in this review, we discussed some significant natural chemical compounds with their mechanisms of actions, which can be very effective against the breast cancer and can be more potent by their proper modifications and further clinical research. the etiology of breast cancer and proliferation of cancerous cells is generally mediated by a number of mechanisms or pathways [13–16]. the development of targeted therapy in tnbc is very challenging, though lehmann et al. from many studies, it is evidenced that many of the natural compounds have anticancer activity and they have the property to function as a treatment approach via many mechanisms (figure 2) [45–48]. found a positive correlation between the expression levels of cox-2 and distant metastases in breast cancer . in combination therapy with herceptin, dim reduced the expression of foxm1 in her-2/neu-expressing breast cancer cells through downregulating akt and nf-kb p65 . it was reported that biochanin a is tolerated better than genistein and causes positive expression of tumor suppressor genes in hmec, mcf 12a, and mcf7 (er-positive breast cancer cell line) cell lines [91, 178]. curcumin is reported to induce breast cancer apoptosis by regulating the expression of apoptosis related genes and proteins . it can be suggested that curcumin is one of the most significant compound to face the challenges of breast cancer treatment.  suggested that egcg inhibited the proliferation of estrogen-sensitive mcf-7 breast cancer cell line and also binds to both erα and erβ .
it is also reported that genistein induced apoptosis via the upregulation of bax and p21waf1 proteins in mda-mb-231 cell lines  and also downregulated the expression of caspase-3 . the expressions of other genes such as rarβ2 and hin1 remained unaltered by lycopene treatment in mcf-7 and mda-mb-468 breast cancer cells [131, 213]. in er-positive breast cancer cell, shikonin induces apoptosis with the characteristics of necroptosis  and also decreases the expressions of steroid sulfatase genes . at the same time it can induce cell cycle arrest and apoptosis in breast cancer cells. reported that resveratrol acts as dnmt 3b inhibitor and decreases in rassf-1α methylation with increasing circulating resveratrol and it also suppresses expression of the androgen receptor . showed that , in the presence of e2, resveratrol acts as antiestrogen and an agonist or antagonist in the absence of e2 in different breast cancer cell lines. in adjuvant therapy, silibinin is reported to increase the efficacy of cisplatin and paclitaxel in mcf-7 breast cancer cells  and also to sensitize the chemoresistant breast cancer cells . a natural compound egcg, derived from green tea, is reported to block uncontrolled cell growth and can inhibit the migratory behavior of triple-negative breast cancer . the significance and contribution of natural derived compounds in the treatment and prevention of breast cancer is evident and cannot be ignored. molecular targets of natural compounds in breast cancer pathway.
little is known about adherence and persistence to aromatase inhibitors and about the causes of treatment discontinuation among older women. in the field of oncology, the use of oral therapy is on the rise, and treatment adherence is under increasing scrutiny , . bc patients are reported to the nhis by their physician and receive all treatment free of charge. women who agreed to participate in the elippse 65 cohort were then sent a short self-administered questionnaire by mail, which included questions on patient characteristics and the circumstances of patient diagnosis. drug characteristics, including name, dosage, and number of pills are recorded in the database. in short, 382 women were included in the cohort used to describe rates of non-persistence to ai therapy.
a mere 13.7% of women reported having been involved in the decision to take hormonal therapy. ai treatment was prematurely discontinued by a large proportion of the women under study. the prevalence of cam use has been reported to reach 17% in older patient . further studies are needed to evaluate more precisely the impact of cam use on adherence in cancer patients, and to improve patient-physician communication on this topic. by combining data from different sources, we were able to identify women who were taking their medication without outside help, as well as study the association between cam use (which is not recorded in pharmacy databases) and a reliable measure of adherence to ai. we would like to thank both the women who agreed to participate in this study and their physicians for the time they devoted to medical data collection.
 and aromatase inhibitors by chumsri et al. . a number of phytochemicals such as curcumin, ginsetin, lycopene, and apigenin have been directly aromatase inhibitor therapy (ai) significantly improves survival in breast cancer patients. little is known about adherence and persistence to two other aromatase inhibitors, exemestane and letrozole, can be used instead of anastrozole to help reduce your risk of breast cancer, survival rate without aromatase inhibitors, survival rate without aromatase inhibitors, refusing aromatase inhibitors, latest research on aromatase inhibitors, which aromatase inhibitor is best with least side effects.
tamoxifen is the first choice for premenopausal women while aromatase inhibitors are used primarily for postmenopausal women; however, in cases where postmenopausal women cannot tolerate aromatase inhibitors, tamoxifen may provide an alternative option. otc anti-estrogens via aromatase inhibition. 2. 3-ohat is a bit less common, but still effective, it is known to be faster acting than atd. 3. 6-oxo is an old for over 20 years, tamoxifen – a selective estrogen receptor modulator (serm) – has been the favored treatment option. a newer class of medications called aromatase inhibitors work by blocking the enzyme aromatase, which turns the hormone androgen into small amounts of estrogen in the body., natural aromatase inhibitors, the truth about aromatase inhibitors.
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