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Introduction: Many training programs have been conducted, aiming to encourage women to perform breast self-examination for early detection of breast cancer. This study aimed to review studies performed on efficacy of educational interventions to correct women’s behavior in breast self-examination.Method: Through systematic search of MEDLINE and ISI Web of Science databanks to retrieve titles and abstracts of articles containing results of educational interventions associated with women’s breast self-examination, the articles that focused on determining efficacy of educational interventions were selected. Eventually, results obtained from reviewing full text of 19 selected articles were analyzed.Results: The majority of educational programs were designed for training skills, and most trainers were healthcare staff, and in some cases, educators were made up of peers and families of breast cancer patients. A huge diversity was observed in studies in terms of demographics, such as age, race, education, and occupation, and in some cases, first degree relatives of breast cancer patients were educated as the most important at-risk group.Conclusion: Teaching breast self-examination, with regard to knowledge, attitude, and behavior, plays an essential role in increasing cases of early detection and treatment of breast cancer. More effective education is provided by nurses and other medical staff compared to doctors. Attention to finding a suitable location for education, including healthcare centers and workplace, attributes to success.

Background: During the past few years, HESA-A, a herbal-marine mixture, has been used to treat cancer as an alternative medicine in Iran. However, weight of the evidence is not sufficient to accept or refuse the use of this compound as a cytotoxic drug. We investigated the selective anticancer effects of HESA-A on breast, prostate, colon, and glioblastoma multiforme (GBM) neoplastic cell lines.Methods: MTT-based cytotoxicity assay was performed on HCT-116 (colon adenocarcinoma), MCF-7 (breast adenocarcinoma), PC-3 (prostate adenocarcinoma), U-87MG (GBM), and HDF-1 (normal dermal fibroblast) cell lines using different concentrations of HESA-A (0, 1, 3.3, 10, 33 and 100 µg/ml) and doxorubicin as positive control (10 µM). If there was seen an inhibitory response, median inhibitory concentration (IC50) was determined. We defined the cytotoxicity as the extrapolated IC50 became equal to or lower than 50 µg/ml.Results: HESA-A at the highest concentration (100 µg/mL) significantly inhibited the growth of HCT-116 cell line (P = 0.003; compared to control) .Percentage growth inhibition of HESA-A at this concentration was determined as 40.13%. IC50 of this compound on HCT-116 cell line was extrapolated 117.28 µg/mL. There were no statistically significant differences between the mean absorbance measures of HESA-A treated groups in other cell lines.Conclusion: This study showed that HESA-A doesn't fulfill the predetermined criterion of cytotoxic agents. More preclinical investigations are needed to assess the efficacy of HESA-A in cancer.

Background: Breast cancer is the most common cancer among females that will cause death ifit does not be recognized and cured. One out of eight Iranian women in 40-55years old is likely to develop breast cancer. Early detection of breast cancerby screening programs is a useful approach in controlling the disease.Methods: In this descriptive study, 196 female healthcare providers were selected from52 Tabriz health centers by proportional cluster random sampling and theirhealth beliefs about breast cancer early detection behaviors are assessed byusing Champion’s Health Belief Model (CHBM) questionnaire. Data analyzed bySPSS software.Results: The mean age of participants was 37.01 (S.D= ± 7.54), and 73.5% of them weremarried and the job of 45.6% were midwife. 73.2% of participants have performedBSE, but only 26.9% of them performed it regularly. 26.6% of them had mammogramand 10.7% reported performance of CBE. The BSE performance was higher amongnurses and midwifes. BSE and mammography performance were higher in marriedhealth workers. Health workers who performed mammography and CBE were older(P> 0.05).Conclusion: In spite of good knowledge of healthcare providers in compare with otherpeople; the results of this study showed that the rate of BSE, mammography andCBE performance is low in Tabriz healthcare providers. So providing educationalprograms with focus on performance of breast cancer early detection behaviorsis strongly recommended by health service policy makers.

Background: Inhibin is a dimeric glycoprotein that has a depressive effect on the anterior hypophyse secretion. The level of this tumor marker is undetectable in menopause women. In patients with gynecological cancer, especially granulosa and epidermal-type (mucinous), ovarian cancers considerable increase in the serum level of Inhibin has been reported. The increased level of Inhibin has been reported in patients with recurrent ovarian cancer.Methods: We measured total serum Inhibin and CA125 tumor marker level in 38 postmenopausal women with pathologically confirmed ovarian cancer before and after surgery out of 51 suspected women. Our control group were postmenopausal women that attended to our clinic for routine gynecologic checkup. Both tumor markers were measured in these patients too.Results: Among 38 women with ovarian cancer, 13(34.2%) had elevated serum levels of total Inhibin. Among the 16 women with serous adenocarcinoma, 3 patients (18.8%) had elevated serum levels of Inhibin. All the three women with granulosa cell tumor had elevated serum levels of Inhibin (100%) and 3 of 4(75%) women with mucinous ovarian cancer had the same result. three out of 38 women in control group had elevated serum levels of Inhibin . Among all 38 patients, 6(15.7%) showed tumor recurrence, that all were concomitant with rising of both serum CA125 and Inhibin levels (p=0/001).Conclusions: Serum Inhibin level is a useful tumor marker in granulosa cell and in mucinous tumor of ovary. In this study combined Inhibin and CA125 assay showed better results in early detection of ovarian cancer in comparison to either CA125 or Inhibin alone.

Background: Allocation of the new (expensive) drugs for difficult refractory diseases and financial protection of the patients is an important challenge in the national health systems worldwide especially in developing countries.  Trastuzumab (Herceptin) as one of the effective but expensive drugs, put major financial burden for the Iranian patients and government. So the Ministry of Health and Medical Education (MOHME), decided to implement a national program for appropriate management of breast cancer and regulation of Trastuzumab in I.R of Iran (NPMBCT). In this policy brief we evaluated this issue and provided necessary recommendations.Method: We designed a conceptual model consisting of the goals, main and supporting processes for management of Trastuzumab in the national program. Five macro-processes selected as the main concerns. Then an expert panel including different scientific disciplines discussed the different aspects of the issue and provided the necessary recommendations. We determined the link between the suggested recommendations and the objectives of the program.Results: Based on the five selected main processes, the experts provided 10 recommendations including: 1) balance in the resource allocation, 2) appropriate modeling for the subsides allocation, 3) avoiding “poor subsidize the rich†phenomenon, 4) development and updating the clinical guidelines, 5) cost-effectiveness analysis on accepted guideline, 6) Quality improvement of diagnostic tests, 7) standardization of the laboratory kits, 8) brand management and lowering the drug cost, 9) improving the patient registry system by ICT infra-structure, 10) development of expert systems to empower the diagnostic laboratories.Conclusion: Given these recommendations, the NPMBCT program will be a successful model for the appropriate management of the expensive drugs and treatment of breast cancer in I.R. of Iran and other developing countries.

Background: This study was set to determine the optimal technique of breast cancer with supraclavicular fossa irradiation.Methods: Three techniques was compared in this study. Techniques were two point symmetric (2p-sym), two point asymmetric (2p-asym) and single point (sp). In 2p-sym all of beams were symmetric, in 2p-asym Tangential beams were symmetric and supra was asymmetric, in SP all of beams were asymmetric. This study performed in 2 parts. In one part three techniques were compared in thirty patients and in second part was done dosimetry by gafchromic film in phantom. Techniques were analyzed by DVHs treatment’s volumes and organ at risk (OAR) volumes.Result: There are no notable differences between dose distributions in three techniques but hot spot in the junction of treatment’s beams in single point (SP) technique was 115% and 118% for other techniques. The analysis of DVHs showed a decrease in OAR’s doses with sp technique. There was a significant difference of V20%, V20, V30 for lungs and V10, V40 for heart in sp technique compared to other techniques. The profiles of dose that obtained from films showed a gap in matchline, while matchline’s dose distribution in software was right and there was no gap.Conclusion: Observed gap in gafchromic films was created because of mechanical limitations in accelerators. Correction methods for this limitation was offered in articles. SP technique is optimal technique compared to other techniques if correction methods are done. It seems that Iranian radiotherapy clinics don't pay attention to this correction methods.

Background: The association of the mobile phone use and risk of brain tumor remains controversial among radiationepidemiologists.Methods: We hypothesized if an association between brain tumor and mobile phone use exists, this association will be manifested as a cohort effect (as a proxy of association between mobile phone use and brain tumor) in the incidence rates of brain tumor during the period of 1990 to 2009. We used age-period-cohort methodology (generalized log-linear model) and compared the distribution of cohort effects in the observed rates of brain tumor from 1990 to 2009 to the cohort effects from rates driven based on epidemiological study results that reported a positive association between brain tumor and mobile phone use in the Nordic population. Three latency period of 1-4 years with odds ratio (OR) of 1.2, latency period of 5-9 years with OR of 1.3, and latency period of more than 10 years with OR of 2.7 were used to estimate expected rates.Result: the distribution of cohort effects between observed and expected rates were more similar among the males compared with females. A shorter latency was more consistent to observed rates.Conclusion: Our study supports a possible a weak association between mobile phone use and brain tumor; further fueling the controversies in association.