Breast cancer is the most commonly diagnosed cancer in women with an estimated 287,850 cases in 2022. Approximately 684,000 deaths each year are associated with breast cancer across the world. Risk factors of breast cancer include increased estrogen exposure, family history of breast cancer, and environmental factors. Treatment of breast cancer is highly dependent on the presence of HER2, estrogen, and progesterone receptors. Breast cancers that present with increased receptors for estrogen, progesterone, and HER2 are typically the least aggressive and the easiest to treat. The percentage of cases in the United States associated with hormone receptor positive and HER-2 negative or positive are approximately 82%. Absence of receptors for estrogen, progesterone, and HER2 is known as triple negative breast cancer. In the United States, only about 10% of cases are associated with this form. However, it is considered the most aggressive and difficult to treat. Two emerging flavonoids known as CT1 and CT3 have shown cytotoxic activity against cell lines that represent some of the most common breast cancers: MCF7, MDA-MB-231, and SKBr3. CT1 and CT3 were extracted from the leaves of Chromolaena tacotana using a Soxhlet extractor and the compounds then underwent isolation and purification. The cells were then treated with CT1 or CT3 at concentrations of 5, 10, 20, 40 and 80 µM. MTT assays were then used to determine cell viability. MDA-MB-231, the most aggressive type of breast cancer cells, responded to both CT1 and CT3. The most profound cytotoxic effects of CT1 were seen with MCF7 and MDA-MB-231, while CT3 exhibited a greater toxicity against SKBr3 cells. Preliminary results indicate that CT1 and CT3 target the MEK-ERK signaling pathway. Further studies need to be completed to determine mechanistically how these compounds lead to receptor-independent toxicity.

The problem with which this study is concerned is articulating all possible CT3 and KR21 reliability measures for every case of a 5x5 binary matrix (32,996,500 possible matrices). The study has three purposes. The first purpose is to calculate CT3 for every matrix and compare the results to the proposed optimum range of .3 to .5. The second purpose is to compare the results from the calculation of KR21 and CT3 reliability measures. The third purpose is to calculate CT3 and KR21 on every strand of a class test whose item set has been reduced using the difficulty strata identified by Order Analysis. The study was conducted by writing a computer program to articulate all possible 5 x 5 matrices. The program also calculated CT3 and KR21 reliability measures for each matrix. The nonparametric technique of Order Analysis was applied to two sections of test items to stratify the items into difficulty levels. The difficulty levels were used to reduce the item set from 22 to 9 items. All possible strands or chains of these items were identified so that both reliability measures (CT3 and KR21) could be calculated. One major finding of this study indicates that .3 to .5 is a desirable range for CT3 (cumulative p=.86 to p=.98) if cumulative frequencies are measured. A second major finding is that the KR21 reliability measure produced an invalid result more than half the time. The last major finding is that CT3, rescaled to range between 0 and 1, supports De Vellis' guidelines for reliability measures. The major conclusion is that CT3 is a better measure of reliability since it considers both inter- and intra-item variances.

Introduction: Breast cancer is the most frequently diagnosed cancer found in women across the world, with an estimated 2.3 million new cases occurring in 2020. Additionally, over 684,000 deaths annually are attributed to breast cancer across the globe, making it the most common cause of cancer-related death in women. Further, treatment of breast cancer relies heavily on whether or not the cancer cells express estrogen, progesterone, and HER 2 receptors and this expression profile is often related to how quickly the cells grow and spread. In the United States, breast cancer cells that are hormone receptor positive and HER-2 negative make up about 73% of breast cancer cases, and cells that do not express any receptor and are known as triple negative, make up around 12% of cases (American Cancer Society, 2019). With that being said, CT1 and CT3 are novel compounds that have a cytotoxic effect on cell lines representing up to 85% of all breast cancer subtypes in the United States. Methods: The leaves of Chromolaena tacotana that contains the flavonoids CT1 and CT3 were dried and placed in a soxhlet extractor using dichloromethane (CH2Cl2) to extract the chlorophyll. The flavonoids were extracted using a column chromatography eluted with trichloromethane (CHCl3), a 1:1 dilution of CHCl3:methanol and methanol, followed by isolation and purification of the compounds. Human breast cancer cell lines MCF7, MDA-MB-231, and SKBr3 were treated with CT1 and CT3 at concentrations of 5, 10, 20, 40 and 80 µM, followed by incubation for 24 hours. To assess cell viability an MTT assay was conducted by adding a 5-diphenyl-tetrazolium bromide reagent. The purple-colored formazan crystals were solubilized with acidified isopropanol, then analyzed by spectrophotometry. Results: CT1 appeared to have the most cytotoxic effects compared to CT3 on MCF7. The opposite effect was observed for SKBr3 with CT3 showing the most effects as compared to CT1. No differential effect was observed on MDA-MB-231 since both CT1 and CT3 showed similar inhibition of cell viability. Conclusions: The results from the different breast cancer cell lines SKBr3, MCF7, and MDA-MB-231 vary based on how they responded to CT1 and CT3. CT3 was more effective on SKBr3 than CT1. CT1 was more effective on MCF7 than CT3. For MDA-MB-231, both CT1 and CT3 showed similar significant cytotoxic effects. The antiproliferative effects of CT1 and CT3 appear to be concentration dependent on all cells studied. In view of the results from MDA-MB-231 triple negative breast cancer cell line, the cytotoxic effect of the flavonoids is not dependent on the presence of estrogen, progesterone, or HER2 receptors on breast cancer cells. Further studies on the mechanism of action are necessary to elucidate the molecular targets of CT1 and CT3.