Ananya De

Background: Breast cancer (BC) represents a significant disease burden globally as well as in India, with a higher proportion of young women affected with BC in Indian population. Postpartum breast cancer (PPBC), defined as BC diagnosed within 5 years following childbirth, has been associated with poorer outcomes compared to sporadic breast cancer (SBC). However, data comparing clinicopathological characteristics and prognosis between PPBC and non-PPBC (SBC) cases in Indian population remain limited. To address this gap, we aimed to compare these characteristics and evaluated breastfeeding practices and their prognostic relevance between these groups.Methods: This retrospective study included BC (n=65) patients, categorized into PPBC (n=13) and SBC cases (n=52). Clinicopathological parameters including age, total breastfeeding duration, tumor stage, grade, and molecular subtypes were compared. The disease-free survival (DFS) was analyzed using Kaplan–Meier methods and compared using log-rank tests.Results: In the current cohort, PPBC patients were younger (<40 years) and more likely to present with advanced-stage disease (stage IV) compared to SBC cases (p<0.05). No statistically significant difference in distribution of molecular subtypes was observed between PPBC and SBC groups. In the overall BC cohort (PPBC and SBC combined), the cumulative breastfeeding duration beyond 6 months and 12 months significantly associated with improved DFS compared to BC patients with shorter duration of breastfeeding (log-rank p = 0.033-0.039).Conclusion: Our data suggests a difference in clinicopathological features between PPBC and SBC patients with respect to age and stage of disease presentation. And longer breastfeeding duration might have a potential protective influence on BC patients and warrants further studies on larger cohorts of BC patients.

Chronic kidney disease (CKD) induces several systemic effects, including the accumulation and production of uremic toxins responsible for the activation of various harmful processes. Gut dysbiosis has been widely described in CKD patients, even in the early stages of the disease. The abundant discharge of urea and other waste substances into the gut favors the selection of an altered intestinal microbiota in CKD patients. The prevalence of bacteria with fermentative activity leads to the release and accumulation in the gut and in the blood of several substances, such as p-Cresol (p-C), Indoxyl Sulfate (IS) and p-Cresyl Sulfate (p-CS). Since these metabolites are normally eliminated in the urine, they tend to accumulate in the blood of CKD patients proportionally to renal impairment. P-CS, IS and p-C play a fundamental role in the activation of various pro-tumorigenic processes, such as chronic systemic inflammation, the increase in the production of free radicals and immune dysfunction. An up to two-fold increase in the incidence of colon cancer development in CKD has been reported in several studies, although the pathogenic mechanisms explaining this compelling association have not yet been described. Based on our literature review, it appears likely the hypothesis of a role of p-C, IS and p-CS in colon cancer development and progression in CKD patients.

Thyroid cancers require complex and heterogeneous therapies with different impacts on renal function. In our systematic literature review, we analyzed several aspects: renal function assessment, the impact of radiotherapy and thyroid surgery on kidney functioning, and mechanisms of nephrotoxicity of different chemotherapy, targeted and immunologic drugs. Our study revealed that the renal impact of thyroid cancer therapy can be a limiting factor in all radiotherapy, surgery, and pharmacological approaches. It is advisable to conduct a careful nephrological follow-up imposing the application of body surface based estimated Glomerular Filtration Rate (eGFR) formulas for the purpose of an early diagnosis and treatment of renal failure, guaranteeing the therapy continuation to thyroid cancer patients.