Purpose Cardiotoxicities are adverse effects often reported in chemotherapy-treated breast cancer patients. This study evaluated the potential risk factors and cumulative incidence of doxorubicin-induced cardiotoxicity in Korean breast cancer patients. Methods We retrospectively analyzed the data of 613 breast cancer patients who underwent a multigated acquisition (MUGA) scan or echocardiography prior to chemotherapy and at least one post-chemotherapy follow-up MUGA scan/echocardiography between 2007 and 2016 at National Cancer Center, Korea. The Cox proportional hazards models were used to evaluate cardiotoxicity risks. Competing risks analyses were performed to estimate cumulative incidence of cardiotoxicity. Results Risk factors associated with cardiotoxicity within 2 years of doxorubicin administration included age [adjusted hazard ratio (aHR) = 1.02, 95% confidence interval (CI) 1.00-1.04; p = 0.05], metastasis (aHR = 2.66; 95% CI 1.36-5.20; p less then 0.01), and concomitant trastuzumab (aHR = 4.08; 95% CI 2.31-7.21; p less then 0.01). The cumulative incidence of patients with cardiotoxicity was 6.1% at 2 years (without substantial change from about 9 months)and 20.2% at 2 years (without substantial change from about 15 months) after initiation of doxorubicin-containing therapy without and with trastuzumab, respectively. Conclusions Susceptibility to chemotherapy-induced cardiotoxicity within 2 years of doxorubicin initiation in breast cancer patients was elevated with old age, metastasis, and concomitant trastuzumab. Regular imaging monitoring at least up to 9 months after doxorubicin initiation in patients treated without concomitant trastuzumab, and 15 months in patients treated with concomitant trastuzumab, is needed for early detection of chemotherapy-induced cardiotoxicity.Purpose Breast cancer patients with overall poor health are at a greater risk of both complications during treatment and mortality from competing causes. We sought to determine the association of pre-existing comorbidities on treatment-related complications and overall survival. Methods We identified women ages 40-90 years old from our institutional registry with stage I-II invasive breast cancer from 2005 to 2014. Recursive partitioning was used to stratify women based on pre-existing comorbidities as low, moderate, or high risk of treatment-associated complications. Cox proportional hazards model was constructed to estimate the association of risk with overall survival. Results 2077 women were studied. Mean age was 60 (IQR 51-68). Over half (54%) had ≥ 1 comorbid condition, and 29% experienced at least one adverse medical event within 1 year of diagnosis. Risk categories included low (no comorbidities or hypertension), moderate (combinations of comorbidities excluding congestive heart failure), and high (congestive heart failure in isolation or in combination with other conditions). High-risk women had a lower 10-year OS compared to moderate- or low-risk women (89% vs 90% vs 96%, log-rank p less then 0.001). After adjustment, being at moderate (HR 2.20, 95% CI 1.30-3.72, p = 0.003) or high risk (HR 5.07, 95% CI 1.66-15.52, p = 0.004) of adverse sequelae was associated with reduced OS compared to those at low risk of these adverse medical events. Conclusions Following breast cancer diagnosis, overall poor health was associated with a greater risk of mortality and complications within the first year of treatment, which was driven by a pre-existing diagnosis of congestive heart failure.Mhlathuze Estuary constitutes one of the ecological most important estuaries in southern Africa and is regarded as an estuary of high conservation importance. The ongoing expansion of the adjacent industrialized Richards Bay Harbour increases the risk of metal pollution to the estuary. This study provides insight into the extent and sources of trace metal contamination using pollution indices and sediment quality guidelines and the effect on macrobenthic habitat quality. Sediment samples for sediment metal and macrobenthic analysis were collected quarterly during 2016-2017 at five sites in the estuary using a marine-grade Zabalocki grab. Metal concentrations were determined using an ICP-OES. read more Sediment metal concentrations were consistently highest in the subtidal mudflats and lowest in marine sand at the mouth of the estuary. Concentrations of all metals displayed significant differences between sites (P less then 0.05). Pollution indices indicated moderate enrichment of Cr at all sites, although the mean pollution load index showed the estuary to be unpolluted. Comparison with sediment quality guidelines revealed that concentrations of Ni and Cr were potentially toxic to biota. Using multivariate analysis, metal concentrations appeared not to significantly affect the macrobenthic community. The multi-metric biotic index M-AMBI proved to be a robust tool in the habitat quality assessment of the estuary. The continuing use of M-AMBI as a biomonitoring tool for ecological management of the estuary is advocated.The impact of social media on the practice of ART is rapidly increasing, heralding great promise, but also significant risks. Since social media are likely here to stay, providers should familiarize themselves with this rapidly emerging phenomenon and decide how to best use it for their practice.Purpose Whole brain radiation therapy (WBRT) remains an important component of treatment for patients with multiple brain metastases (BrM) but is associated with significant neurotoxicity and memory impairment. Although RTOG 0614 demonstrated that administration of memantine to patients receiving WBRT may reduce radiation-associated cognitive decline, prior literature has suggested that radiation oncologists are hesitant to prescribe memantine. We sought to assess the frequency of memantine prescription in patients managed with non-stereotactic, brain-directed radiation for BrM. Methods Patients > 65 years old with newly diagnosed BrM between 2007 and 2016 receiving non-stereotactic, brain-directed radiation (including WBRT) were identified using the SEER-Medicare database. Receipt of memantine with non-stereotactic, brain-directed radiation was defined as any Part D claim for memantine 30 days before or after initiation of non-stereotactic, brain-directed radiation. Clinical and demographic variables among patients who did and did not receive memantine were compared.