Abstract
Invasive oncological procedures affect the remaining tumor cells by increasing their survival, proliferation, and migration through the induction of wound healing response. The phenomena of local relapse after breast-conserving surgery (BCS) has resulted in a series of research and clinical trials with the aim of assessing whether localized intraoperative radiotherapy (IORT), may be beneficial in inhibiting local recurrences. Therefore, it is essential to assess the impact of intraoperative radiotherapy in modulating the immunological response and wound healing process. Thus, we decided to perform a quantitative analysis of the composition of surgical wound fluids (SWF) in two groups of breast cancer (BC) patients: those treated with BCS followed by IORT, and those who underwent BCS alone. We found that several cytokines, which are believed to have anti-tumor properties, were highly expressed in the luminal A breast cancer subtype in the IORT treatment group. Interestingly, we also found significant differences between IORT patients with tumors of different molecular subtypes. Based on these findings, we hypothesized that IORT treatment might be beneficial in changing the tumor bed microenvironment, making it less favorable for tumor recurrence due to decreased concentration of tumor-facilitating cytokines, especially in the luminal A subtype of BC.
Highlights
Breast cancer (BC) is the most common cancer in women
The main aim of this study was to perform an analysis of the surgical wound fluids (SWF) composition in two groups of breast cancer patients: those patients who underwent breast-conserving surgery (BCS) followed by intraoperative radiotherapy (IORT) treatment, and those who underwent BCS only
The main aim of this study was to perform the quantitative analysis of the SWF composition in two groups of breast cancer patients: patients which undergo BCS followed by IORT treatment, and those who underwent BCS only
Summary
Breast cancer (BC) is the most common cancer in women. After lung cancer, it is the second most common cause of cancer-related death. Breast cancer surgery of the primary tumor is required to reduce the potential of cancer cells to mutate and metastasize. It has become evident that some types of immune response, or immune cells, can promote tumor progression more than others [3]. Using an in vitro model, Krall et al proved that the systemic consequences of surgery could promote the regrowth of tumor cells even at distal anatomical sites. They found out that surgery-induced tumor regrowth was associated with both local and systemic inflammatory responses characterized by the release of cytokines and the mobilization of myeloid cells into the circulation of wounded mice [7]. They found that the composition of SWF differs between patients depending on the treatment (quadrantectomy or mastectomy), type (invasive or in situ) and the molecular subtype of breast cancer (BC) (luminal or triple-negative)
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