Updates in the Treatment of Breast Cancer with Radiotherapy

Castañeda, Serguei A.; Strasser, Jon

doi:10.1016/j.soc.2017.01.013

Cited by 115 publications

(90 citation statements)

References 40 publications

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“…A total of 393 women who were histopathologically diagnosed with invasive breast cancer and underwent staging FDG PET/CT between February 2012 and December 2016 were screened for study enrollment. Among them, 106 patients who: (1) had no evidence of distant metastasis on staging imaging studies and underwent curative surgical resection, (2) received adjuvant 3D-CRT after curative surgical resection with/without other adjuvant treatment, and (3) underwent post-RT FDG PET/CT; thus, underwent both staging and post-RT PET/CT scans were initially enrolled in the study. Patients who (1) were found to have distant metastasis on the initial staging work-up and received palliative treatment, (2) were diagnosed with ductal carcinoma in situ, (3) had received any type of treatment before staging FDG PET/CT, (4) had received adjuvant 3D-CRT, but, did not undergo post-RT FDG PET/CT, and (5) had previous history of another malignant disease or heart disease such as coronary artery disease and heart failure were excluded.…”

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Breast conserving surgery followed by adjuvant radiotherapy (RT) is widely accepted as an essential part of breast cancer treatment [1,2]. Adjuvant RT reduces the risk of mortality by 16% and that of local recurrence by more than 50% in patients with breast cancer [1,3]. However, for patients with left breast cancer, some territory of the heart is often included in the RT field, which could result in radiation-induced damage to the myocardium and coronary artery [4,5], and previous clinical studies have reported increased risk of ischemic heart disease, myocardial infarction, and cardiac disease-related mortality in patients with left breast cancer compared to those with right breast cancer [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer

Lee

Kim

et al. 2020

JCM

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This study aimed to assess the relationship between radiation dose and changes in the irradiated myocardial F-18 fluorodeoxyglucose (FDG) uptake after radiotherapy (RT) in breast cancer patients. The data of 55 patients with left and 48 patients with right breast cancer who underwent curative surgical resection and adjuvant three-dimensional conformal RT and staging (PET1), post-adjuvant chemotherapy (PET2), post-RT (PET3), and surveillance (PET4) FDG positron emission tomography/computed tomography (PET/CT) were retrospectively reviewed. The median interval between PET1 and curative surgical resection, between the end of adjuvant chemotherapy and PET2, between the end of RT and PET3, and between the end of RT and PET4 were five days, 13 days, 132 days, and 353 days, respectively. The myocardial-to-blood pool uptake ratio was measured in all patients. For patients with left breast cancer, the 30 Gy-(30 Gy) and 47.5 Gy-irradiated myocardium-to-low-irradiated myocardium (47.5 Gy) FDG uptake ratios were additionally measured. There were no differences in the myocardial-to-blood pool uptake ratios between left and right breast cancer on all PET scans. For left breast cancer, higher 30 Gy and 47.5 Gy uptake ratios were observed on PET3 than on PET1 and PET2. Both uptake ratios decreased on PET4 compared to PET3, but, were still higher compared to PET1. On PET3 and PET4, the 47.5 Gy were higher than the 30 Gy uptake ratios, while there were no differences between them on PET1 and PET2. Although the whole myocardium FDG uptake showed no significant change, the irradiated myocardium FDG uptake significantly increased after RT and was related to radiation dose to the myocardium in breast cancer patients. These results might be an imaging evidence that supports the increased risk of heart disease after RT in patients with left breast cancer.

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Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer

Lee

Kim

et al. 2020

JCM

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“…Surgical treatment strategies are nowadays based on tumor size and lymph node status basing on current breast cancer guidelines, independently of neuroendocrine component. Likewise, radiotherapy is usually performed after BCS [10,15]. Medical therapy depends on immunohistochemical analysis: in case of strong hormone receptors positivity, hormonal therapy is usually indicated [10].…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and Clinical Management of Neuroendocrine Tumor of the Breast: Report of Six Cases and Systematic Review of Existing Literature

Bottini¹,

Luca²,

Sagona³

et al. 2020

ACO

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Introduction: Neuroendocrine neoplasm of the breast (bNENs) are considered a rare disease, even if in WHO data they represent about 2-5 % of all breast cancer. The last WHO classification includes: welldifferentiated neuroendocrine tumor (bNET), neuroendocrine carcinoma (NEC) and invasive carcinoma with neuroendocrine differentiation. The current knowledge on clinical management of bNENs is poor and patients are usually treated according to non-endocrine tumor components guidelines. Materials and Methods: We presented our experience of six cases of bNENs. Moreover, we conducted a systematic review of published data on diagnosis, treatment and outcome of this kind of tumors. Results: bNENS usually presented as palpable breast masses, classically appearing as irregular hypoechoic lesions at US examination and as hyperdense masses at mammography. Usually pre-operative tumor biopsy is not able to recognize the neuroendocrine components and the final diagnosis is performed only on definitive histopathological assessment. The most frequent subtype seems to be neuroendocrine carcinoma and synaptophysin is positive in most specimens. Treatment strategies, including surgical treatment, radiotherapy and medical treatment are nowadays based on current non-endocrine breast cancer guidelines, independently from neuroendocrine components, even if some studies have proposed the use of somatostatin analogues for bNET and cisplatin-etoposide for NEC. Prognosis of all bNENs, especially of poorly differentiated neoplasia, seems worse compared to non-neuroendocrine breast cancer and stage and morphology seem the best predictor of tumor outcome. Conclusions: We provide an algorithm for clinical management of bNETs, basing on available data. More studies are necessary for confirming the best treatment strategy for these patients, in order to improve clinical outcome

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“…Although great advances had been reached for breast cancer (BC) treatment, BC still brought huge health burden to women worldwide as the results of high frequency of metastasis and chemo-resistance, and searching for strategies to improve the therapeutic e cacy for current chemical drugs might help to cure BC in clinic [1,2]. Among all the chemotherapeutic drugs, doxorubicin (Dox) was commonly used for cancer treatment, including non-small cell lung cancer (NSCLC) [3], ovarian cancer [4], hepatocellular carcinoma (HCC) [5], BC [6][7][8], etc..…”

Section: Introductionmentioning

confidence: 99%

Blockage of AMPK-ULK1 pathway mediated autophagy promotes cell apoptosis to increase doxorubicin sensitivity in breast cancer (BC) cells: an in vitro study

Shi

Jin

et al. 2020

Preprint

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Background: Activation of autophagy flux contributed to resistance of breast cancer (BC) cells to current chemotherapeutic drugs, which seriously limited their therapeutic efficacy and facilitated BC recurrence in clinic. However, the detailed mechanisms are still not fully understood. In the present study, we identified that inactivation of AMPK-ULK1 signaling cascade mediated protective autophagy sensitized BC cells to doxorubicin in vitro. Methods: Cell counting kit-8 (CCK-8) assay and colony formation assay were performed to evaluate cell proliferation abilities. Trypan blue staining assay was used to examine cell viability, and Annexin V-FITC/PI double staining method was conducted to determine cell apoptosis. The autophagosomes in BC cells were observed and photographed by electronic microscope (EM). Western Blot analysis was employed to examine genes expressions at protein levels.Results: The parental doxorubicin-sensitive BC (DS-BC) cells were exposed to increasing concentrations of doxorubicin to establish doxorubicin-resistant BC (DR-BC) cells, and the DR-BC cells were much more resistant to high-dose doxorubicin stimulation compared to the DS-BC cells (P < 0.05). Interestingly, high-dose doxorubicin specifically increased LC3B-II/I ratio, promoted autophagosomes formation and decreased p62 expression levels to facilitate autophagy in DR-BC cells, instead of DS-BC cells (P < 0.05), and the autophagy inhibitor 3-methyladenine (3-MA) enhanced the cytotoxic effects of high-dose doxorubicin on DR-BC cells (P < 0.05). In addition, we proved that high-dose doxorubicin triggered protective autophagy in DR-BC cells by activating AMPK-ULK1 pathway. Functionally, high-dose doxorubicin increased the expression levels of phosphorylated AMPK (p-AMPK) and ULK1 (p-ULK1) to activate AMPK-ULK1 pathway in DR-BC cells (P < 0.05), and the inhibitors for AMPK (compound C) and ULK1 (SBI-0206965) blocked autophagy to promote cell death and slow down cell growth in DR-BC cells treated with high-dose doxorubicin (P < 0.05). Conclusions: Collectively, our in vitro data indicated that blockage of AMPK-ULK1 signaling cascade mediated protective autophagy might be a promising strategy to increase doxorubicin sensitivity for BC treatment.

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Updates in the Treatment of Breast Cancer with Radiotherapy

Cited by 115 publications

References 40 publications

Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer

Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer

Diagnosis and Clinical Management of Neuroendocrine Tumor of the Breast: Report of Six Cases and Systematic Review of Existing Literature

Blockage of AMPK-ULK1 pathway mediated autophagy promotes cell apoptosis to increase doxorubicin sensitivity in breast cancer (BC) cells: an in vitro study

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