IntroductionHistone deacetylase inhibitors (HDIs) are a group of compounds that exhibit anticancer activity, but their significance and usefulness in breast cancer (BC) treatment are still controversial. The ability of cancer cells to invade and migrate is augmented by the acquisition of a mesenchymal phenotype – a process known as epithelial-to-mesenchymal transition (EMT). Changes in the expression level of different cadherins, so-called cadherin switches, have been used to monitor the EMT process in development and tumor progression, in particular migration and invasion potential. The aim of this study was to analyze the influence of two HDIs – valproic acid (VPA) and vorinostat (SAHA) – on the migration potential of different BC cell types, as well as on EMT, or its reverse process – mesenchymal-to-epithelial transition, progression by means of shift in epithelial and mesenchymal marker expression.MethodsHDI treatment-induced expression of E- and N-cadherin at the mRNA and protein levels was evaluated by qPCR, Western blotting and immunostaining methods, respectively. BC cell proliferation and migration were assessed by BrdU, xCELLigence system and wound-healing assay.ResultsVPA and SAHA inhibited the proliferation and migration in a dose- and time-dependent manner, regardless of the BC cell type. Unawares, BC cells having a more mesenchymal phenotype (MDA-MB-468) were found to overexpress N-cadherin, whereas BC lines having an epithelial phenotype (T47D, MCF7) responded to HDI treatment by a significant increase of E-cadherin expression.DiscussionWe suggest that HDAC inhibition results in a more relaxed chromatin concomitant to an increase in the expression of already expressing genes.ConclusionBy using multiple cancer cell lines, we conclude that HDI induction or reversal of EMT is not a universal mechanism, yet inhibition of cell migration is, and thus EMT should not be considered as the only measurement for tumor aggressiveness.
Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year. Breast-conserving surgery (BCS) predominated in all but one center (range 50-70%). Immediate breast reconstructions (IBR) accounted for 6-42% of procedures, The most frequent type of IBR was either a two-stage expander followed by a permanent implant or one-stage implant- based with or without synthetic mesh. The most frequent type of delayed breast reconstruction (DBR) was a two-stage expander followed by implant-based reconstruction. None of the surveyed cancer centers performed free flap reconstruction. Deep inferior epigastric perforator (DIEP) flaps were performed in the plastic surgery department. Reconstructions based on pedicled flaps were performed in cancer centers. Acellular dermal matrices (ADM) and fat transfer were used in selected centers. In the clinical scenario of adjuvant radiotherapy, delayed breast reconstruction was favored. The full range of oncoplastic BCS was performed. Patient-reported outcome measures (PROM) and complications were assessed. Our findings can act as a platform for further improvement in skills, certification, data collection and audit, including patient reported expectation measures. There is also an urgent need to address pan-European inconsistencies in procedural reimbursement.
Around 40% of post-mastectomy women meet the requirements of general guideline recommendations of 150 minutes of moderate-intensity physical activity as a sufficient minimum for adults. However, Kyu et al. disagree with this concept in their systematic review of literature on energy expenditure, claiming it to be insufficient in breast cancer prevention. The aim of the present study is to determine which specific type of physical activity is most commonly pursued among postmastectomy women, as well as which type of exercise proves the most beneficial for those patients. One hundred and ten original papers were identified in all 4 research databases, out of which 8 were subjected to final evaluation. The exercise programs under evaluation comprised aerobic exercise (n = 4), muscle strengthening exercise (n = 2), and mixed aerobic and muscle strengthening activities (n = 2). Aerobic exercises were established as the most frequently pursued type of physical activity in post-mastectomy women. Presently, the task of credibly evaluating overall effectiveness of rehabilitation programs featuring different types of physical activities proves rather challenging, as there is still no consensus as to the actual methods of designing a set of uniformly structured evaluation tools to be applied by all investigators. StreszczenieOkoło 40% kobiet po mastektomii podejmuje wysiłek fizyczny o umiarkowanej intensywności trwający 150 minut w tygodniu. Kyu i wsp. stwierdzają w systematycznym przeglądzie literatury dotyczącym wydatku energetycznego, że normy te nie są wystarczające do zapobiegania nowotworowi piersi. Celem pracy była odpowiedź na pytanie, jaki typ aktywności fizycznej jest najczęściej stosowany przez kobiety po mastektomii oraz jaki typ treningu wydaje się przynosić najlepsze korzyści dla pacjentek. Znaleziono 110 oryginalnych prac w 4 bazach naukowych. Do ostatecznej analizy włączono 8 prac naukowych. Interwencje aktywności fizycznej u kobiet po mastektomii były wykonywane w programach aerobowych (n = 4), siłowych (n = 2) oraz mieszanych, aerobowo-siłowych (n = 2). Treningi aerobowe są najczęściej stosowaną formą aktywności fizycznej u kobiet po zakończonym leczeniu z powodu raka piersi. Brak spójnych narzędzi oceny efektywności programów zawierających różne typy aktywności fizycznej nie pozwala na jednoznaczne określenie, który z programów wydaje się najbardziej korzystny dla kobiet po zabiegach mastektomii.Medical Studies/Studia Medyczne 2018; 34/1 87 Effectiveness of specific types of structured physical activities in the rehabilitation of post-mastectomy women: a systematic review
Introduction: The article presents the results of the management of patients with breast cancer treated in the Holycross Cancer Centre during the period 2008-2012. In all the patients, invasive breast cancer clinically node negative was diagnosed and multidisciplinary treatment with sentinel node biopsy was applied. Material and methods: The study included a group of 213 women who had previously undergone surgery, breast-conserving and/or mastectomy. In 206 patients, the sentinel lymph node was identified. Due to metastasis to the sentinel lymph node in 32 patients axillary lymphadenectomy was performed and additionally in 7 patients due to the failure of sentinel lymph node identification. Due to the higher tumor burden 10 patients were subjected to more extensive surgical treatment-mastectomy. After surgical treatment the patients were qualified for adjuvant therapy. The mean time of observation of patients after treatment was 61 months. Results: Relapse of the disease was noted in 7 patients, 5 patients died (4 patients due to the spread of the disease, 1 due to the second carcinoma-gastric cancer). Recurrence in the axillary region was observed in 1 patient, metastases to the lungs-in 1 patient, metastases to the liver-in 1, metastases to the ovary-in 1, and in 3 patients metastases to the bones. Based on analysis of the Kaplan-Meier estimator of the survival function, it was found that the probability of survival for 5 years without symptoms of the disease was 96.2%, whereas the probability of overall 5-year survival was 96.4%. Conclusions: The outcome of patients after sentinel lymph node biopsy was excellent. In breast cancer patients sentinel lymph node biopsy is safe and effective.
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