[Show abstract][Hide abstract] ABSTRACT: AIMS: To evaluate the immune risk profile of elderly women with breast cancer and to assess whether this can be a reliable predictor to determine types of treatment and oncologic follow-up. METHODS: We assessed the CD4+/CD8+ ratio in peripheral blood cell, as well as serology for cytomegalovirus, of 37 women who were aged 60 years or more at the time they were diagnosed with breast cancer/. They all had surgical treatment at the Breast Center from Pontificia Universidade Catolica do Rio Grande do Sul. Those with positive serology for HIV, or immuno-suppressed due to organ transplant, as well as those who had neoadjuvant chemotherapy. Data was analyzed according to axillary involvement, tumor size, tumor immunohistochemical profile and occurrence of adverse events (axillary relapse, local relapse and/or metastases) RESULTS: The mean value of CD4+/CD8+ ratio was 1.72 (min. 1.1, max. 2.32) and cytomegalovirus serology was positive in all subjects. Comparing the groups, patients with positive axillary metastases (n=10) had a CD4+/CD8+ ratio greater than in those with negative axillary metastases (p=0.04). No statistically significant difference was detected regarding the size and immunohistochemical profile of the tumor. Two adverse events occurred at a mean follow-up of 14 months (one axillary relapse and one bone metastasis), when an increase in the CD4+/CD8+ ratio was observed. CONCLUSIONS: The CD4+/CD8+ ratio appear to increase in cases of breast cancer with worst prognosis. As far as was possible to search, these are the first data on CD4+ and CD8+ peripheral blood of elderly women with breast cancer. A longer follow-up will determine the value of these cells as a prognostic and/or predictive marker.
[Show abstract][Hide abstract] ABSTRACT: Radiotherapy following breast cancer conserving surgery decreases the risks of local recurrence. Because 85% of breast cancers relapse in or around the surgical bed there has been some debate on the need for irradiating the whole breast. Electron intraoperative radiotherapy (ELIOT) has been used as a viable alternative for conventional external radiotherapy (RT). While the former requires a single dose of 21 Gy in the tumoral bed, the latter requires 5-6 weeks of irradiation with a total dose of 50 Gy and a boost of 10 Gy that irradiates the surgical bed. Herein, we investigated whether any significant differences exist between the mammography findings obtained from patients submitted to one of the two techniques. Two groups of 30 patients each were included in this study. All patients had mammographies taken at 12 and 24 months after finishing treatment. The mammography findings evaluated were: cutaneous thickening (>2mm), architectural distortion secondary to fibrosis, edema, calcifications (both benign and malignant), and fat necrosis. For all variables studied, there was no statistical difference between the two groups. This indicates that the mammography findings obtained in either 12- or 24-month follow-up periods after breast cancer conserving surgery are similar, regardless of which of the two radiotherapy techniques (ELIOT or RT) is employed as a treatment for breast cancer.
No preview · Article · May 2010 · European journal of radiology
[Show abstract][Hide abstract] ABSTRACT: HspBP1 is a co-chaperone that binds to and regulates the chaperone Hsp70 (Hsp70 is used to refer to HSPA1A and HSPA1B). Hsp70 is known to be elevated in breast tumor tissue, therefore the purpose of these studies was to quantify the expression of HspBP1 in primary breast tumors and in serum of these patients with a follow-up analysis after 6 to 7 years. Levels of HspBP1, Hsp70, and anti-HspBP1 antibodies in sera of breast cancer patients and healthy individuals were measured by enzyme-linked immunosorbent assay. Expression of HspBP1 was quantified from biopsies of tumor and normal breast tissue by Western blot analysis. The data obtained were analyzed for association with tumor aggressiveness markers and with patient outcome. The levels of HspBP1 and Hsp70 were significantly higher in sera of patients compared to sera of healthy individuals. HspBP1 antibodies did not differ significantly between groups. HspBP1 levels were significantly higher in tumor (14.46 ng/microg protein, n = 51) compared to normal adjacent tissue (3.17 ng/microg protein, n = 41, p < 0.001). Expression of HspBP1 was significantly lower in patients with lymph node metastasis and positive for estrogen receptors. HspBP1 levels were also significantly lower in patients with a higher incidence of metastasis and death following a 6 to 7-year follow-up. The HspBP1/Hsp70 molar ratio was not associated with the prognostic markers analyzed. Our results indicate that low HspBP1 expression could be a candidate tumor aggressiveness marker.
Full-text · Article · Dec 2008 · Cell Stress and Chaperones
[Show abstract][Hide abstract] ABSTRACT: Intraoperative radiotherapy with a single dose of electrons (ELIOT) in the conservative treatment of breast cancer is a possibility under evaluation in clinical trials. The costs of the mobile linear accelerator with a robotic arm, used in intraoperative radiotherapy, are prohibitive for poor countries. The aim of this study was to evaluate the feasibility of ELIOT in the accelerator room of the Radiotherapy Service for early breast cancer treatment. We analyzed 40 patients submitted to breast conservative surgery and ELIOT, in the accelerator room of the Radiotherapy Service at the Hospital of Pontificia Universidade Católica do Rio Grande do Sul in Brazil from January 2004 to July 2005. Patients with unifocal breast carcinoma smaller than 25 mm, aged over 45 years, who were candidates for conservative surgery were selected and a total dose of 21Gy was delivered, without further radiotherapy. In the short-term follow-up (median 18 months), six patients (15%) presented with some grade of fibrosis under the scar. One case (2.5%) of local recurrence was reported. There are no cases of contralateral carcinoma or distant metastases so far. Our data show that intraoperative radiotherapy with electrons can be safely performed in an accelerator room with a conventional machine.
No preview · Article · Oct 2007 · Journal of experimental & clinical cancer research: CR
[Show abstract][Hide abstract] ABSTRACT: Heat shock protein (Hsp)-peptide complexes purified from tumors can prime the immune system against tumor antigens, but how they contribute to the generation of immune responses against naturally occurring tumors is unknown. Murine tumors expressing high amounts of Hsp70 are preferentially rejected by the immune system, suggesting that low Hsp70 expression is advantageous for tumor growth in the host. To determine whether Hsp70 was differentially expressed in human tumors, inducible Hsp70 expression was quantitatively (by Western blot) and qualitatively (by immunohistology) analyzed in 53 biopsies of tumor and normal breast tissue. The mean expression of inducible Hsp70 was significantly higher in tumor compared with normal tissue (U = 899.0; P = 0.0033). However, a significant negative association of the amount of Hsp70 expressed by tumor tissue was found with metastasis (r = -0.309; P = 0.05). After 3 years, follow-up analysis determined that 7 of the 53 patients relapsed, and 5 died. Hsp70 expression in tumor (but not normal) cells was significantly lower in relapse patients and patients with metastatic disease than in patients with no relapse or metastasis. Together, these observations support the hypothesis that Hsp70 plays a role in tumor expansion in vivo, and tumors that downregulate it may be able to evade immunosurveillance and grow.
Full-text · Article · Feb 2006 · Cell Stress and Chaperones
[Show abstract][Hide abstract] ABSTRACT: Axillary lymphadenectomy is a very important procedure in the staging of breast cancer patients. However, it is associated with a significant morbidity rate. On the other hand, using early diagnosis we can see a high number of cases where the lymph nodes are negatives. With the intention of avoiding unnecessary axillary dissection, the possibility of evaluating a single node has been studied. This lymph node, defined as "sentinel node", would be the first to receive tumoral lymphatic drainage. The aim of this study is to evaluate: (i) the efficacy of the methods to identify the sentinel nodes, (ii) estimate the predictability of the histological examination of the sentinel node in comparison to other nodes of the axilla, (iii) compare the efficacy of the frozen section regarding the definitive histological examination of the same node. This study was performed in 29 patients, and the sentinel node was identified in all of them. It was metastatic in 7 (24.1%). Out of the 22 patients where the node was negative, 15 were submitted to complete dissection. Out of these 15, there was one case (6.7%) where one lymph node of the first level was positive. All 7 patients with the positive sentinel node were submitted to axillary dissection. When comparing the histological examination of the sentinel node with other nodes, we got a sensitivity of 87.5%, specificity of 100%, predictive positive value of 100%, predictive negative value of 93% and efficacy of 95%. The intra-operative examination was made in 24/29 cases (82.7%). The correlation between both examinations was 95.8%. This study shows that the technique of the sentinel node will be a reliable method to avoid radical axillary dissection in breast cancer patients with early diagnosis.
No preview · Article · Jul 2002 · Journal of experimental & clinical cancer research: CR