Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: new findings and a review.

To explain a bimodal pattern of hazard of relapse among early stage breast cancer patients identified in multiple databases, we proposed that late relapses result from steady stochastic progressions from single dormant malignant cells to avascular micrometastases and then on to growing deposits. However in order to explain early relapses, we had to postulate that something happens at about the time of surgery to provoke sudden exits from dormant phases to active growth and then to detection. Most relapses in breast cancer are in the early category.

Promising development from translational or perhaps anti-translational research in breast cancer.

Background: A great deal of the public's money has been spent on cancer research but demonstrable benefits to patients have not been proportionate. We are a group of scientists and physicians who several decades ago were confronted with bimodal relapse patterns among early stage breast cancer patients who were treated by mastectomy. Since the bimodal pattern was not explainable with the then well-accepted continuous growth model, we proposed that metastatic disease was mostly inactive before surgery but was driven into growth somehow by surgery.

NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup.

To explain a bimodal relapse hazard among early stage breast cancer patients treated by mastectomy we postulated that relapses within 4 years of surgery resulted from something that happened at about the time of surgery to provoke sudden exits from dormant phases to active growth. Relapses at 10 months appeared to be surgery-induced angiogenesis of dormant avascular micrometastases. Another relapse mode with peak about 30 months corresponded to sudden growth from a single cell.

Recurrence and mortality dynamics for breast cancer patients undergoing mastectomy according to estrogen receptor status: different mortality but similar recurrence.

(Cancer Sci 2010; 101: 826-830) The purpose was to ascertain whether the recurrence risk patterns for patients with estrogen receptor (ER)-positive (P) and ER-negative (N) breast cancer support the ER-related clinical divergence suggested by the observed different mortality patterns and gene expression profiles. Both recurrence and death were considered in a series of 771 patients undergoing mastectomy. ER status was available for 539 patients.

Verbal and nonverbal indices of learning during problem-based learning (PBL) among first year medical students and the threshold for tutor intervention.

Background: During problem-based learning (PBL), students brainstorm on a problem, generate hypotheses and formulate learning objectives. Certain verbal and non-verbal expressions are used by students in response to specific learning issues.

Aims: This study examines the use of these expressions as indices of the learning taking place and the tutors' threshold to intervene.

Surgery triggers outgrowth of latent distant disease in breast cancer: an inconvenient truth?

We review our work over the past 14 years that began when we were first confronted with bimodal relapse patterns in two breast cancer databases from different countries. These data were unexplainable with the accepted continuous tumor growth paradigm. To explain these data, we proposed that metastatic breast cancer growth commonly includes periods of temporary dormancy at both the single cell phase and the avascular micrometastasis phase.

Hypothesis: primary antiangiogenic method proposed to treat early stage breast cancer.

Background: Women with Down syndrome very rarely develop breast cancer even though they now live to an age when it normally occurs. This may be related to the fact that Down syndrome persons have an additional copy of chromosome 21 where the gene that codes for the antiangiogenic protein Endostatin is located. Can this information lead to a primary antiangiogenic therapy for early stage breast cancer that indefinitely prolongs remission? A key question that arises is when is the initial angiogenic switch thrown in micrometastases? We have conjectured that avascular micrometastases are dormant and relatively stable if undisturbed but that for some patients angiogenesis is precipitated by surgery.

Medical students' perceptions of peer feedback on an anatomy student-selected study module.

Objective: The study aimed to determine student views of peer feedback on their student-selected study (SSS) module.

Methods: A questionnaire was developed to study perceptions of three groups of medical students (N = 42) towards feedback received from peers about their anatomy SSS presentation.

Results: Most students felt comfortable receiving and giving feedback.

A comparison of clinicopathological features and molecular markers in british and nigerian women with breast cancer.

Background: Some studies have suggested that breast cancer in black women is more aggressive than in white women. This study's aim was to look for evidence of differences in tumour biology between the two cohorts.

Methods: This study compared the stage, grade and pathological expression of five immunohistochemical markers (oestrogen receptor [ER], progesterone receptor [PR], ERBB2, P53 and cyclin D1 [CCND1]) in tumour biopsies from age-matched cohorts of patients from Nigeria and England.

Global paradigm shift in medical education: issues of concern for Africa.

Introduction: When medical education became established in Africa, many curricula were adopted from the West so as to achieve comparable standards in training. Over the last half a century however, major global pedagogical shifts have occurred in medical education without African keeping pace.

Methods: This article reviews key pedagogical changes and other innovations in medical education that have occurred over the last half a century as reported in the literature and identifies some of the issues that need to be addressed in Africa.

Enhanced surgery-induced angiogenesis among premenopausal women might partially explain excess breast cancer mortality of blacks compared to whites: an hypothesis.

There is excess breast cancer mortality for African-Americans (AA) compared to European-Americans (EA) of 1.5-2.2 fold that first appeared in 1970s and has been worsening since.

Racial disparities in breast cancer outcome: insights into host-tumor interactions.

Since the 1970s, overall age-adjusted breast cancer mortality rates in the U.S. have been higher among African American (AA) women than among Caucasian American (CA) women.

A comparison of the pattern of occurrence of breast cancer in Nigerian and British women.

Studies have suggested a predominance of premenopausal breast cancer in black compared to white women. The aim of the study was to compare the age specific incidence of breast cancer in Nigerian and British women. The mean age at presentation was 43.