Comprehensive Treatment Of Breast Cancer Research Articles

The Accessible Clinical Application Progress of Supine Fixation Technique in Radiotherapy After Breast Conserving Surgery for Early Breast Cancer in China

Radiation therapy (radiotherapy) is one of the important methods for comprehensive treatment of breast cancer. Radiotherapy after breast conserving surgery for early breast cancer can not only achieve local control rate and long-term survival rate similar to total mastectomy, but also meet patients' pursuit of higher quality of life. With the development of intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), helical tomotherapy (HT), and other advanced radiotherapy technique, the consistency of patient position fixation during radiotherapy is the key to ensure the implementation of accurate radiotherapy. Due to the special and high activity of breast organs, there is no unified fixation method for breast conserving postoperative radiotherapy. This article reviews the clinical application and research progress of various accessible supine fixation techniques in early breast cancer postoperative radiotherapy in recent years. This paper analyzes the clinical application method and clinical application effect of various techniques, compares the advantages and disadvantages of each technology. It is found that breast bracket is the most widely used for classical breast cancer radiotherapy. In any fixation technique, it is still a practical problem for the clinic to solve the problem of the normal location of the breast activity and the consistency of the radiation. It is recommended that the position of the supposition fixation technique should be selected according to the patient's BMI, breast size and target area.

Psychological problems in breast cancer patients should be taken seriously

With the transformation of the biopsychosocial medical model, psychological problems and related interventions for breast cancer patients have received more and more attention. Patients often have various psychological problems, in diagnosis, treatment, and even in the state of disease-free survival, such as anxiety and depression, which not only seriously reduces the quality of life, but also affects the follow-up treatment and increases the risk of recurrence and metastasis. Therefore, physicians should perform routine psychological screening and appropriate intervention for patients. In recent years, psychological intervention has gradually become an important part of comprehensive breast cancer treatment, in which cognitive behavior therapy can alleviate patients' anxiety and sleep disorders, mindfulness therapy can treat patients' anxiety, depression and fear of cancer recurrence, and psychoeducational support is mainly used to address patients' mood disorders and sexual dysfunction. Improving patients' compliance with treatment and quality of life is the main goal of psychological intervention for breast cancer patients.

Clinical implications and immune implications features of TARS1 in breast cancer.

There has been an increase in the number of women suffering from breast cancer in recent years, and discovering new therapeutic targets and efficacy predictive markers is critical for comprehensive breast cancer treatment. First, we used bioinformatics methods to analyze TARS1(encoding cytoplasmicthreonyl-tRNA synthetase) expression, prognosis, and clinicopathological characteristics in TCGA database breast cancers, and then we collected breast cancer specimens from our center for validation. TARS1 was then subjected to GSEA (Gene Set Enrichment Analysis) enrichment analysis, GO/KEGG pathway enrichment analysis, and breast cancer immune infiltration characterization. As a last step, we examined TARS1's effects on breast cancer cell behavior with cellular assays. The overexpression of TARS1 has been found in several malignant tumors, including breast cancer, and has been linked to poor prognoses. Breast cancers with large primary tumors and negative hormone receptors are more likely to overexpress TARS1. Overexpression of TARS1 promotes the infiltration of T cells, such as Tregs and Th2s, while inhibiting the infiltration of NK cells and CD8+ T cells, which are anticancer cells in breast cancer. TARS1 was also found to be co-expressed with the majority of immune checkpoint-related genes, and breast cancer with TARS1 overexpression responded better to immunotherapy. By knocking down TARS1, breast cancer cells were prevented from proliferating and invading, as well as exhibiting other malignant biological properties. According to our study, TARS1 may be an oncogene in breast cancer and may be a biomarker of efficacy or a target of immunotherapy in breast cancer.

Lung cancer with breast metastasis: a case report and review of the literature.

In this article, we present a rare case of breast metastasis of lung cancer. Chest computed tomography (CT) for a woman in her early 50s indicated right lung malignancy, multiple bone metastases, and an irregular mass in her right breast. Further inquiry into the case history revealed that the patient had been aware of the breast mass for 3 years, without respiratory symptoms. Biopsy of the breast mass suggested estrogen receptor (ER) (+), progesterone receptor (PR) (-), and human epidermal growth factor receptor 2 (HER2) (+ +) breast cancer. The patient was initially diagnosed with breast cancer with lung and bone metastasis. However, comprehensive breast cancer treatment was ineffective, and thyroid transcription factor-1 (TTF-1), napsin A, and cytokeratin 7 (CK7) were evaluated to better understand the origin of the cancer. To the best of our knowledge, this patient had the longest reported disease course from presentation with a breast lump as the first symptom to the final diagnosis of breast metastasis of lung cancer. To provide a better reference for differential diagnosis of ambiguous tumors, we also performed a systematic literature review.

Changes in pulmonary function in patients with breast cancer before and after radiation therapy

Background: The respiratory system is negatively affected by radiation exposure during the comprehensive treatment of breast cancer (BC), which has an effect on the treatment effectiveness and patients’ quality of life.Objective: To evaluate changes in pulmonary ventilation and diffusion characteristics and ventilation effectiveness in patients with BC before and after radiation therapy (RT).Methods: Our prospective cohort study included 232 women with BC admitted to the Meshalkin National Medical Research Center for an adjuvant RT after surgical treatment. Before and after the RT we conducted pulmonary function tests: body plethysmography, lung diffusion capacity testing, and cardiopulmonary exercise testing with measurement of peak oxygen consumption. We used multivariate regression analysis to determine predictors of pulmonary function decline during RT (decrease in the lung diffusion capacity > 5% compared with baseline).Results: Pulmonary function tests prior to RT demonstrated that 15% of the patients with BC had pulmonary ventilation disorders, and 25% of the patients had pulmonary gas exchange abnormalities (most of them were newly diagnosed). In the general group following RT, we saw a significant decrease in the lung diffusion capacity (P = .044) and an increased incidence of obstructive breathing patterns among the examined patients (P = .036). Other pulmonary ventilation parameters, its effectiveness, and reserve capacity of the respiratory system after RT did not change significantly in the study group and corresponded to the reference values. The postradiation pulmonary function was negatively affected by the reduced level of pulmonary diffusion capacity at baseline (≤ 70% of the reference value) [OR 1.15 (1.03-1.34), P = .004], abnormal breathing pattern prior to RT [OR 1.08 (1.01-1.15), P = .029], involvement of regional lymph nodes (N1-3) [OR 1.10 (1.04-1.26), P = .003].Conclusion: Early postradiation respiratory disorders in patients with BC are marked by a decrease in the lung diffusion capacity and an increased incidence of obstructive patterns of pulmonary ventilation. The factors negatively affecting changes in pulmonary ventilation and diffusion characteristics after RT were the baseline pulmonary gas exchange disorders, obstructive breathing pattern prior to RT, and radiation exposure to lymph nodes. Received 28 December 2022. Revised 26 May 2023. Accepted 30 May 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: O.V. Kamenskaya, V.V. Lomivorotov Data collection and analysis: S.S. Porotnikova, E.A. Samoilova, V.G. Tihomirov Statistical analysis: I.Yu. Loginova, A.S. Klinkova Drafting the article: I.Yu. Loginova, O.V. Kamenskaya Critical revision of the article: S.E. Krasilnikov, A.M. Chernyavskiy Final approval of the version to be published: O.V. Kamenskaya, I.Yu. Loginova, A.S. Klinkova, S.S. Porotnikova, E.A. Samoilova, V.G. Tihomirov, S.E. Krasilnikov, V.V. Lomivorotov, A.M. Chernyavskiy

Impact of Medicaid Expansion on Breast Cancer Diagnosis and Treatment in Southern States.

Medicaid expansion impacted patients when assessed at a national level. However, of the 32 states that expanded Medicaid, only three were Southern states. Whether results apply to Southern states that share similar geopolitical perspectives remains elusive. We aimed to assess the impact of Medicaid expansion on breast cancer diagnosis and treatment in 8 Southern states in the US. We identified uninsured or Medicaid patients (age 40 to 64 years) diagnosed with invasive breast cancer from 2011 to 2018 in Southern states from the North American Association of Central Cancer Registries-Cancer in North America Research Dataset. Medicaid-expanded states ([MES], Louisiana, Kentucky, Arkansas) were compared with non-MES ([NMES], Tennessee, Alabama, Mississippi, Texas, Oklahoma) using multivariate logistic regression and differences-in-differences analyses during pre- and postexpansion periods; p < 0.05 was considered statistically significant. Among 21,974 patients, patients in MES had increased odds of Medicaid insurance by 43% (odds ratio 1.43, p < 0.01) and decreased odds of distant-stage disease by 7% (odds ratio 0.93, p = 0.03). After Medicaid expansion, Medicaid patients increased by 10.6% in MES (Arkansas, Kentucky), in contrast to a 1.3% decrease in NMES (differences-in-differences 11.9%, p < 0. 0001, adjusting for age, race/ethnicity, rural-urban status, and poverty status). MES (Arkansas, Kentucky) had 2.3% fewer patients diagnosed with distant-stage disease compared with a 0.5% increase in NMES (differences-in-differences 2.8%, p = 0.01, after adjustment). Patients diagnosed in MES had higher odds of receiving treatment (odds ratio 2.27, p = 0.03). Unlike NMES, MES experienced increased Medicaid insured, increased treatment, and decreased distant-stage disease at diagnosis. Medicaid expansion in the South leads to earlier and more comprehensive treatment of breast cancer.

Research Status of Systemic Adjuvant Therapy for Early Breast Cancer.

Breast cancer has surpassed lung cancer as the most common cause of cancer deaths, worldwide. Early breast cancers are treatment sensitive and patients under standardized treatment have prolonged. Breast cancer treatment has significantly evolved from the conventional surgical approach and radiotherapy to local and systemic adjuvant therapies. Though localized breast cancers are clinically manageable, distant recurrence is a cause of morbid concern. Adjuvant systemic therapy is effective in both distant and local recurrences and hence gained significant attention. Early breast cancer prognosis has greatly improved in the past 3 decades with reduced mortality rates due to the widespread use of adjuvant therapy. It can markedly increase the cure rate of breast cancers, and postoperative adjuvant therapy became a part of comprehensive breast cancer treatment. Further research to understand the early breast cancer characteristics could expand the treatment modalities that can improve the outcomes and survival benefits of breast cancer patients.

Microsurgical Breast Reconstruction: Maximizing Success.

Breast reconstruction is becoming increasingly recognized as a fundamental component in comprehensive breast cancer treatment. The primary goal for any reconstruction is to safely restore a natural appearing breast. When it comes to achieving the elements of size, shape, symmetry, and softness, the use of autologous tissue has many advantages. The approach to autologous breast reconstruction has changed substantially over the years as microsurgical free tissue transplants become more routine and accessible. While a variety of flap donor sites exist, careful flap selection based on surgical history and the availability of donor tissue is critical in achieving reliable results. This article reviews the clinical considerations in patient evaluation, donor site selection, and surgical approach taken at the Buncke Clinic.

Experience of the usage intraoperative radiation therapy in patients with early breast cancer

Background. Comprehensive treatment of breast cancer includes surgery, radiation therapy and systemic treatment. Radiation therapy plays an integral role in the treatment of early breast cancer. The appointment of a targeted dose of radiation to the bed of the primary tumor reduces the risk of local recurrence.Objective: to evaluate the effectiveness of intraoperative radiation therapy in the treatment of early breast cancer.Materials and methods. A retrospective study was conducted on the basis of the St. Petersburg City Clinical Oncology Center. Patients with organ-preserving surgery and intraoperative radiation therapy were selected. Of the 352 patients, 273 patients met the inclusion/non-inclusion criteria. Inclusion criteria were verified breast cancer, clinical stage I–IIA, tumor size no more than 3 cm, absence of visible axillary lymph nodes and monocentric nature of tumor growth. All patients underwent sectoral resection of the mammary gland with a biopsy of the sentinel lymph nodes and intraoperative radiation therapy.Results. The mean age of the patients was 59 years. For 273 patients, the median follow-up was 59.1 months. During this period, 18 (6.6 %) local recurrences of the disease were noted, of which 7 (39 %) patients with luminal A, 6 (33 %) patients with luminal B, 1 (6 %) patient with luminal B HER2/neu 3+, and 4 (22 %) patients with triple negative breast cancer. Within 3 years of follow-up, recurrence-free survival was 98.5 %, within 5 years – 96.4 %.Conclusion. The use of intraoperative radiation therapy for early breast cancer is an effective and safe treatment method.

CD146 interaction with integrin β1 activates LATS1-YAP signaling and induces radiation-resistance in breast cancer cells

Radiotherapy is an indispensable modality in comprehensive treatment of breast cancer. However, inherent or acquired radiation resistance of tumors compromises the efficacy of radiotherapy. Herein, we found that CD146, a unique epithelial-to-mesenchymal transition (EMT) inducer particularly highly expressed in triple-negative breast cancer (TNBC), is dramatically induced by ionizing irradiation. Further study demonstrates that CD146 promotes tumor cell radioresistance in vitro and in vivo. Specifically, we report the underlying mechanism that CD146 activates YAP protein, and drives its relocation from plasma to nucleus by regulating LATS1, and promoting abnormal DNA damage repair, as well as inducing EMT and stemness. Moreover, CD146 can form a novel co-receptor complex with integrin β1 and induces radiation-resistance in breast cancer. Dual inhibition of CD146 and integrin β1 activity had a stronger inhibitory effect on breast cancer tumor growth and synergistically increased their sensitivity to radiotherapy. This study identifies a unique function of CD146 implicates with integrin β1 and YAP signaling, contributing to radiation resistance. Targeted therapy against CD146 or inhibition of integrin β1 is a potential strategy to overcome radiotherapeutic resistance of breast cancer.

A narrative review of five multigenetic assays in breast cancer.

Background and ObjectiveBreast cancer is a highly heterogeneous disease. Its incidence rate is increasing year by year and the mortality rate is the highest in female malignant tumors. Even patients with the same clinical stage and pathological grade have different response to treatment and postoperative recurrence risk. Although the prognosis of breast cancer in China has been gradually improved, there is still a certain gap compared with the 5-year survival rate as high as 89% in developed countries. In recent years, with the continuous enrichment of molecular sequencing data of breast cancer, gene detection technology has important reference value in prognosis judgement and guiding treatment of early breast cancer. This article reviews the current application and latest progress of genetic tests in comprehensive treatment for breast cancer, with a view to promote the precise treatment of breast cancer in clinical practice.MethodsWe conducted searches using the MeSH terms ‘breast neoplasms’ and ‘genetic testing’ in the PubMed databases from root to 22 January 2021. We conducted an additional search in the National Comprehensive Cancer Network (NCCN) and American Society of Clinical Oncology (ASCO) guidelines to obtain additional information. The search was limited to English, Dutch, French and German articles and research involving humans. Out of the references screened, 51 articles were found eligible for inclusion finally.Key Content and FindingsThe article reviews the mechanisms and clinical trials of five genetic tests including Oncotype Dx, Mammaprint, Endopredict, mRNA expression of 50 genes (PAM50) and breast cancer index (BCI) in comprehensive treatment for breast cancer. All these tools have been proved to have prognosis value, but only two of them, Oncotype Dx and Mammaprint, are recommended as predictive tools for chemotherapy by National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO).ConclusionsIn order to promote the comprehensive treatment of breast cancer to “precision” and “individualization” for further development, people have extensively researched on multigene testing technology represented by Oncotype Dx, Mammaprint, Endopredict and mRNA expression of 50 genes (PAM50) and breast cancer index (BCI). Each of these five tools has its advantages and limitation, which must be weighed in a wise application.

Abstract P3-12-17: Breast cancer treatment related survival gains in the African breast cancer - Disparities in outcomes study

Abstract Background: Breast cancer (BC) survival in Low and Middle Income Countries (LMICs), and particularly Sub Saharan Africa (SSA), is low and incidence rates are increasing. Accordingly, an almost 90% increase in annual BC mortality is projected to occur until 2040. The WHO Breast Cancer Global Initiative named comprehensive breast cancer treatment as one of three main pillars to reduce BC mortality. Here, we present the urgently needed up-to-date benchmark estimates of treatment effects on BC survival in SSA using data from the African Breast Cancer Disparities in Outcomes (ABC-DO) study.Methods: Since 2014 the hospital-recruited ABC-DO cohort follows-up women diagnosed with BC in five SSA countries. Socio-demographic, diagnostic, treatment and mortality data were obtained from medical records and via three-monthly follow-up calls with the patient. Cox proportional hazard models were fitted to estimate 5-year overall survival related to treatment initiation (surgery or systemic therapy) and treatment completion as time varying variates (surgery and systemic therapy completed) stratified by country and ethnicity and separate for localised and regional tumours. All models were adjusted for age, tumour grade, tumour size, node positivity, HIV status, and socioeconomic status. Results: Of 1699 ABC-DO women with invasive non-metastatic BC, 89% initiated BC treatment (from 72% in Nigeria to 100% in South African white women). Potentially curative treatment (surgery plus systemic therapy) was initiated by 63%, 22% initiated systemic treatment and 5 % only surgery. Initiated systemic therapy was completed by 49% of patients (from 16% in Nigeria to 70 % in South African black women). Median time to first treatment was 1.4 (IQR: 0.8–3) months and differed between countries (from 1.1 (0.6–1.7) in Namibian non-black to 3 (1.5–4.3) in Uganda). After 5 years, 49% (0.44 (CI: 0.31 – 0.62) ) of women initiating any treatment and 59% (0.39 (0.27 – 0.56) of women receiving surgery and initiating systemic treatment were still alive compared to 20% of women receiving no treatment. Conclusion: Timely and comprehensive BC treatment are needed to increase the very low survival rates in SSA. Citation Format: Milena Foerster, Eva Kantelhardt, MD, Pauline Boucheron, Isabel dos-Santos-Silva, PhD, Valerie McCormack, the ABC-DO study team. Breast cancer treatment related survival gains in the African breast cancer - Disparities in outcomes study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-17.

Photographic image processing to predict radiation dermatitis in breast cancer patients using machine learning algorithms

Radiation therapy is an essential part of the comprehensive breast cancer treatment strategy, and radiation dermatitis is the inevitable side-effect. According to either patient-related or treatment-related factors, patients will experience different degrees of acute radiation dermatitis. This study proposes a machine learning architecture based on image and time series features. Using the skin image of the irradiated part during radiotherapy, the image feature is extracted with a gray-level co-occurrence matrix (GLCM) and color space, combined with the time series feature with gradient boosting decision trees (GBDT) to predict the severity of dermatitis after seven days of treatment. The results show that, through the combination of image and time series features, the predicted accuracy (ACC) and area under the curve (AUC) can be effectively improved to 0.8 and 0.85 respectively. The results of GBDT show higher prediction accuracy and robustness than AdaBoost algorithm. This framework can be used as an auxiliary diagnostic tool to assist doctors in making appropriate treatments before severe dermatitis occurs, in order to reduce the radiotoxicity caused by radiotherapy of patients.

Depression and survival of breast cancer patients: A protocol for systematic review and meta-analysis.

Background:Breast cancer is the most common malignancy in women worldwide. Compared with other malignant tumors, breast cancer patients have a higher incidence of depression and other psychiatric symptoms. The purpose of this meta-analysis was to determine the association between long-term survival and depression in patients with breast cancer.Methods:This review will include cohort studies only. Multiple databases will be searched by 2 independent reviewers, including PubMed, EMBASE, the Cochrane Library, and PsycINFO. The language of studies should be English and Chinese, published from inception to the September 2020. Two independent reviewers will carry out literature screening, research selection and data extraction. Revman5.3 software will be used to generate funnel map, assess heterogeneity, make the subgroup analysis and complete sensitivity analysis.Results:This review will summarize the available evidence to determine the association between depression and survival in breast cancer patients.Conclusion:The results of this study will provide reference for the development of comprehensive treatment for breast cancer, and will promote further research.PROSPERO registration number:CRD42020202200

Newly Synthesized Imino-Derivatives Analogues of Resveratrol Exert Inhibitory Effects in Breast Tumor Cells

Breast cancer represents the most frequently diagnosed malignancy in women worldwide. Various therapeutics are currently used in order to halt the progression of breast tumor, even though certain side effects may limit the beneficial effects. In recent years, many efforts have been addressed to the usefulness of natural compounds as anticancer agents due to their low toxicity. Resveratrol, a stilbene found in grapes, berries, peanuts and soybeans, has raised a notable interest for its antioxidant, anti-inflammatory, and antitumor properties. Here, we report the design, the synthesis and the characterization of the anticancer activity of a small series of imino N-aryl-substituted compounds that are analogues of resveratrol. In particular, the most active compound, named 3, exhibited anti-tumor activity in diverse types of breast cancer cells through the inhibition of the human topoisomerase II and the induction of apoptotic cell death. Therefore, the abovementioned compound maybe considered as a promising agent in more comprehensive treatments of breast cancer.

Association between αβ and γδ T-cell subsets and clinicopathological characteristics in patients with breast cancer.

The aim of the present study was to discuss the effect of surgery on the T-lymphocyte subsets of patients with breast cancer (BC) and investigate the association between peripheral blood αβ and γδ T-cell counts and the clinicopathological characteristics of BC. The CD3+, CD4+, CD8+ and γδ T-cell subsets in the peripheral blood of healthy volunteers and Patients with BC before and after surgery were determined using flow cytometry. The association between αβ and γδ T-cell counts in the peripheral blood and clinicopathological characteristics was analyzed by comparing the differences in the αβ and γδ T-cell counts in the peripheral blood of Patients with BC before and after surgery with those of healthy volunteers and combining with clinicopathological data. The CD3+, CD4+ and γδ T-cell counts in the peripheral blood of Patients with BC were lower compared with those in healthy volunteers (P=0.0077, 0.0116 and 0.0003, respectively), whereas the number of CD8+ cells was higher (P=0.0241). The CD3+, CD4+ and γδ T-cell counts and the CD4+/CD8+ ratio after surgery were significantly higher compared with those before surgery (P=0.0109, 0.0031, 0.0165 and 0.018, respectively). There was no significant difference between the number of CD8+ cells before and after surgery (P=0.0053), but the number of CD8+ cells was higher in healthy volunteers compared with that in Patients with BC (P<0.05). Moreover, the CD3+ cell number was higher in patients with TNM stage II/III compared with those with TNM stage I disease (P=0.187 and 0.022, respectively), and the peripheral blood CD4+/CD8+ ratio and number of γδ T cells were lower in stage III compared with stage I Patients with BC (P=0.0065 and 0.0176, respectively). Histological grading demonstrated that the CD4+/CD8+ ratio and number of γδ T cells in patients with stage III BC were lower compared with those with stage I BC (P=0.02 and 0.0128, respectively). The γδ T-cell count in patients with luminal A and B subtypes was significantly higher compared with that in patients with basal-like subtype (P=0.004 and 0.0104, respectively). The CD3+, CD4+ and γδ T-cell counts were significantly lower in patients with lymph node (LN) metastasis compared with those without LN metastasis, and the CD8+ cell number was lower in patients without LN metastasis compared with that in patients with >10 LN metastases (P=0.0086, 0.0000 and 0.00468, respectively). The CD8+ cell count in patients without LN metastasis was lower compared with that in patients with 4–9 and >10 LN metastases (P=0.0435 and 0.0283, respectively). Surgery affects the T-lymphocyte subpopulations in patients with BC, and αβ and γδ T-cell counts may increase following mastectomy. Therefore, measurement of peripheral blood lymphocyte subsets is crucial for understanding the immune function status of Patients with BC with differences in TNM stage, histological grade, cell subtypes and LN metastases, and may provide a basis for the application of T-cell subsets in the comprehensive treatment of BC.

Brachytherapy in comprehensive treatment of breast cancer

Purpose. Based on the data analysis to define the role and function of brachytherapy in comprehensive treatment of breast cancer, indications and contraindications to brachytherapy, appropriate ways of effectiveness planning and control.&#x0D; Materials and methods. The following scientometric databases were used: Google Scholar, Russian Science Citation Index (RSCI), Index Copernicus (IC), Bibliometrics of Ukrainian Science («Бібліометрика української науки»), Scholarometer, Microsoft Academic Search). The search was restricted to the studies published within the 1983-2020 time­frame.&#x0D; Results. The analysis of irradiated volume study EORTC (unpublished data indicate a real decrease in the amount of irradiation 3 times in pa­tients who received intra-tissue boost compared with those who used a remote boost). Despite the reduction of exposure, the incidence of local recurrence is not increased.&#x0D; Conclusions. The brachytherapy method makes it possible to reduce ra­diation exposure to surrounding tissues and to increase the total focal dose on the tumor mass. Along with that, following the results of observing lo­cal recurrence frequency and cosmetic effect, the effectiveness of internal tissue exposure in comprehensive treatment at early stages of breast can­cer has been proved.

Breast Cancer

Breast cancer is the most common malignancy in women in the Western world. Its prevalence and public health impact are increasing in developing countries, and breast cancer leads to the death of hundreds of thousands of women worldwide annually. In the United States, surgeons are involved in the treatment of most women with breast cancer and surgical care must be coordinated with other components of comprehensive breast cancer treatment. This review covers breast evaluation and management of findings suspicious for cancer, management of clinical or screening-detected findings, management of breast cancer, noninvasive cancer (carcinoma in situ), invasive breast cancer, special circumstances, and follow-up after breast cancer treatment. This review contains 9 figures, 41 tables, and 106 references. Key words: Breast cancer, ductal carcinoma in situ, lobular carcinoma in situ, chemotherapy, hormone receptor-positive, HER2/neu, breast-conserving therapy, reconstruction, mastectomy, adjuvant therapy, radiation therapy

Morphine Promotes the Angiogenesis of Postoperative Recurrent Tumors and Metastasis of Dormant Breast Cancer Cells

Background: Surgery plays a significant role in the comprehensive treatment of breast cancer, and opioids are often the first-choice analgesics in the perioperative period. However, recent studies showed that opioids may enhance the angiogenesis of breast cancer and the recurrence and metastasis of tumor cells. Objectives: We aim to investigate the influence of opioids on recurrence and metastasis of breast cancer in nude mice. Methods: Forty female nude mice with breast tumor were randomly divided into 4 groups (n = 10). They were treated with (i) normal saline (10 mL/kg), (ii) morphine (10 mg/kg), (iii) morphine plus naloxone (10 + 4 mg/kg), and (iv) naloxone (4 mg/kg) for 2 weeks. Four groups of MDA-MB-231 cells were administered (i) Dulbecco’s Modified Eagle’s Medium, (ii) morphine (10 μmol/mL), (iii) morphine plus naloxone (10 + 10 μmol/mL), and (iv) naloxone (10 μmol/mL). The influence of morphine in each treated group was evaluated by immunocytochemistry and Western blotting. Results: Mice in the morphine group had higher rates of Ki67-positive cells, lower rates of apoptotic index, and a significant increase in the microvessels density of the tumor as evidenced by CD31 staining (p < 0.05). Furthermore, the MDA-MB-231 cells in the morphine group showed an increase in p-Akt, c-Myc, and thrombosponin-1 expression. Conclusion: In the current study, we found that morphine promotes the angiogenesis of the recurrent postoperative tumors of nude mice with breast cancer and the proliferation of tumor cells and such promotion may be related to the PI3K-c-Myc signaling pathway.

SNP mutation-related genes in breast cancer for monitoring and prognosis of patients: A study based on the TCGA database.

Advances in cancer biology have allowed early diagnosis and more comprehensive treatment of breast cancer (BC). However, it remains the most common cause of cancer death in women worldwide because of its strong invasiveness and metastasis. In‐depth study of the molecular pathogenesis of BC and of relevant prognostic markers would improve the quality of life and prognosis of patients. In this study, bioinformatics analysis of SNP‐related data from BC patients provided in the TCGA database revealed that six mutant genes (NCOR1, GATA3, CDH1, ATM, AKT1, and PTEN) were significantly associated with the corresponding expression levels of the proteins. The proteins were involved in multiple pathways related to the development of cancer, including the PI3K‐Akt signaling pathway, pertinent microRNAs, and the MAPK signaling pathway. In addition, overall survival and recurrence‐free survival analysis revealed the close associations of the expression of GATA3, NCOR1, CDH1, and ATM with survival of BC patients. Therefore, detecting these gene mutations and exploring their corresponding expression could be valuable in predicting the prognosis of patients. The results of the high‐throughput data mining provide important fundamental bioinformatics information and a relevant theoretical basis for further exploring the molecular pathogenesis of BC and assessing the prognosis of patients.