Conferences and Symposia

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    Serum ferritin in newly diagnosed breast cancer and apparently healthy individuals
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Akalanka, H.M.K.; Ekanayake, S.; Samarasinghe, K.
    BACKGROUND: Iron is an essential element for the cell proliferation and is primarily stored in human body in the form of ferritin. Iron metabolism is influenced by oestrogen and interactions between iron and oestrogen is thought to synergistically promote breast cancer (BC). OBJECTIVES: To assess serum ferittin concentrations of BC patients and healthy females. METHODS: Newly diagnosed BC patients (n=150) and apparently healthy females (n=75) who consented to be on the study were enrolled. Serum ferritin concentration was assessed using enzyme immunoassay method using mini vidas immune analyser. RESULTS: Median serum ferritin concentrations (IQR) of pre (n=58) and postmenopausal (n=92) BC patients were 32.32 (37.84) ng/ml and 64.33 (27.18) ng/ml respectively. Postmenopausal BC patients had significantly high (p<0.05) serum ferritin concentrations compared to premenopausal BC patients. Apparently healthy pre (n=35) and postmenopausal (n=40) women had median values of 26.06(28.09) ng/ml and 45.00(51.24) ng/ml respectively the difference of which was statistically significant (p<0.05). A significant difference in serum ferritin concentration was not observed among premenopausal BC women and apparently healthy women (p>0.05). However, postmenopausal BC women had significant high levels of serum ferritin compared to postmenopausal healthy women (0<0.05). The postmenopausal ferritin concentrations among BC and normal women studied via ROC curve showed 70% (p=0.000, CI 0.62-0.79) of area under the curve with ferritin cutoff value of 58 ng/mL with 60% sensitivity and 75% specificity. Among postmenopausal BC and healthy women, 56.5% and 29% had ferritin levels above this cutoff value respectively and postmenopausal women having ferritin levels above the cutoff had 3times (OR=3.1, 95%CI 1.6-5.9) risk of having breast cancer. CONCLUSIONS: Elevated serum ferritin concentration in postmenopausal women is associated with breast cancer risk but not in premenopausal women.
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    Nottingham grade 2 breast cancer; is it a true prognostic category?
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Peiris, H.H.; Mudduwa, L.K.B.; Thalagala, N.I.; Jayatilake, K.A.P.W.
    BACKGROUND: Nottingham grade (NG) is a well-recognized prognostic factor derived by adding scores (1-3) given for three histological features of breast cancer (BC). NG is assigned according to the final score (NG1=score 3-5, NG2=score 6-7, NG3=score 8-9) where NG1 has the best and NG3 has the worst prognosis. OBJECTIVE: To assess whether the NG2 entails only patients with a similar prognosis. METHODS: Data were collected from all NG2 BC patients who had sought the services of our unit from 2006 to 2012. Grading was done by a single investigator. Patients were divided into two groups according to the score assigned in grading (6 and 7) and followed up with a mean follow-up time of 45 (SD=23) months. Clinico-pathological features were compared using chi-square test. Kaplan-Meier model with log-rank test was used for survival analysis. RESULTS: The study included 352 NG2 BC patients (score 6=195; score 7=157) with a mean age of 52 (SD=11) years. Majority of the patients with score 6 had ER/PR positive tumours (p=0.007 and 0.029) whereas score 7 patients had Her 2 positive tumours (p=0.002). There was a significant survival difference between the patients who had scores 6 and 7 (breast cancer specific survival p=0.007; recurrence free survival p=0.019). There was no survival difference between the patients with NG1 and score 6 and NG3 and score 7 (p>0.05). CONCLUSIONS: NG2 comprises two subsets of patients with a significant survival difference. Their prognosis is more in line with the preceding/subsequent grade than the same grade, probably due to the difference in ER/PR and Her 2 expression.