Ha Sung Whan;Yang Mi Gyoung;Chung Woong Ki;Park Charn Il;Bang Yung Jue;Kim Noe Kyung;Choe Kuk Jin
Radiation Oncology Journal
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v.6
no.2
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pp.203-209
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1988
Thirty eight women with recurrent breast carcinoma involving chest wall and/or regional lymph nodes after surgery with or without systemic therapy were treated with radiation between 1979 and 1986. Among them, 5 patients were excluded from analysis because of incomplete treatment. The median follow up of survivors was 30 months (randged 1-79 months). Fifteen (45%)patients had their disease confined to the chest wall and eighteen patients had lymph node involvement as some of their locoregional recurrent disease. Within 36 months after the initial treatment, 87% of recurrences manifested themselves. All patients had radiotherapy to at least the site of involvement. In 8 patients, recurrent tumors were treated with complete excision followed by radiation. Of the remaining 25 patients,18 (72%) had complete response (CR) following radiotherapy. The actuarial 3-year survival of all patients following locoregional recurrence was 50% Three year survival was 24% in those 25 patients who had recurrences within 24 months of the initial treatment. For those 8 patients whose recurrences occurred after more than 24 month disease free interval, the 3-year survival was 100%. For those patients with recurrences confined to chest wall alone, 3-year survival was 57% The patients who had lymph node involvement as part of their locoregional recurrences had a 43% 3-year survival. The majority of them developed distant metastases. Those patients who had a CR showed 63% 3-year survival. On the other hand, 1 year survival was only 33% for those patients who had a less than CR. Three patients developed carcinoma of the contralateral breast following radiotherapy. Three year survival following locoregional recurrence was 40% for patients whose initial treatment for their primary breast carcinoma was surgery and adjuvant systemic therapy. For those patients whose primary breast carcinoma was treated by surgery alone, the 3-year survival following locoregional recurrence was 71%. In patients who had subsequent recurrence after radiotherapy, the actuarial survival was 25% at 2 years.
In breast cancer, the treatment volume presents a relatively complex three dimensional structure. Effective radiation therapy requires the delivery of adequate dose to a large target volume using complex beam arrangements. The technique proposed here is our department's method using asymmetric jaw with appropriate couch, collimator and gantry rotation. This technique has the following advantages: 1) all treatments are given in a single clinical set up 2) it does not require half beam blocks 3) it produces exact geomatric match 4) it is very convenient and easy to use 5) it has daily reproducibility.
Underwent on modified radical mastectomy(MRM) and radiation therapy, it affects increasing rates of chronic morbidity, because of including chest wall and internal mammary nodes(IMNs). It causes the high absorbed dose on heart and ipsilateral lung. Thus in this study, we compared dose distributions through utilizing the intensity modulated radiation therapy(IMRT) and the volumetric modulated arc therapy(VMAT). We selected 10 breast cancer patients at random who took MRM and radiation therapy. Treatment plannings were done by using IMRT and VMAT from each patient ranging supraclavicular lymphnodes(SCL) and IMNs. After that we analysed the planning target volume(PTV)'s conformity and absorbed doses on heart and lungs. As a results, PTV conformities were indicated the same patten(p<0.05) in both plans. In case of Lt breast cancer patients, the dose maximum regions of the heart were more lesser in VMAT technique rather than the IMRT(p<0.05). Also, the maximum dose areas of lungs were lesser in VMAT technique rather than the IMRT(p<0.05). Therefore, it would be safe to say that it is more effective way to adapt the VMAT technique than IMRT in such cases like involve IMNs in breast cancer patients.
To determine the effectiveness of radiotherapy for pain control in metastatic bone disease, we retrospectively analyzed the treatment results in 126 patients who received short-course radiotherapr(2,000 rad/1wk vs 3,000 rad/2wks) in the Department of Therapeutic Radiology, Seoul National University Hospital from Feb. 1979 to July 1983. Pain relief was obtained in $82\%$ of patients and complete Pain relief was obtained in $35.3\%$ of patients. The incidence of metastatic bone tumor was highest in spine and pelvis, $43.7\%\;and\;26.3\%$>, respectively. Primary sites of metastasia were lung, breast, unknown primary, stomach, uterine cervix, in order of frequency. There was no significant difference in the response to treatment between 2,000 rad in 1 week and 3,000 rad in 2 weeks.
Background: Male breast cancer accounts for less than 1% of all cancers found in men. It usually presents at a later age and stage as compared to female breast cancer. Treatment strategies are extrapolated from the management of female breast cancer. Our study here looked at 18 patients diagnosed with and treated for male breast cancer at The Aga Khan University Hospital in Pakistan. We compared our findings with the existing data from Asian and Western countries. Materials and Methods: A retrospective study was conducted looking at patients with male breast cancer between January 1986 and December 2009. Patient and disease characteristics were analyzed and 5 year overall survival was calculated using Microsoft Excel and SPSS. Results: The average age at diagnosis was 52 years (38-67 years). Twelve (66.7%) patients had axillary lymphadenopathy. Stage II disease was the most common stage at presentation (9 patients, 50%). Infiltrating ductal carcinoma was seen in 16 patients (88.8%). Seven lesions were positive for both estrogen and progesterone receptors. Sixteen patients had surgery in the form of either modified radical mastectomy or radical mastectomy. Radiation was used in 7 patients in an adjuvant setting. The five year overall survival for stage I, II, III and IV disease was 100% vs 78% vs 50% vs 0%( p<0.05). Five year overall survival was 61%. None of the other prognostic factors were statistically significant. Median follow up was 15 months (3-202 months). Conclusions: Male breast cancer may be on a slow rise but is still an uncommon disease. Tumor stage and lymph node status are important prognostic markers. Public awareness and screening may help in detecting the disease at an earlier stage. Prospective trials are needed to improve the management of this disease.
Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterized by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d'orange appearance. It accounts for 1-3% of all newly diagnosed cases of breast cancer in the west. Data on IBC from India are lacking. The aim of our study was to assess the clinical-pathological parameters and outcome of IBC at, All India Institute of Medical Sciences, a large tertiary care centre. Materials and Methods: We screened 3,650 breast cancer cases registered from January 2004 to December 2012 and found 41 cases of IBC. Data included demographics as well as clinical, radiological and histopathological characteristics, and were collected from clinical case records using the International Classification of Diseases code (C-50). Patients who presented with IBC as a recurrence, or who had a neglected and advanced breast cancer that simulated an IBC were excluded from this study. Results: The median age was 45 years (range 23-66). The median duration of symptoms was 5 months. The American Joint Committee on Cancer stage (AJCC) distribution was Stage III - 26 and IV - 15 patients. Estrogen receptor (ER), progesterone receptor (PR) positivity and human epidermal growth factor receptor 2 (HER2/neu) positivity were 50%, 46% and 60%, respectively. Triple negativity was found in 15% of the cases. All the non metastatic IBC patients received anthracycline and/ or taxane based chemotherapy followed by modified radical mastectomy, radiotherapy and hormonal therapy as indicated. Pathological complete remission rate was 15%. At a median follow-up of 30 months, the 3 year relapse free survival and overall survival were 30% and 40%respectively. Conclusion: IBC constituted 1.1% of all breast cancer patients at our centre. One third of these had metastatic disease at presentation. Hormone positivity and Her2 neu positivity were found in 50% and 60% of the cases, respectively.
During the last decades, research and therapeutic methods in cancer treatment have been evolving. As the results, nowadays, cancer patients are receiving several types of treatments, ranging from chemotherapy and radiation therapy to surgery and immunotherapy. In fact, most cancer patients take a combination of current anti-cancer therapies to improve the efficacy of treatment. However, current strategies still cause some side effects to patients, such as pain and depression. Therefore, there is the need to discover better ways to eradicate cancer whilst minimizing side effects. Recently, immunotherapy, particularly immune checkpoint blockade, is rising as an effective anti-cancer treatment. Unlike chemotherapy or radiation therapy, immunotherapy has few side effects and a higher tumor cell removal efficacy depend on cellular immunological mechanisms. Moreover, recent studies suggest that tissue immune responses are regulated by their microbiome composition. Each tissue has their specific microenvironment, which makes their microbiome composition different, particularly in the context of different types of cancer, such as breast, colorectal, kidney, lung, and skin. Herein, we review the current understanding of the relationship of immune responses and tissue microbiome in cancer in both animal and human studies. Moreover, we discuss the cancer-microbiome-immune axis in the context of cancer development and treatment. Finally, we speculate on strategies to control tissue microbiome alterations that may synergistically affect the immune system and impact cancer treatment outcomes.
This study aims to provide basic data to reduce the incidence of radiation dermatitis and improve patient satisfaction by investigating the management status and satisfaction level of radiation dermatitis in patients undergoing radiation therapy. From October 28, 2022, to April 4, 2023, a survey was conducted on 137 breast cancer patients who received radiation therapy at G Hospital in Busan. The Radiation Therapy Oncology Group (RTOG) cutaneous acute radiotherapy toxicity score was used as the standard for measuring skin reactions, and the association between cancer stage and RTOG was analyzed. SPSS program (ver. 18.0) was used for statistical analysis. The frequency of radiation dermatitis occurrence was relatively low, with 73% in the RTOG 0-1 group and 27% in the 2-3 group. Patient satisfaction after radiation therapy varied significantly depending on the RTOG group, with lower levels of dermatitis resulting in higher satisfaction and higher levels resulting in dissatisfaction (p=0.001). Although there was no statistically significant difference in RTOG group and skin satisfaction depending on the frequency of aloe mist use (p=0.065), the group that used it 1-2 times a day (69.3%) showed a higher satisfaction level. The perceived effects of aloe mist use were statistically significant for decreasing heat sensation (p=0.001), pain (p=0.033), itching (p=0.001), and psychological stability (p=0.027), especially in the higher RTOG groups. Additionally, as cancer stage increased, the severity of radiation dermatitis also increased, which was statistically significant (p=0.001). In conclusion, radiation dermatitis is the most common side effect of radiation therapy, and it can appear in various forms depending on individual skin sensitivity and external factors during treatment. Adequate education before treatment and the use of MD Cream and aloe vera mist are recommended to reduce the incidence and manage radiation dermatitis effectively.
Goksu, Sema Sezgin;Tastekin, Didem;Arslan, Deniz;Gunduz, Seyda;Tatli, Ali Murat;Unal, Dilek;Salim, Derya;Guler, Tunc;Coskun, Hasan Senol
Asian Pacific Journal of Cancer Prevention
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v.15
no.16
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pp.6665-6668
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2014
Introduction: Breast cancer in young women is a relatively rare disease; however it tends to be more aggressive and is the leading cause of cancer death in this population. The aim of this study is to investigate the clinical and biological features of breast cancer arising in young Turkish breast cancer patients. Materials and Methods: Patients with breast cancer aged 35 or less (${\leq}35$ years) were selected for the study. In total 211 cases were included. Pathologic features; histologic subtypes, grade, lymphovascular invasion, axillary involvement, and stage were recorded for each. Results: The most common subtype was luminal B (36.5%), followed by luminal A (30.8%), triple negative (23.2%) and HER2+(9.5%) subtypes. Twelve percent of the patients had stage 4, 32.7% had stage 3, 46.4% had stage 2, and 6.2% had stage 1 disease at the time of diagnosis. Mean tumour diameter was 3.87 cm (range 0.3-13 cm). The axillary lymph nodes were positive in 74.4% of the patients, while lympho-vascular invasion was seen in 56.4%. Some 9.5% of patients had grade 1, 51.2% had grade 2, and 31.8% had grade 3 tumors. Conclusions: Young women with breast cancer in Turkey are more likely to present with luminal B subtype. Tumors in young women are more likely to present with advanced disease, to be high grade and and to have more lymphovascular invasion. Further research should focus on whether we need new treatment strategies for young patients with breast carcinoma.
DNA double-strand break (DSB) is a serious treat for the cells including mutations, chromosome rearrangements, and even cell death if not repaired or misrepaired. Ku heterodimer regulatory DNA binding subunits (Ku70/Ku80) bound to double strand DNA breaks are able to interact with 470-kDa DNA-dependent protein kinase catalytic subunit (DNA-PKcs), and the interaction is essential for DNA-dependent protein kinase (DNA-PK) activity. The Ku80 mutants were designed to bind Ku70 but not DNA end binding activity and the peptides were treated in breast cancer cells for co-therapy strategy to see whether the targeted inhibition of DNA-dependent protein kinase (DNA-PK) activity sensitized breast cancer cells to ionizing irradiation or chemotherapy drug to develop a treatment of breast tumors by targeting proteins involved in damage-signaling pathway and/or DNA repair. We designed domains of Ku80 mutants, 26 residues of amino acids (HN-26) as a control peptide or 38 (HNI-38) residues of amino acids which contain domains of the membrane-translocation hydrophobic signal sequence and the nuclear localization sequence, but HNI-38 has additional twelve residues of peptide inhibitor region. We observed that the synthesized peptide (HNI-38) prevented DNA-PKcs from binding to Ku70/Ku80, resulting in inactivation of DNA-PK complex activity in breast cancer cells (MDA-465 and MDA-468). Consequently, the peptide treated cells exhibited poor to no DNA repair, and became highly sensitive to irradiation or chemotherapy drugs. The growth of breast cancer cells was also inhibited. These results demonstrate the possibility of synthetic peptide to apply breast cancer therapy to induce apoptosis of cancer cells.
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