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Introduction: Radiotherapy after breast cancer surgery will increase local control of the disease and also increase overall survival. Radiation have some side effects on lung function. In different radiotherapy techniques, these side effects are different. Pulmonary function tests and oxygen saturation are methods for evaluation of these complications. In this study we decide to campare pulmonary complications in two radiotherapy methods. Materials and Methods: In this clinical trial study fifty one patients with breast cancer in stage II and III according to TNM staging system, which were under modified radical mastectomy in Imam Hosein hospital and refered for adjuvant radiotherapy, randomly divided in two groups. In one group patients were treated with three field technique and in others with four field technique. All patients received total dose of 48-50 Gy. For patients, pulmonary function test and pulse oxymetery were done once before initiation of radiotherapy and then one and three months after radiotherapy. Results: Measurement of FEV1 , FVC and show that no significant statistical difference was present between the two groups one month and three months after radiotherapy, also in each of the two groups the amount of FEV1 , FVC and one month after radiotherapy had no significant statistical difference in comparison to baseline tests but FEV1 and FVC after three months was decreased and had significant statistical difference respectively (p<0.001, p<0.006). SO2 had no significant defference between the two groups and also in each group after one and three month of radiotherapy. Conclusion: Locoregional radiotherapy of breast and lymph nodes areas causes a decrease in some parameter of pulmonary function tests but no difference was present between three field and four field techniques.

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Introduction: Due to the absence of frozen section in the majority of hospitals, malignant breast masses are being operated in two admissions first for biopsy and second for mastectomy. With simple and rapid technique of touch imprint (intraoperative cytology) both operations can be done in the same time. In this study the diagnostic accuracy of intraoperative cytology (touch imprint) in malignancy of breast masses is evaluated. Materials and Methods: During 2003 to 2006, reports of touch imprints of 70 patients with breast masses were compared to reports of their permanent section. Based on gathered data, positive and negative predictive value, sensitivity and specificity, and positive and negative likelihood ratio of the test were determined. Results: In 70 patients, 39 cases had malignant and 31 cases had benign masses. In 39 patients with malignant masses, 36 patients had malignant and 3 patients had benign cytologic reports. In 31 patients with benign masses 2 patients had malignant reports in cytology. Therefore sensitivity, specificity and accuracy of touch imprint in diagnosis of malignant breast masses were 92.3%, 93.5% and 92.9% respectively. Conclusion: Because of high specificity of touch imprint, it seems that this test can be done in centers that do not have frozen section for intraoperative diagnosis of malignant breast masses.

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Background: Breast cancer is the most prevalent type of all cancer in women. In this study form various methods for treatment of depression due cancer. This study conducted for comparison drug therapy and drug-cognitive therapy on decreasing depression, effect of drug and cognitive theray on decreasing depression. Methods and Materials: This is a clinical trial study. Form patient refered to oncology clinic and ward of vali-e-Asr hospital 78 women were selected by simple sampling. Based on Beck depression test, 42 of them had depression. They randomly divided to case and control groups. Both groups received antideresant drug as usual. But case group had also cognitive- drug therapy. Afrer 6 Month treatment both group were tested again for depression. Data was analyzed by spss using independent and paired t tests. Results: The mean depression score hadnot signigiant difference between case and control grops beor and after treatment. The mean depression score in control group had no significant deference before and after treatment the mean depression score in the case group was significantly different after treatment (p<0.05). The mean score of depression in control group was more than case group after treatment. Conclusion: In the present study cognitive therapy cause a significant decrease in depression score of case group.

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Background: Pain management is the challenging concepts in health workers. Since neonates have higher pain sensitivity in compare to childhood and adults. The objective of this study was to examine the pain relieving effect of breast feeding during immunization injections in healthy neonates. Methods and Materials: In this control randomized clinical trial, Samples were divided two groups (by age and sex) of 76 healthy 2- 4 months old term infants. In breast-fed group, 2 minutes before, during, and 15 seconds after the DPT immunization injection were in mother hug, and in control group as routine of clinic, were lied on the examining table during injection. Appearance of Neonates were observed and assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Results: In breast fed and control group mean of age were 81.53±41.46 and 81.61±40.59 day and for weight were 6.65±1.17 and 6.70±1.14 kg for hight were 64.27±5.5 and 63.38±5.06 cm respectively. There were significant differences in Behavioral Pain Scores of two groups include: facial expression (4 items), cry (5 items), and movements (6 items). (P<0.0001). There is no statistically significant difference between the 2 groups for age, sex and the time of feeding prior to vaccination Conclusion: Regarding to significant difference in behavioral of pain responds in two groups, it is suggested, with simple and safe intervention method of straight breast feeding reduce pain during immunization and muscular injections too.

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Background: Breast Cancer is the most common malignancy and is the second largest cause of death among 35-55 years old women. The aim of this study is explore and to describe women's experiences with breast cancer for achieving a deeper comprehension of their individual experiences. Methods and Materials: This is a qualitative study with a phenomenological approach. Sampling method was purposive and continued till data saturation. Twenty two participants (patients,families and treatment team) attended in the study.Data were collected by using in-depth interviewing and were analyzed by “Parse”method. We tried to analyze qualitative data based on valid criteria. Results: The findings of this research were summarized into four core concepts:delay in diagnosis and treatment, treatment rejection, drowning in suffering (reaction to disease,facing with outcome of treatment,exposure to treatment system, ineffective care and disturbance in daily life of the family) and moving toward normal life. Conclusion: Knowledge of treatment team from the expriences of women suffering from breast cancer helps them to play a better role in their treatment. It seems, this is essential for make a shift from terminal treatment to early diagnosis. Also it emphasise to use of source for support of patients.

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Background: The existence of estrogen and progesterone receptors, p53, human epidermal receptor-2(HER-2) and cathepsin-D are among the prognostic markers for breast cancer. In this study, we investigated the relationship between these factors and lymph-node involvement. Materials and Methods: In this case-control analytic study, 105 patients with breast cancer were investigated. After detecting breast mass, surgical biopsy was done and the status of the estrogen and progesterone receptors, p53, HER-2, and cathepsin-D were studied. Collected data were registered in a checklist and were subjected to analysis. Results: There was no relationship between lymph-node involvement and estrogen and progesterone receptors, p53, cathepsin-D and HER-2. Conclusion: In order to get more precise results about hormonal receptors, p53, HER-2 and cathespin-D, a similar research with a larger sample size over a longer period of time is needed.

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Background: Nowadays, mothers have ceased to breastfeed due to several factors and resort to bottle-feeding or other forms of complementary feeding for their children. This results in physical and emotional problems for children, and socio-economic harms in communities. The aim of this study is to assess the impact of BASNEF model based education on successful breastfeeding in pregnant mothers referring to health centers in Arak. Materials and Methods: This quasi-experimental study was carried out with the participation of 88 pregnant women. The participants were randomly allocated to interuention and control groups. Instructions were given in four sessions on the basis of BASNEF model and behavioral objectives. Eventually, the collected data were analyzed by using statistical tests. Results: Mean scores of knowledge, attitude, enabling factors and subjective norms in the inerurntion group before and after education showed a significant difference in comparison with control group (p<0.001). Conclusion: Model-based education has positive impacts on behavior improvements. Thus, in health programs instead of applying traditional instructions, appying planned education programs based on health education models that have measurable and reliable effects is suggested.

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Background: Nursing caries is a developing and rampant form of caries in the primary dentition, which results from pooling of fermentable liquids on primary teeth. This study was carried out to determine the effect of feeding factors on the development of nursing caries in 2-4 year old children in kindergartens of Zahedan. Materials and Methods: In this analytical-cross-sectional study that was conducted in 2006, the social-economic status background (educational background of parents), past feeding practice (breast or bottle feeding and frequency of feeding in day or at night) of 230 2-4 year old in Zahedan, who had been selected in a multi-stage random manner, were examined. The children were examined by mirror and catheter. Diagnostic criterion for nursing caries was caries of at least two maxillary incisors. Results: Prevalence of nursing caries in the studied population was 13%. Factors such as breast feeding, frequency of bottle feeding at night, referring to dentist, and gender correlated with development of nursing caries (p<0.05). Bottle feeding during day or at night and the frequency of breast feeding did not have any significant effects on the development of nursing caries. Conclusion: The prevalence of nursing caries was less in children who had breast feeding, whereas it was higher in children who had frequent bottle feeding at night. Nursing caries was also more common in boys than girls.

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Background:Breast cancer is one of the most common cancers in women worldwide and one of its most desirable treatments is tamoxifen. The reported side effect associated with tamoxifen is endometrial thickness and increased risk of endometrial cancer. The aim of this study was to assess the influence of tamoxifen on the endometrial thickness in amenorrhea breast cancer patients treated with tamoxifen. Materials and Methods: This descriptive-analytic, cross-sectional study was conducted in Radiotherapy Departments of Mashhad University of Medical Sciences over a period of seven years.162 patients treated with tamoxifen whose bleeding cycle had been disrupted were selected and the relationship between tamoxifen usage and endometrial thickness was investigated in them. In addition, the relationship between abnormal vaginal bleeding and the ultra sonographic findings was assessed. Data analysis was done by using t-test and Chi-square test. Results: There was a significant relationship between tamoxifen usage and abnormal endometrial thickness while the greatest relationship was observed in the first year of treatment. The relationship between abnormal vaginal bleeding and abnormal endometrial sonographic findings was significant (P=0.001). The incidence of endometrial cancer in tamoxifen users was more than general population (0.61% vs. 0.1%). Conclusion: Considering the findings of this study, in the presence of abnormal sonographic and clinical observations indicating abnormal vaginal bleeding, pathological evaluation of the endometrial biopsy should be carried out for patients who use tamoxifen.

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Background: There are various factors effective in the appearance of metastasis that have been surveyed and recognized in different studies. However, the appearance of metastasis by determination of these factors cannot be predicted. One of the models used for the analysis of recurrent data and consideration of heterogeneity between patients is frailty model. Materials and Methods: In this survival study, 133 women with breast cancer were treated in Fayazbakhsh Hospital, Tehran, during 2005-2007. All patients were followed until April 2011. Frailty model was employed for the analysis of data and gamma frailty distribution was assumed with the average one and Ө variance. All statistical methods were run in R software. Results: Disease-free survival rates for 3 and 5 years were 0.78 and 0.72, respectively. During the follow-up period, the risk of metastasis was estimated to be 43%. Two factors were identified as the prognostic factors in the appearance of metastasis: tumor malignancy grade and the number of positive lymph nodes. Frailty variance was 4.27 (P=0.001). Conclusion: The significant variance of frailty component in the model indicates that patients who have identical explanatory variables face different levels of risk experiencing metastasis. Also, specific characteristics of the patients are important in the incidence of metastasis.

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Background: Breast cancer is the most common cancer among women. An important goal for cancer patients is to improve the quality of life (QOL) by maximizing functions affected by the disease and its therapy. This study examined the effects of massage therapy on quality of life in women with breast cancer after surgery.

Materials and Methods: The study was quasi-experimental. Among the 53 women with breast cancer surgery and oncology clinic of Arak, 30 were randomly allocated in two groups of massage therapy (n=15) and 5 weeks (30 min, 2 sessions per week) and control (15 cases). Cortisol levels and quality of life questionnaire (SF36) was redirected and mental health groups. Data analysis software SPSS version 16 using paired t-test and one-way analysis of variance and a confidence level of 95% (p<0.05) was performed.

Results: The results showed a significant increase in the experimental group improved after the massage, physical (p=0.001) and psycho-social (p=0.002) were compared with control subjects. Massage also improves quality of life and mental health in breast cancer patients after surgery was (p<0.05). However, serum cortisol levels between the experimental and control groups were not significant (p>0.05).

Conclusion: The overall results of this study showed that massage therapy can be an effective intervention to improve quality of life and mental health in patients with breast cancer during radiotherapy is used.

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Background: The prevalence and incidence of cancer in different parts of the world have different patterns. To recognize the frequency of malignancies in different social groups according to climatic conditions is considered as the primary component of prevention programs at different levels. This study was conducted to investigate the epidemiology, survival rates and geographical epidemiology of breast cancer in Markazi province.

Materials and Methods: In this epidemiological study, needed data were obtained from cancer registration program and death registration data. The data were analyzed by using SPSS software version 16 and Winpepi and significant level was 0.05. And to draw a map to show the breast cancer incidence rate in Markazi district, Arc view software was used.

Results: Out of the 400 cases recorded during the 5-year, 8.5% died due to breast cancer. 5-year survival rate was 87% and there was a significant correlation between survival rate and age. Most records were related to the age group 49-40 years and the highest incidence rate was in Arak. The trends of incidence rate was not significant.

Conclusion: The results showed that 5-year breast cancer survival rate is more than some other places which could be due to new and improved methods of treatment and methods of screening and early detection of disease. Other aspects of the epidemiology of the disease is similar to other parts of Iran.

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Background: Vascular endothelial growth factor (vegf) is one of the most important regulator of angiogenesis, there are some reports about the relation of VEGF over expression and progression of tumor in several cancers. The aim of this study is assay of four VEGF isoforms expression in breast cancer tumor samples.

Materials and Methods: 25 breast cancer tumor samples and 25 health samples were used in this study, mRNA was extracted from each sample and then cDNA was made. The expression of four isoforms VEGF121, VEGF165, VEGF183 and VEGF189 was measured by real time reverse transcription PCR (RT-PCR) and gel electrophoresis.

Results: Among the four isoforms, VEGF165 and VEGF 121 had maximum and VEGF 183 and VEGF 189 had minimum expression level in all samples. The total expression level of VEGF had a significant increase in tumor samples in comparison with the control samples (4/6, p<0.01).

Conclusion: There is a significant relation between the VEGF over expression and breast cancer tumor formation, which it can be used as a prognosis marker of breast cancer in future.

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Background: Estrogen hormone regulates cell proliferation in breast tissue physiologically. Evidences show that changes in estrogen signaling pathways, including the receptor alpha (ER&alpha), happen during breast cancer progression. ER&alpha is expressed in most breast tumors and its association with the development of low-grade tumors has been demonstrated. Single nucleotide polymorphisms (SNPs) in genes may differ in susceptibility to cancer and result in different respond to treatment in different populations. The present study aimed investigated the association between single nucleotide polymorphisms (rs2234693: C/T) in gene ESR&alpha in patients with breast cancer.

Materials and Methods: In this case-control study 150 women with breast cancer and 142 healthy women without a family history of breast cancer were enrolled. DNA was extracted from blood samples. After primer design, technique of PCR-RFLP was used and samples were genotyped by acrylamide gel electrophoresis. Statistical analyzes were performed using SPSS version 20 and chi square test and Final findings were specified.

Results: TT and CT genotypes for ra2234693: C/T site compared with the CC had 5.5 and 1.5-fold increased risk respectively. Statistically significant differences were found between cases and controls for fibrocystic disease and age at menarche.

Conclusion: We not found an association between C/T polymorphism and breast cancer. But CC and TT genotypes of this polymorphism in estrogen receptor alpha gene related with breast cancer that are consistent with the findings of some other researchers.

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Background: Breast cancer is the most common cancer and one of the main causes of cancer-related death all over the world that has become a major public health concern. Human apurinic/apyrimidinic endonuclease (ApE1) is a multifunctional protein that has an important role in the base excision repair (BER) pathway. Single- nucleotide polymorphism T>G found in exon 5 led to substitution of Asp>Glu at codon 148 (Asp148Glu). In this case-control study, we aimed to evaluate the association of this polymorphism on the risk of breast cancer in Guilan population.

Materials and Methods: To study gene polymorphism APE1 (Case- Control), blood samples were collected from 75 patients diagnosed with breast cancer and 75 control subjects, and genotyped by allele-specific PCR (AS-PCR). To estimate the association between genotype and allele frequencies in cases and controls, Chi-Square analysis was used.

Results: Analysis revealed no significant differences were found in genotype and allele distributions of ApE1 Asp148Glu polymorphism between breast cancer patients and controls (p=0.1, p=0.6 respectively) in this population.

Conclusion: Data from this study indicated no significant association between the Asp148Glu polymorphism and breast cancer risk (p=0.1). Further study is needed to clarify the impact of Asp148Glu polymorphism on the breast cancer.

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Background: Exclusive breastfeeding for the first six months after delivery plays a crucial role in preventing infants morbidity and mortality. Exclusive breastfeeding intention during pregnancy is one of predictors of this behavior. Determining the effective factors in exclusive breastfeeding intention helps plan for promoting breastfeeding intention and behavior. The aim of this study is to determine predictive factors of exclusive breastfeeding intention in pregnant women, based on the theory of planned behavior.

Materials and Methods: This analytical study was conducted in 2014 on 224 primigravide women referred to Health Centers of Kashan. The samples were randomly selected from 16 health centers. The mothers completed the questionnaires of demography, intention, attitude, subjective norms and the perceived behavior control. A linear regression analysis was used to identify independent predictors of the exclusive breastfeeding intention.

Results: In regression model, the perceived behavior control (&beta=0.42, p<0.001), attitude (&beta=0.27, p<0.01) and subjective norms (&beta=0.18, p=0.059) were predictors of the exclusive breastfeeding intention. This model could explain 63% of the variance of the exclusive breastfeeding intention. The knowledge and demographic factors were not predictors of the intention.

Conclusion: The results reveal the perceived behavior control, attitudes and subjective norms could predict exclusive breastfeeding intention, so they should be considered as general guidelines in designing educational interventions in order to improve exclusive breastfeeding in women.

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Background: Breast cancer is one of the major causes of cancer-related death and the most common solid malignancy in women worldwide. Chemerin as a new adipokine has an inflammatory activity that initiates inflammation via chemotaxis of immature DCs and macrophages. This study aimed to evaluate the level of chemerin in patients with breast cancer.

Materials and Methods: In this cross-sectional study that was performed as a case-control study, we enrolled 45 patients with breast cancer in Vali-asr hospital from June to December 2015 (age range, 18-60 years) and 40 healthy volunteers as a control group (age range, 22-56 years). The patients with invasive breast were selected before mastectomy. The level of serum chemerin was measured by ELISA kit.

Results: The results showed that the mean serum chemerin level in the breast cancer patients (1536 ±608 ng/L) was significantly lower than the normal individuals (1919±544 ng/L),(p=0.04). There is no correlation between the level of chemerin with body weight, stage of disease, duration of disease and the number of white and red blood cells.

Conclusion: With due attention to the inflammatory role of chemerin, decreasing the serum chemerin level in patients with breast cancer may be related to the consumption of chemerin in the inflammatory responses or immunosuppression by tumor. The low level of chemrerin may be suitable for tumor growth and progression.

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Background: Breast cancer is both the prevailing malignancy and the most common cause of cancer death among women. Many factors may play a role in the susceptibility to the breast cancer and Oxygen Free Radicals may be one of these. There are various known antioxidant systems against oxidative stress, including ParaoxonaseI. The aim of this study was to investigate the association between rs854560 polymorphism in the PON1 gene in patients with breast cancer.

Materials and Methods: We performed genotyping analysis using polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) assay in a case–control study of 83 confirmed breast cancer patients and 100 cancer-free controls in Markazi Province.

Results: In our study of the PON1 gene L55M polymorphism, the LL genotype was found in 2 (2.40%) patients, whereas the LM genotype was found in 69 (83.13%) patients. The MM genotype was present in 12 (14.45%) patients. In the control group, LL, LM and MM genotypes were found in 4 (4%), 81 (81%), and 15 (15%) subjects, respectively. There was no statistically significant difference between patient and control groups in terms of the PON1 gene L55M polymorphism (p= 0.825). Allele distributions were different but this difference did not reach statistical significance (p= 0.920).

Conclusion: We found no association between M55L polymorphism and breast cancer.

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Background: Biological and epidemiological data indicate that the levels of vitamin D maybe affect the breast cancer risk. Vitamin D plays an important role in cell proliferation, apoptosis and tumor growth suppression. Vitamin D receptor is a critical mediator for the cellular reactions of vitamin D. Some of the epidemiological studies, reviewed the relationship between VDR gene polymorphism ApaI and breast cancer, but the controversial findings have been achieved.

Materials and Methods: In this study, a population-based case-control study including 140 patients and 160 healthy individuals of women in Markazi Province were evaluated using PCR-RFLP approach. Genomic DNA was extracted from blood samples using the salting-out procedure. Polymorphism of interest was determined by PCR-RFLP method using ApaI enzyme and statistical analysis was performed by SPSS software.

Results: Based on the results of this study, distribution of AA genotype in cancer and control groups was, 38.6 and 26.87, for AC genotype 55.00 and 66.87, and finally for CC genotype 6.43 and 6.26 respectively. The results of this study showed no association between ApaI polymorphism of the VDR gene and breast cancer(OR=0.903,CI=95%, 0.29-2.95.)

Conclusion: In this study, we found no association between ApaI polymorphism and breast cancer, which are consistent with the findings of some other researchs. It is necessary to examine a larger population to achieve more definitive results.

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