), is frequently seen in human malignancies and can lead to CDK4/6 mediated cell proliferation via activation of a unique signaling network . Functional studies have indicated that Retinoblastoma (pRb) and FoxM1 are direct and natural downstream substrates of CDK4/6 which play a crucial role in the regulation of the G1/S transition through regulation mainly, of the phosphorylation state of the pRb. Hyper phosphorylation of pRb causes release of transcription factors that allow the transition from G1 to S phase and progression through the cell cycle. There are three available oral CDK 4/6 inhibitors (Palbociclib, Ribociclib and Abemaciclib) for the treatment of HR+ advanced BC which have resulted in significant improvements in progression free survival. Furthermore, there are several ongoing clinical trials evaluating predictive markers or response to these agents, their clinical utility in the adjuvant setting, and in other subtypes of BC.

Biography

Dr. Maysa Abu-Khalaf is the director of Breast Medical Oncology for the Division of Solid Tumor, and co-director of the Jefferson Breast Care Center for the Sidney Kimmel Cancer Center at Thomas Jefferson University in Philadelphia, PA. She is a medical oncologist with clinical expertise in the management of breast cancer. Her research focus is evaluating novel agents for the treatment of breast cancer and predictive markers of response to these therapies.

Speaker
Maysa Abu-Khalaf / Thomas Jefferson University
USA

Abstract

Introduction: Aging could influence the atrial response to premature atrial depolarizations increasing the vulnerability of the atrial myocardium to develop atrial fibrillation in elderly women. Material and Methods: Programmed atrial stimulation with single extrastimulus were performed in 102 female patients, 48 of them had normal sinus node function and did not have atrial fibrillation (Group I), and 54 of them had paroxysmal atrial fibrillation, idiopathic or associated to other arrhythmias (Group II). Results: The incidence of induction of repetitive atrial firing (68% vs 36%; p<0.02), fragmented atrial activity (85% vs 47%; p<0.005), and sustained atrial fibrillation (43% vs 5%; p<0.001) was significantly higher in Group II than in Group I. The zone of induction of repetitive atrial firing (34±33 vs 10±19 ms; p<0.005), fragmented atrial activity (49±40 vs 12±15 ms; p<0.001), and interatrial conduction delay (51±32 vs 26±28 ms; p<0.02) was significantly wider in Group II than in Group I. Conclusions: The electrophysiological indicators of augmented atrial vulnerability are significantly altered with increasing age in women with paroxysmal atrial fibrillation. There is a significantly greater predisposition to atrial fibrillation in aging women because they develop a significantly greater augmented atrial vulnerability with increasing age.

Biography

Professor Osmar Antonio Centurión, is a cardiologist with expertise in Coronary Heart Diseases and Cardiac Arrhythmias, Hemodynamics and Electrophysiology and Arrhythmia Ablation. He is Professor of Medicine at the School of Medical Sciences from the Asuncion National University (UNA) in Asunción, Paraguay. He received is PhD degree in Cardiology, at the Nagasaki University School of Medicine, Nagasaki, Japan in 1994. He is the Founding Member of Sociedad Latinoamericana de Cardiología Intervencionista (SOLACI). Author of more than 200 medical articles published in peer-reviewed American, European and Japanese journals in cardiology. He is a Fellow of the American College of Cardiology, American Heart Association, and member of more than 10 International Cardiovascular Societies. He is currently chief of the Department of Cardiology, Hospital de Clinicas. In addition, he is the Director of the Department of Health Science Investigation at the Metropolitan Hospital. He is currently Member of the Editorial Board of more than 50 international scientific journals. He is Past-Editor-In-Chief of the Revista de la Sociedad Paraguaya de Cardiología, and current Editor-in-Chief of Mathews Journal of Cardiology, and Blood, Heart and Circulation Journal.

Speaker
Osmar Antonio Centurión / Asunción National University
Paraguay

Abstract

According to ACS (American Cancer Society) 2017 registry, breast cancer is the most frequently diagnosed cancer in women (30%).Regardless thesuccess story of 97% 5/yr survival rate that comes with diagnosis at an early stage, breast cancer still remains the second leading cause of cancer related death in women. Breast cancer treatment planning, besides disease staging with lymph node status and metastasis is based widely on ER , PR, Her2/neustatus and ki 67 or ΜΙΒ1 markers.But favorable profiling is not always associated with excellent prognosis so various genomic tests of the tumor (OncotypeDx , Mammaprint..) have been developed in order to try to predict more accurately tumor’s biology and customize treatment . (Also breast cancer awareness and screening strategies, have come up with the dilemmas how to deal with high risk and precancerous lesions: not all patients will develop breast cancer but some will.?? In the forthcoming era of tailored strategiesand individualized medicine it is vital in order to write a success story, to study and understand the interactions between the tumor and the hosting environment ie breast and axillary tissue with the draining lymph nodes.The presence of TILs (Tumor- infiltrating lymphocytes) and TLS (tertiary lymphoid structures)in the tumor’s microenvironment (TME) have attracted much attention and seem to play a key role for improved prognosis. Studies of subpopulations of T cells within the TLS indicate that different Tcell subsets play an important role on functionality and immunes’ system efficiency. All the aforementioned are an area of ongoing research in order to understand immune and tissue dynamics around a tumor. Archival paraffin-embedded tissue from breast cancer patients with different characteristics and also fresh tissue collected during breast cancer surgery is being investigated regardingT cell dynamics.

Biography

Speaker
Antigoni Poultsidi / University of Thessaly
Greece

Abstract

The odds of preserving gonadal function after gonadotoxic chemotherapy are significantly better for prepubertal girls than for boys.Although ovarian function has been preserved in most long-term female survivors treated prepubertally for lymphoma, but only in approximately half of the similarly treated adult reproductive-age women, it is clinically logical to generate a temporary and reversible prepubertal milieu before and during the gonadotoxic chemotherapy. Many groups of clinicians have been using gonadotropin-releasing hormone agonist (GnRHa) cotreatment for minimizing the gonadotoxic effects of chemotherapy, by simulating a prepubertal hormonal milieu, with the rationale that preventing premature ovarian insufficiency (POI) is preferable to treating it. However, reported results addressing this strategy have been conflicting, and several major international guidelines still consider it experimental.

Biography

Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Rambam Health Care Campus, Rappaport Institute, Technion‐Israel Institute of Technology, Faculty of Medicine, Bath‐Galim, Haifa, Israel

Speaker
Zeev Blumenfeld / Technion–Israel Institute of Technology
Israel

Abstract

Purpose:The adoption of healthy diet and regular physical activityhas been advanced as non-pharmacological interventions to relieve cancer therapy-related side effects and improve cancer prognosis. A clinical trial carried out at the Cancer Institute of Montpellier (France) has investigated the effect of an Adapted Physical Activity and Diet counseling (APAD) intervention onfatigue, physical, anthropometric and quality-of-life (QoL) outcomes in women undergoing adjuvant therapy for breast cancer. Methods: 143 women diagnosed with breast cancer were randomized to APAD or Control (usual care) group. The APAD group received an intervention including 3 weekly exercise sessions and 9 dietetic consultations in the course of the 26 weeks of chemotherapy and radiotherapy. Patient-reported outcomes (PROs) and objective outcomes (measured by assessors),such as anthropometric, muscular and cognitive variables, have been measured at baseline, 18 and 26 weeks (end of intervention), and at 52- and 78-week of follow-up.Mixed effects models were used to assess the efficacy of the intervention. Results: Beneficial effects of the APAD intervention were observed on allPROs i.e., fatigue, QoL, anxiety, depression and leisure physical activity at 18 and 26 weeks, with persistent significance at 52- and 78-week follow-up for some outcomes. Significant improvements were also observed on body mass index, fat mass, muscular strengthand cognitive flexibility at 26 weeks. Subgroup analyzes revealed that beneficial effects on anthropometric variables, mental fatigue, anxiety/depression, and QoL were predominantly observed in overweight/obese or socially disadvantaged women. It was not necessary to be physically active at baseline to obtain favorable effects from the intervention. Conclusion:The APAD1study relieved breast cancer patients from adjuvant therapy-related side effects at short and long term. Overweight/obese, socially disadvantaged or inactive womenat baseline particularly benefited from the intervention. Funding: Liguecontre le Cancer (PI: G.Romieu); M.Carayol was supported by the Fondation de France (grant#2014-00050542)

Biography

Speaker
Marion Carayol / Université de Toulon
France

Abstract

High-risk pregnancy refers to a pregnancy that negatively affects the health of the mother, the baby, or both, and evoking a range of emotional/psychological experiences. Research on high-risk pregnancy is predominantly found in the medical arena, while women’s emotional/psychological experiences are not sufficiently documented. For this reason, the objectives of this study was to examine the medical conditions and complications in the reviewed articles that make a pregnancy high-risk, while at the same time investigating the emotional/ psychological experiences of women throughout their high-risk pregnancies. The systematic review examined qualitative studies, including the qualitative components of mixed method studies published between January 2006 and June 2017. The databases searched are EbscoHost, JSTOR, Sage Journals Online, ScienceDirect, SpringerLink, Sabinet, Scopus, Emerald eJournals Premier, Pubmed, as well as Taylor and Francis Open Access eJournals. The study evaluated the literature found on these databases for methodological quality by using three stages of review (i.e. abstract reading, title reading, and full-text reading) and applying a meta-synthesis to the current evidence on the research topic. The findings provide empirical evidence based on sound research that medical conditions and complications (i.e. HELLP syndrome, thrombophilia, gestational diabetes, maternal near-miss syndrome, foetal abnormality, preterm birth, hypertension, and uterine rupture) are associated with women’s emotional/psychological experiences (i.e. fear, shock, feeling frightened, sadness, worry, alienation, frustration, grief, guilt, anger, ambivalence, despair, upset, loneliness and isolation, anxiety, depression, and PTSD) throughout their high-risk pregnancies. As a result of this, survivors of severe pregnancy complications have subsequent psychological and emotional challenges.

Biography

Nazeema Isaacs is a Registered Counsellor with the Health Professions Council of South Africa (HPCSA) and an HIV/AIDS tester and counsellor. She has over 3 years’ experience working with children, adolescents and adults who have experienced multiple trauma, sexual violence, gender-based violence, child abuse and so forth. During her Honours degree she did a study on HELLP syndrome and women’s coping mechanisms using an online platform (i.e. Facebook). She did a structured Masters Course in Research Psychology at the University of the Western Cape and after her 12 month internship she will apply to HPCSA to write the board exam to be able to register as a Research Psychologist.

Speaker
Nazeema / University of the Western Cape
South Africa

Sessions:

Women Health-2019

Abstract

Since ancient times, plants have been playing a significant role in women's healthcare and well-being. In fact, numerous phytochemicals have historically been used as starting points in the development of new drugs, and a large proportion of the modern pharmaceuticals and cosmetics have been derived from plants. In addition, an increasing number of herbal products, specifically targeting women's disorders, has appeared in the worldwide marketplace during the last decades. Medicinal plants are the most widespread agents of the traditional medicines and women their most frequent consumers. Often, they are perceived by women as being safer than conventional drugs and some are used by patients to treat a number of gynaecological problems and conditions, such as genital infections, menstrual problems, infertility, discomforts and dysfunctions of pregnancy, and menopause. Plants are also attractive sources of cosmetic ingredients. However, their use for cosmetic purposes has often been neglected in ethnobotanical surveys that focus mainly on plants with medicinal or food uses. In this symposium, we will talk about medicinal and cosmetic plants and the possible impact of using them in the promotion of women´s health and well-being. We will also discuss the evidence supporting plants´ gynaecological and dermatological utilization, the development of innovative formulations and the importance of controlling the quality, efficacy and safety of medicinal and cosmetic plant-based products.

Biography

Branca M. Silva has completed her Ph.D in Pharmaceutical Sciences (Nutrition and Food Chemistry branch) from the Faculty of Pharmacy – University of Porto (Porto, Portugal) in 2005. Currently, she is an Associate Professor at the Faculty of Health Sciences – University of Beira Interior (Covilhã, Portugal).

Speaker
Branca M Silva / University of Beira Interior
Portugal

Abstract

Liver diseases (LD) are present in 4% of pregnancies. Maternal vaccination against hepatitis B, or A, virus is feasible during pregnancy. In acute LD, drug-induced (DI) LD must always be contemplated. Four conditions may cause pregnancy-specific LD. Hyperemesis gravidarum is exceptionally complicated by accidental chlorpromazine-induced cholestasis or by hyperammonemic acute liver failure (ALF) in women affected by OTC deficiency. Intrahepatic cholestasis (IHC) of pregnancy (IHCP) must be treated immediately by ursodeoxycholic acid (UDCA), at least 12 mg/kg/d, and then confirmed by eliminating DI, or previously unrecognized chronic, IHC. The 95% risk of recurrence associated with familial history of IHCP and/or consanguinity may be prevented by early administration of UDCA. In 2 other pregnancy-specific entities, rapid/immediate termination of pregnancy is life-saving. Pre-eclampsia (PE)-associated major liver ischemic lesions (hepatic infarctus, liver subcapsular hematomas, liver capsular rupture) almost never require abdominal surgery. Acute fatty liver of pregnancy must be diagnosed when recent polydypsia and/or nausea/vomiting are associated with hyperuricemic hypertransaminatis and hyperleukocytosis. The most frequent acute LD not specific of pregnancy is acute hepatitis E virus infection, a potential cause of ALF. Herpes simplex virus liver injury must be diagnosed when recent fever is associated with hypertransaminitis. When the later is > 1 000 U/L, immediate IV acyclovir without proven diagnosis is mandatorily required. Auto-immune hepatitis requires immediate corticosteroids administration. Diagnosis of acute Budd-Chiari syndrome requires urgent liver ultrasonography and immediate anticoagulation must be initiated. Pregnancy may superimpose to compensated chronic LD with or without specific treatment. Liver transplantation is feasible during pregnancy.

Biography

Jacques Bernuau has completed his MD in Paris University. He served as an Assistant Professor in clinical hepatology in the Liver Unit, in Hôpital Beaujon, Clichy, France. He also worked as a hepatologist in the gynecology and obstetrics department of the same hospital. He has published several papers on the topic of liver disease in pregnancy in international journals.

Speaker
Jacques Bernuau / Hôpital Beaujon
France

Abstract

Major depressive disorder and bipolar disorder are leading causes of disability worldwide, yet many people remain undiagnosed, are misdiagnosed, and/or ineffectively treated. Depression occurs in 10% of women and 5,6% of men. Diagnosis relies on the clinical assessment of symptoms, and there is currently no molecular diagnostic test available. Depression is almost twice as likely to affect women than men and tends to have different contributing causes in women than it does in men. Contributing factors include reproductive hormones, a differing female response to stress, and social pressures that are unique to a woman’s life experiences Identifying and validating blood biomarkers could provide a more accurate and objective means of diagnosis. Epigenetic events are involved in psychiatric aetiology: among them RNA editing modifications have been associated with inflammation and neuropsychiatric disorders. RNA editing is post-transcriptional process that leads to functional diversity of proteins. These marks form the molecular interface between the genome and the environment. Alcediag’s test, EDITDIAG, identifies in blood specific signatures through the RNA editing modifications of patients with major depressive syndroms A cohort of depressed patients (n=163) was compared to controls (n=100). Specific RNA editing signatures were identified in depressed patients and are different in women and men. Using a panel of 5 biomarkers Alcediag’s tests identify depression in women and men with high specificity and sensibility. The test shows that RNA editing-related blood biomarkers allow to stratify patients, characterize psychiatric conditions, and follow up the disease/treatment modifications along time. This test paves the way for a better management of psychiatric patients.

Biography

Dinah Weissmann is PharmD, PhD. She completed her PhD at University Louis Pasteur, Strasbourg. From 2013 she serves as Alcediag’s Executive VP R&D and CSO, a biotech company dedicated to innovative diagnostics in medical disciplines with high needs of objective tools such as psychiatry... Her research background includes 15 years as Director of Research at the CNRS (French academic research institute) and various key positions in pharma companies such as Sanofi. From 2001 to 2011 she founded Biocortech, a biotechnology company developing new generation therapeutics as treatment for depression, which she served as CEO.

Speaker
Dinah WEISSMANN / ALCEDIAG
France

Abstract

Preventive, predictive, and personalized medicine (PPPM) has created a wealth of new opportunities but added also new complexities and challenges. The European Cancer Prevention Organization already embraced unanimously molecular biology for primary and secondary prevention. The rapidly exploding genomic language and complexity of methods face oncologists with exponentially growing knowledge they need to assess and apply. Tissue specimen quality becomes one major concern. Some new innovative medicines cost beyond any reasonable threshold of financial support from patients, health care providers, and governments and risk sustainability for the health care system. In this review, we evaluate the path for genomic guidance to become the standard for diagnostics in cancer care and formulate potential solutions to simplify its implementation. Basically, introduction of molecular biology to guide therapeutic decisions can be facilitated through supporting the oncologist, the pathologist, the molecular laboratory, and the interventionist. Oncologists need to know the exact indication, utility, and limitations of each genomic service. Minimal requirements on the label must be addressed by the service provider. The interventionist is there to bring the most optimal tissue sample to pathology where the tissue is expanded to a variety of appropriate liquid-based samples. The large body of results then should be translated into meaningful clinical guidance for the individual patient. Surveillance, with the appropriate application of health economic indicators, can make this system long lasting. For governments and health care providers, optimal cancer care must result in a cost-effective, resource-sustainable, and patient-focused outcome.

Biography

Speaker
Jaak Janssens / Catholic University of Leuven
Belgium

Abstract

Vitamin D, also known as the sunshine vitamin. It is important for calcium absorption and bone growth. Vitamin D status is linked to the pathogenesis of skeletal and non-skeletal disorders. Vitamin D deficiency is relatively prevalent all over the world. The aim of this study was to determine the prevalence of and to identify factors associated with vitamin D deficiency and severe vitamin D deficiency among Afghan adolescents diagnosed at French Medical Institute for Mothers and Children, Kabul. An analytical cross-sectional study design was conducted from Jun to Sep 2016. Blood samples were obtained, serum 25OHD levels were measured, A total of 308 adolescents were part of the sample for the final analysis. Of all, 202(65.6%) were females and 106(34.5%) were males. Out of total, a large number of the participants 107(34.7%) had severe vitamin D deficiency, 81(26.3%) had vitamin D deficiency, 50(16.2%) had vitamin D insufficiency, and only 70(22.7%) had vitamin D sufficiency. Gender, sun-exposure, usage of sun protector, calcium+vitamin D supplement intake, Vitamin D rich foods intake, regular milk intake, skin color, and BMI were found as significant factors associated with vitamin D levels. There was a high prevalence of vitamin D deficiency among adolescents who visited a tertiary healthcare facility, Kabul. Low serum vitamin D concentration is prevalent among general Afghan population. Screening and ongoing investigation for vitamin D deficiency should be considered for all adolescents in the country. Based on our results, the regular use of fortified milk and supplements are suggested in this region.

Biography

Dr. Shabnam Azizi has obtained MD degree from Kabul Medical University in 2013. After graduation she joined FMIC PGME programme at Clinical Pathology Department. After successful training in March 2016 she is working as consultant Pathologist at FMIC, Kabul Afghanistan

Speaker
Shabnam Azizi / French Medical Institute for Mothers and Children
Afghanistan

Abstract

Targeted low dose chemotherapy using Insulin as a biologic response modifier, is a therapy known as Insulin Potentiation Targeted LowDose therapy (IPT). It is an original cancer treatment regimen that allows for the use of chemotherapy drugs selected according to accepted oncological practice. These drugs are delivered at much lower doses than what is accepted as the standard dose. IPT practitioners use 1/10th the dose of conventional chemotherapy drugs. Clinical experience and some studies suggest that the use of insulin as a biological response modifier allows this fractionated dose to yield clinically significant tumor responses Historically, IPT's original was developed in the 1920s as an alternative to treating syphilis with nearly lethal doses of mercury and arsenic. IPT was first used for cancer in 1945. The review of numerous patients medical records suggests that using Insulin Potentiation Targeted or LowDose Chemotherapy (IPT ) and nutrition therapy in the treatment of cancer results in levels of tumor response that are equivalent to full dose chemotherapy in many patient populations. Currently there are only a few published clinical trials exploring the effectiveness of IPT and nutrition therapy. The effectiveness of the lower dose chemotherapy is enhanced by using insulin as a biological response modifier. Clinical experience strongly suggests IPT minimizes the debilitating side-effects associated with conventional treatment. Cancer patients treated with IPT report improvement in quality of life as compared to patients receiving full dose chemotherapy. It is well established that Insulin modifies the cell membrane, also Insulin is known to modify the growth characteristics of cancer cells, furthermore, it is well well-known Scientifically that cancer cell membranes express an excess of insulin-sensitive receptors on. These factors make insulin a significant biological modifier facilitating, enhancing and modulating the transport of chemotherapy drugs across cancer cell membrane concentrating chemotherapy preferentially inside cancer cells making more cancer cells vulnerable to anticancer drug effects. This phenomenon enables a clear differentiation between cancer and normal cells facilitating targeted chemotherapy by using insulin as a biological Modifier targeting Cancer cells. Considering the favorable safety profile of insulin and the long history of its use along with the effectiveness of IPT in allowing Integrative Oncologist to use lower dose of chemo is very attractive and Promising. So, insulin as a biological modifier strategically directs the targeted chemotherapy drugs into the cancer cells only. This is an Off-label use of approved drugs. I will present to you the science, the clinical applications and favorable results.

Biography

Dr. Akoury founder and Medical Director of The AWAREmed Health and Wellness Resource Center is Fellowship trained and certified in Integrative Cancer Therapy, Healthy Aging, Regenerative, Metabolic and Functional Medicine, Dr. Akoury is fellowships in pediatric hematology/oncology. She performed research with the CDC. Dr. Akoury is an advanced Integrative Medicine Authority, Healthcare Educator, Author/Researcher, Media Contributor, Global Speaker. Dr. Akoury published several cancer research papers and written several articles on cancer. Dr. Dalal is an authority on cancer, obesity, fitness, and nutrition, Dr. Akoury writes for The Townsend Letters, she is on the Medical Advisory Board of (IOICP), and Best Answer for cancer.

Speaker
Dalal Akoury / AWAREmed
USA

Abstract

Breast cancers have been extensively studied, which renders them quite representative of the nature of neoplastic disease. When describing cancer pathogenesis one has to consider the organism as a whole, the tumor microenvironment, and the tumor cells. It is well known that micro environmental factors secreted by stromal cells can influence tumor growth. The permanent evolution of the organism from the embryonic stage on and up to senescence can create variable vulnerability factors for the growth of breast cancers, influenced by environmental factors. We found that a population of fibroblasts in connective tissue of cancer patients, distant from the tumor,has abnormal growth characteristics suggesting that the whole organism – through the microenvironment - participates in the neoplastic process. This population of fibroblasts is present long before the cancer becomes apparent. Finally during senescence the incidence of breast cancers declines due to tissue, cellular and molecular modifications occurring in the organism during the last developmental stage of the human life span.

Biography

Dr. Alvaro Macieira-Coelho is a Research Director at the French National Institute of Health. He received an MD from the University of Lisbon, Portugal, and a PhD from the University of Uppsala Sweden. He made an internship at the University Hospital in Lisbon and was a research associate at the Wistar Institute in Philadelphia (USA) and at the Department of Cell Biology of the University of Uppsala (Sweden). He became Head of the Department of Cell Pathology at the Cancer Institute in Villejuif (France) and was a visiting Professor at the University of Linkoping (Sweden). He published 150 papers in professional Journals and 9 books on cancer and aging. He received the following awards: Fritz Verzar Prize (University of Vienna, Austria), “Seeds of Science” Career Prize (Lisbon, Portugal), Dr. HonorisCausa (University of Linkoping, Sweden), Johananof International Visiting Professor (Institute Mario Negri, Milano, Italy).

Speaker
Alvaro Macieira-Coelho / French National Institute of Health
France

Abstract

States of vitD deficiency are associated with adverse pregnancy outcomes, including preeclampsia and preterm birth (PTB). We conducted 3 RCTs and found circulating 25(OH)D was linked with outcome. In a 3rd RCT, from 2012-2016, 257 women were randomized to 1 of 2 vitD daily regimens (400 vs 4400 IU VitaFusion gummies) beginning at 8-12 weeks' gestation until delivery. Maternal/fetal health status, circulating 25(OH)D, and calcium and urinary calcium/creatinine (Ca/Cr) ratio were measured monthly. Comorbidities of pregnancy were recorded for each maternal/fetal/neonatal pair: hypertension (HTN), diabetes, preeclampsia, preterm delivery, chorioamnionitis, miscarriage, intrauterine fetal death or bacterial vaginosis (BV). Data were analyzed using R (Vienna, Austria). Baseline characteristics were similar between the treatment groups. By 2nd month, 25(OH)D remained significantly higher in 4400 IU compared to 400 IU group through delivery (p<0.001) withno differences in serum calcium and urinary Ca/Cr ratios. After adjusting for age, BMI, race/ethnicity, and baseline 25(OH)D, 4400IU was not associated with any single pregnancy morbidity; however, higher dose was associated with lower risk of combined pregnancy comorbidities among African Americans (OR=0.26, p=0.034) not demonstrated in Hispanics and Caucasians.When the 3 RCT data were combined, PTL/PTBwas associated with lower 25(OH)D concentration (89.0 nmol/L) vs. 103.8 nmol/L in mothers who delivered at term without a history of PTL (p=0.0002). Results from our 3 RCTs show that the women most impacted by suboptimal vitD status are African American women,who have higher rates of adverse events during pregnancy.

Biography

Carol L. Wagner, MD is Professor of Pediatrics at the Medical University of South Carolina, Charleston, SC, USA, where she works as an academic neonatologist and translational researcher in the area of vitamin D requirements during pregnancy and lactation for more than 18 years. She has published more than 130 papers in reputed journals and has been serving as an editorial board member and reviewer for several journals.

Speaker
Carol L Wagner / Medical University of South Carolina
USA

Abstract

Breast cancer is worldwid e incident among women, whose surgery is frequent and associated with numerous functional changes. Objective: To assess the range of motion and upper limb function postoperatively before and after physiotherapy intervention of women who underwent mastectomy and quadrantectomy. Methods: This is interventional study, descriptive and exploratory, quantitative approach, with 64 women undergoing conservative surgery and mastectomy with follow up at the gynecology outpatient clinic and referred for physical therapy at the Hospital das Clinicas, UNESP. Was performed goniometry of flexion / extension, abduction / adduction and internal rotation / side, measures performed before and three months after the herapy. Results: The chi square test with 0.005 significance level showed that quadrantectomy or mastectomy, not differentiated in relation to the variables; schooling, family income, color, marital status, religion, breast affected, clinical staging, menarche, body mass index and contraceptive methods. There was no association between type of surgery and the median age (type 1: 55 (37-57) x 2 type: 54 (37-82), p = 0.331 by Mann-Whitney). Conclusion: After physiotherapy, the flexion of the homo- and contralateral arm, as well as the homolateral abduction and homolateral extension increased significantly in both surgeries. The contralateral abduction was maintained in both surgeries. The physiotherapeutic intervention provided a significant improvement in the range of movements.

Biography

Speaker
Maria de Lourdes da Silva Marques Ferreira / São Paulo State University
Brazil

Abstract

The decades-old public health policy of universal vitamin D (vitD) supplementation of breastfeeding infants is based on the premise that breast milk, while the best source of nutrition for the infant, provides minimal vitD and necessitates supplementation to prevent rickets. Yet, two methods are equally effective in providing an adequate supply of vitD to the exclusively breastfeeding infant: direct infant supplementation (400 IU vitD/day) or maternal supplementation (6400 IU vitD/day) to raise her vitD status and not supplement the infant. There is evidence that suggests that the health status of both the mother and her recipient breastfeeding infant affects the cellular and immune content of the breast milk, thereby affecting the infant’s immune response to infection. Using 2D-differential gel electrophoresis to quantitatively compare proteomic profiles of the milk fat globule membrane (MFGM) obtained from either vitD-deficient or -sufficient mothers, we found significant fold-changes in relative expression/post-translational modifications for >30 known immune regulator proteins that correlated with maternal vitD status, including perilipin, lactoferrin, and TGF-α. Differential acyl chain lengths of sphingomyelin (known mediator of the immune system), differential in vitro milk macrophage responses to LPS, and mRNA and protein expression of other cytokines also were associated with maternal vitD status. Significant association between infant hepatitis B (HBV) IgG titers, soluble CD14 (sCD14), as well as atopy risk at 4 months with maternal but not infant 25(OH)D were noted, suggesting that the milk itself confers differential immune function in the infants. Maternal vitD status appears to impact milk immune signalling and properties.

Biography

Carol L. Wagner, MD is Professor of Pediatrics at the Medical University of South Carolina, Charleston, SC, USA, where she works as an academic neonatologist and translational researcher in the area of vitamin D requirements during pregnancy and lactation for more than 18 years. She has published more than 130 papers in reputed journals and has been serving as an editorial board member and reviewer for several journals.

Speaker
Carol L Wagner / Medical University of South Carolina
USA

Abstract

Despite the liberal use of episiotomy, instrumental delivery is associated with an increased risk of obstetric anal sphincter injuries (OASIS). Traditionally, lists of the risk factors linked to OASIS have ignored the human factor. The anterior non-episiotomy forceps (ANEF) or natural forceps delivery signifcantly reduces the rate of OASIS, and indeed, perineal trauma, by refning the human factor and improving the operator’s practice. Furthermore, it is associated with improved maternal recovery because it minimizes the need for episiotomy, and therefore, peripartum blood loss. After implementing ANEF in a series of 360 consecutive Neville–Barnes forceps deliveries in primiparae, the rate of OASIS was 1.9%, compared to the reported prevalence of 8.9% in traditional forceps deliveries with routine episiotomy. Enhanced recovery pathways (ERPs) are increasingly being implemented across surgical specialties to reduce the impact of operative procedures and improve patient experience. Part of the authors’ ongoing work to reduce the rate of perineal injury and OASIS, this article describes the ANEF delivery, which should become part of the ERPs in obstetrics.

Biography

Dr Konstantinos Papadakis was also born in Athens, and studied medicine at the National and Kapodistrian University of Athens. He worked in various training posts in London, the East of England, Wessex and the East of Scotland Deanery. Konstantinos is currently in the specialty training programme in obstetrics and gynaecology at the West of Scotland Deanery. He works at the Princess Royal Maternity Hospital in Glasgow. Konstantinos has a special interest in minimally invasive gynaecological surgery. He is also passionate about academic clinical research projects, and simulation training in both advanced endoscopy and innovative acute intrapartum care. Konstantinos has been working on the ANEF project for 2 years.

Speaker
Konstantinos Papadakis / Princess Royal Maternity Hospital
UK

Abstract

The psychological cannon highlights on a new paradigm shift from the traditional models such as the bio-psychosocial model to disease and treatment to the inculcation of spirituality (Bio-psychosocial-S) in holistic treatment plan. Breast cancer is the second leading malignancy in Ghana and appears to be on the ascendency in recent times. Emerging studies have documented increasing diagnosis among premenopausal women which conflicts with previous findings. However, an attempt to handle the disease has been crippled with logistic and structural challenges. Breast cancer patients have adopted various strategies over the years in attempt to cope with the structural challenges inherent in the diagnosis, treatment and post treatment plan. Using qualitative research methodology, twelve participants were conveniently sampled and interviewed. This preliminary study explored views and perceptions of breast cancer patients on breast cancer and how they have coped with the condition. Results were analyzed using Interpretative Phenomenological Analysis (IPA) to explore how participants make meaning of their experiences. Findings showed that socio-cultural factors play an integral role in participants’ interpretations of the disease and this also informed the culture-specific coping ties which were employed respectively. Implications for psychological models, treatment, and research are discussed.

Biography

Dr Yvonne Otubea Otchere is a lecturer/researcher at Lancaster University Ghana, and an alumni of the University of Ghana. Her research has primarily focused on understanding the African sexuality, masculinity and neuropsychological functioning in typical and atypical populations. Dr Otchere’s research concerns are focused on specifically dissecting the layers of the African sexuality. She is known to be one of the avid African scholars documenting on gender roles among homosexual men in Ghana. With funding support from Global Research Challenge Fund, she is currently involved in landscape projects such as the use of technology/apps in mental health among Men who Sleep with other Men (MSM) in Ghana. Her teaching interests include social behaviour, brain and behaviour, understanding organisational psychology, sexuality, understanding psychological assessments, Psychology of religion and spirituality in the African context. As part of her earnest zeal for research work and social responsibility, she serves as the treasurer for the Ghana Psychological Association.

Speaker
Yvonne Otubea Otchere / Lancaster University
Ghana

Abstract

Background: In Pakistan triple negative breast cancer is getting common. Its aggressive behavior accounts for its detection at advanced stage. Neoadjuvant chemotherapy is very helpful before local surgical treatment. Platin based chemotherapy has proven beneficial for treating patients. Cost of drugs and limited resources are very important factors in treating poor patients.Cisplatin and doxorubicin were used as chemotherapeutic agents to see outcome in patients. Methods: Patients were enrolled from Sir Ganga Ram Hospital Lahore, Mayo Hospital Lahore and Services hospital Lahore. All patients had biopsy proven locally advanced invasive triple negative breast cancer. There was no evidence of metastatic disease on (CT chest, CT abdomen and bone scan). Patients were planned for treatment with cisplatin(60 mg/m2) and doxorubicin (50 mg/m2) every three weeks for six cycles. Evaluation was done at regular interval after two cycles for response using response evaluation criteria in solid tumors. Patients showing signs of toxicity or progressive disease were excluded and shifted to other chemotherapy. After completion of chemotherapy, local surgical treatment was givenfollowed by loco regional radiation therapy. End point was to access response rate and disease free survival. Complete response, partial response, stable disease and progressive disease were assessed using response evaluation criteria for solid tumors. Patients with recurrent disease were offered further chemotherapy regimen in follow up. Overall survival was also assessed. Results: A total of 243 patients were enrolled. 10% of the patients progressed during neoadjuvant chemotherapy and were excluded. 230 patients were evaluated for response assessment, disease free interval and overall survival. 28% patients showed complete response, 40% showed partial response and 30% showed stable disease. No acute toxicity was observed during chemotherapy. Conclusion: Cisplatin and doxorubicin are effective as neoadjuvant chemotherapeutic agents in locally advanced disease. More randomized trial can be carried out to clearly define their efficacy. These drugs can prove helpful in better outcome of breast cancer patients.

Biography

Speaker
Azka / Sir Ganga Ram hospital Lahore
Pakistan

Abstract

Breast cancer (BC) is the most common cancer in women, affecting about 10% of all women at some stages of their life. In recent years, the incidence rate keeps increasing and data show that the survival rate is 88% after five years from diagnosis and 80% after 10 years from diagnosis. Early prediction of breast cancer is one of the most crucial works in the follow-up process. Data mining methods can help to reduce the number of false positive and false negative decisions. Consequently, new methods such as knowledge discovery in databases (KDD) has become a popular research tool for medical researchers who try to identify and exploit patterns and relationships among a large number of variables, and predict the outcome of a disease using historical cases stored in datasets. In this paper, using data mining techniques, authors developed models to predict the recurrence of breast cancer by analyzing data collected from ICBC[1] registry. The next sections of this paper review related work, describe the background of this study, evaluate three classification models (C4.5 DT, SVM, and ANN)[2], explain the methodology used to conduct the prediction, present experimental results, and the last part of the paper is the conclusion. To estimate validation of the models, accuracy, sensitivity, and specificity was used as criteria and was compared. Our analysis shows that the accuracy of DT, ANN and SVM are 0.936, 0.947 and 0.957 respectively.

Biography

Leila GhasemAhmad has completed her bachelor degree in Nursing from the Isfahan University of Medical Science, and master degree in Information Technology Management from Science and Research Branch, Islamic Azad University of Tehran-Iran. She has published papers in interdisciplinary research related to breast cancer and data mining. She is Cooperation with “The Breast Cancer Research Center” and also is a member of against Hunger charity (NGO) in Iran.

Speaker
LEILA Ghasemahmad / Islamic Azad University
Iran

Abstract

Background/objective: The purpose of this study is to investigate the use of a more biologic parameter for evaluation of the effect of nuchal cord tightness; the study of blood flow in the umbilical arteries of nuchal cord using Doppler ultrasonography. Methods: This prospective cohort study was conducted at Ain Shams University Maternity Hospital, Cairo, Egypt in the period between August 2015 and August 2017. Hundred primigravidas were recruited with nuchal cord diagnosed by Doppler ultrasonography; whereas the rest of the study population was included in the “Control group”. Doppler velocimetry study was then performed on a free-floating loop of the umbilical cord and Doppler indices were calculated. Both groups were followed up during labor: intrapartum events, mode of delivery, and neonatal outcome were recorded. Results: Intrapartum fetal heart rate abnormalities were significantly more common in the nuchal cord group compared to the control group. The overall cardiotocography category was significantly more commonly reflecting abnormal fetal heart rate patterns in the nuchal cord group compared to the control group with 46.74% of the nuchal group patients falling within the “suspicious – pathological – need urgent intervention” categories. Intervention rate was significantly higher in the nuchal cord group than the control group (33.69 versus 21.84%). Moreover, incidence of intrapartum fetal heart rate abnormalities and intervention rate were significantly higher in the nuchal cord with abnormal Doppler subgroup compared to both nuchal cord with normal Doppler subgroup and the control group; with a calculated number needed to harm of 2.11. Conclusions: In view of these results, it might be concluded that umbilical cord tightness affecting fetal hemodynamics (expressed by changes in umbilical artery Doppler) might be a determinate factor affecting the intrapartum course.

Biography

Lecturer of Obstetrics and Gynecology, Ain Shams University - Consultant of Obstetrics and Gynecology Consultant in IVF IVF - Gynecologic Oncology

Speaker
Ahmed Alanwar / Ain Shams University
Egypt

Abstract

Background: Breast cancer possesses serious health risk for women in Pakistan. It is estimated that one in nine Pakistani women will develop breast cancer at some stage in their lives. Early detection can help save lives. Objectives: To exploreknowledge, attitude and practices regarding breast cancer detection in Pakistaniwomen. Unfortunately no statistical data is available in this regard. Very few researches have been carried out. In Pakistan we do not have a registry at national level. Method: Descriptive exploratory study was carried out. Two hundred Pakistani women, age 30 and above, notsufferingfrom cancer were interviewed from lady Wallingtonhospital, Sir Ganga ram hospital and services hospital Lahore. The interview designed contained questions regarding knowledge, attitudes and practices about symptoms of breast cancer, breastself-examination (BSE) and clinical breast examination (CBE).Data was obtained by face to face interview in local language, translated into English afterwards. Results:20% of participants had knowledge about symptoms of breast cancer.16% of participants did BSE only once.10% of participants practiced BSE monthly.8% had undergone at least once CBE during their lives. The majority (70%) didn’t know much about breast cancer. Age and education showed no statistically significant relationship with breast health practices. Conclusion: Pakistani women have minimal knowledge about breast cancer. They don’t engage themselves in breast cancer detection practices. They need to be better informed about breast cancer and benefits of BSE and early detection.

Biography

Speaker
Azka / Sir Ganga Ram Hospital Lahore
Pakistan

Abstract

The study aimed to identify possible environmental risk factors for breast cancer among women in Gaza Strip and conducted in 2010. A case- control study design was used with face to face interviews by structured questionnaire with breast cancer patient women as well as healthy women. Statistical Package of Social Science (SPSS) was used to analyze the collected data. The study population was 288 women, 144 were women with breast cancer (cases) and 144 were healthy women (controls) with response rate 100% for cases as well as controls. The study was carried out in the two main hospitals in Gaza Strip (El-Shifa and European Gaza) and on cases who had a regular follow up in each hospital, while controls have been chosen from women who had no history of breast cancer by mammogram or by self examination. In this study the main statistically significant risk factors were; marital status, educational status, physical trauma on breast, medication for infertility treatment, eating red meat 500g or more weekly, eating canned food, eating chicken skin, eating raw and cooked vegetables, using oils with saturated fats in cooking, living in or beside a farm, dealing with crops with naked hands, working in a farm during pesticides application or during 24 hours of pesticides application, cleaning pesticides' equipments, living with people working in a farm or a agricultural field, and application of pesticides personally. In contrary, no statistically significant differences were found between cases and controls in relation to area of residency, exposure to X-ray in the past, having radiation therapy, getting contraceptive pills, using hair dyes, using anti-deodorant underarm, using facial cosmetics, using hair removal ointment, washing vegetables and fruits, buying and transporting pesticides, and wearing protective tools during pesticides mixing and application.

Biography

Speaker
Jamal Safi / Al-Azhar University
Egypt

Abstract

Extra-marital affair women, according to a study, have a higher risk for heart disease. Turns out, for women, being extra-marital affair can be injurious to health. According to a study conducted by the New York University, extra-marital affair women have a higher risk for heart disease compared with non-extra-marital affair women across several modifiable risk factors [1-3]. “Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of women and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in extra-marital affair women,” Little is known about the impact of sexual orientation on heart disease risk in women, despite the fact that widow and extra-marital affair women may be at a higher risk based on modifiable factors like tobacco use and poor mental health. In this study, the researchers examined differences in modifiable risk factors for heart disease and heart disease diagnoses in women of different sexual orientations. Risk factors measured included mental distress; health behaviours such as tobacco use, binge drinking, diet, and exercise; and biological risk factors such as obesity, hypertension, diabetes, and cholesterol [4]. Participants who reported having angina, coronary heart disease, heart failure, heart attack, or stroke were considered as having a diagnosis of heart disease. The researchers’ analysed responses from 5000 women data ages 20 to 59 [5,6]. Differences were analysed across four groups based on their sexual identities: gay women, extra-marital affair women, heterosexual women who have sex with women, and heterosexual women. The researchers found no differences in heart disease diagnoses based on sexual orientation, but the risk for heart disease was more complicated. Gay women, heterosexual women, and heterosexual women who have sex with women had similar heart disease risk [7]. Gay women reported lower binge drinking compared with heterosexual women, but otherwise few differences in health behaviours were noted. Extra-marital affair women, however, had higher rates of several risk factors for heart disease relative to heterosexual women: mental distress, obesity, elevated blood pressure, and three different measures of diabetes (medication.

Biography

Dr. Rahul Hajare is bright student of Renowned Immunologist Honorable Respected Dr. Ramesh S Paranjape’’ Retired Director Indian Council of Medical Research New Delhi. He is Fellow Indian Council of Medical Research. He is winner of world academic championship-2017 in pharmacy (antiretroviral therapy). He is among world's 500 most influential experts in pharmacy for the year 2017 on earth. Dr. Hajare is alumni of The Yoga Institute Centenary Celebration Mumbai. He is a member NEWSLETTER MyGov India.

Speaker
Rahul Hajare / Fellow Indian Council of Medical Research
India

Abstract

PURPOSE: To compare the treatment outcomes of breast conserving surgery plus radiotherapy (BCS+RT) vs. mastectomy plus radiotherapy (Mast+RT) vs. mastectomy without radiotherapy (Mast alone) for patients with pT1-2N1 triple negative breast cancer (TNBC). METHODS: 412 patients with pT1-2N1 TNBC were analyzed. Patients underwent BCS+RT (n=48) or Mast +RT (n=103) or Mast alone (n=261) with negative margins. No neoadjuvant chemotherapy was used and axillary dissection was performed for all patients. All patients received adjuvant chemotherapy, mainly with anthrathycline- and/or taxane-based regimens. The Locoregional recurrence (LRR), disease-free survival (DFS) and overall survival (OS) rates were calculated by the Kaplan-Meier method and compared with log-rank test. Multivariate analysis was performed by Cox model. RESULTS: The median follow-up time was 61 months for all patients. For the BCT+RT, Mast +RT and Mast alone groups, the 5-year LRR rates were 2.4% vs. 6.2% vs. 12.8% (p=0.067), the 5-year DFS rates were 90.4% vs. 85.7% vs. 72.7% (p=0.011), the 5-year OS rates were 91.6% vs. 89.4% vs. 85.6% (p=0.042). In multivariate analysis, there were no significant differences in LRR, DFS and OS between BCT+RT group and Mast +RT group; Mast alone was independently associated with higher LRR (p=0.008, HR:2.86 ) and lower DFS and OS (p=0.002,HR:2.08; and p=0.009, HR:2.35) as compared with BCT or Mast +RT. CONCLUSION: In pT1-2N1 TNBC, breast conserving surgery plus RT achieved comparable outcomes with mastectomy plus RT, and mastectomy without RT had poorer outcomes. This indicates that breast conserving therapy is safe and postmastecomy RT is recommended for all patients.

Biography

Shulian Wang has completed his bacherlor degree from Shanghai Medical College, China and doctoral degree from Peking Union Medical College, China. She is a professor and the deputy director of Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Her research focuses on breast cancer. She has published more than 100 papers in reputed journals and has been serving as an editorial board member of repute.

Speaker
Shulian Wang / Chinese Academy of Medical Sciences & Peking Union Medical College
China

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