Sixty-three study participants (43 women and 20 men) were interviewed about their experiences. Interviewers elicited barriers to care, facilitators of care, and questions about the attitudes and behaviors of family and community members were in structured interviews.
The study found that breast problems and their treatment put significant resource and emotional strains on the family. Furthermore, over a third of women in this study reported abuse of some kind, with emotional abuse, neglect, and abandonment being the most frequently reported.
The study reinforced barriers to care identified in the literature for South Asian populations, but only a quarter of participants reported stigma of any kind. Lack of knowledge about breast cancer and inability to pay for care were the most frequently reported barriers, followed by access to care and fear of treatment. Facilitators of care among women who received a biopsy point to the importance of support by the husband and husband’s family, as well as the ability to identify economic support for and knowledge about care.
This study contributes to the understanding of two overarching themes: structural violence and the value of women, as well as how these themes influence poor outcomes for women with breast cancer in rural Bangladesh. Suggestions for future studies and short and long-term interventions to address study findings are offered.
40,000 fatalities annually. The severe impact of breast cancer can be attributed to a poor
understanding of the mechanisms underlying cancer metastasis. A primary aspect of cancer
metastasis includes the invasion and intravasation that results in cancer cells disseminating from
the primary tumor and colonizing distant organs. However, the integrated study of invasion and
intravasation has proven to be challenging due to the difficulties in establishing a combined tumor
and vascular microenvironments. Compared to traditional in vitro assays, microfluidic models
enable spatial organization of 3D cell-laden and/or acellular matrices to better mimic human
physiology. Thus, microfluidics can be leveraged to model complex steps of metastasis. The
fundamental aim of this thesis was to develop a three-dimensional microfluidic model to study the
mechanism through which breast cancer cells invade the surrounding stroma and intravasate into
outerlying blood vessels, with a primary focus on evaluating cancer cell motility and vascular
function in response to biochemical cues.
A novel concentric three-layer microfluidic device was developed, which allowed for
simultaneous observation of tumor formation, vascular network maturation, and cancer cell
invasion/intravasation. Initially, MDA-MB-231 disseminated from the primary tumor and invaded
the acellular collagen present in the adjacent second layer. The presence of an endothelial network
in the third layer of the device drastically increased cancer cell invasion. Furthermore, by day 6 of
culture, cancer cells could be visually observed intravasating into the vascular network.
Additionally, the effect of tumor cells on the formation of the surrounding microvascular network
within the vascular layer was evaluated. Results indicated that the presence of the tumor
significantly reduced vessel diameter and increased permeability, which correlates with prior in vivo
data. The novel three-layer platform mimicked the in vivo spatial organization of the tumor and its
surrounding vasculature, which enabled investigations of cell-cell interactions during cancer
invasion and intravasation. This approach will provide insight into the cascade of events leading up
to intravasation, which could provide a basis for developing more effective therapeutics.
Adaptive therapy utilizes competitive interactions between resistant and sensitive cells by keeping some sensitive cells to control tumor burden with the aim of increasing overall survival and time to progression. The use of adaptive therapy to treat breast cancer, ovarian cancer, and pancreatic cancer in preclinical models has shown significant results in controlling tumor growth. The purpose of this thesis is to draft a protocol to study adaptive therapy in a preclinical model of breast cancer on MCF7, estrogen receptor-positive, cells that have evolved resistance to fulvestrant and palbociclib (MCF7 R). In this study, we used two protocols: drug dose adjustment and intermittent therapy. The MCF7 R cell lines were injected into the mammary fat pads of 11-month-old NOD/SCID gamma (NSG) mice (18 mice) which were then treated with gemcitabine.<br/>The results of this experiment did not provide complete information because of the short-term treatments. In addition, we saw an increase in the tumor size of a few of the treated mice, which could be due to the metabolism of the drug at that age, or because of the difference in injection times. Therefore, these adaptive therapy protocols on hormone-refractory breast cancer cell lines will be repeated on young, 6-week old mice by injecting the cell lines at the same time for all mice, which helps the results to be more consistent and accurate.
Breast cancer is one of the most common types of cancer worldwide. Early detection and diagnosis are crucial for improving the chances of successful treatment and survival. In this thesis, many different machine learning algorithms were evaluated and compared to predict breast cancer malignancy from diagnostic features extracted from digitized images of breast tissue samples, called fine-needle aspirates. Breast cancer diagnosis typically involves a combination of mammography, ultrasound, and biopsy. However, machine learning algorithms can assist in the detection and diagnosis of breast cancer by analyzing large amounts of data and identifying patterns that may not be discernible to the human eye. By using these algorithms, healthcare professionals can potentially detect breast cancer at an earlier stage, leading to more effective treatment and better patient outcomes. The results showed that the gradient boosting classifier performed the best, achieving an accuracy of 96% on the test set. This indicates that this algorithm can be a useful tool for healthcare professionals in the early detection and diagnosis of breast cancer, potentially leading to improved patient outcomes.