scholarly journals The Composition of Surgical Wound Fluids from Breast Cancer Patients is Affected by Intraoperative Radiotherapy Treatment and Depends on the Molecular Subtype of Breast Cancer

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 11 ◽  
Author(s):  
Katarzyna Kulcenty ◽  
Igor Piotrowski ◽  
Joanna Patrycja Wróblewska ◽  
Janusz Wasiewicz ◽  
Wiktoria Maria Suchorska
Keyword(s):  
Breast Cancer ◽  
Wound Healing ◽  
Molecular Subtype ◽  
Breast Cancer Subtype ◽  
Healing Process ◽  
Intraoperative Radiotherapy ◽  
Wound Healing Process ◽  
Surgical Wound ◽  
Luminal A ◽  
The Impact

Invasive oncological procedures affect the remaining tumor cells by increasing their survival, proliferation, and migration through the induction of wound healing response. The phenomena of local relapse after breast-conserving surgery (BCS) has resulted in a series of research and clinical trials with the aim of assessing whether localized intraoperative radiotherapy (IORT), may be beneficial in inhibiting local recurrences. Therefore, it is essential to assess the impact of intraoperative radiotherapy in modulating the immunological response and wound healing process. Thus, we decided to perform a quantitative analysis of the composition of surgical wound fluids (SWF) in two groups of breast cancer (BC) patients: those treated with BCS followed by IORT, and those who underwent BCS alone. We found that several cytokines, which are believed to have anti-tumor properties, were highly expressed in the luminal A breast cancer subtype in the IORT treatment group. Interestingly, we also found significant differences between IORT patients with tumors of different molecular subtypes. Based on these findings, we hypothesized that IORT treatment might be beneficial in changing the tumor bed microenvironment, making it less favorable for tumor recurrence due to decreased concentration of tumor-facilitating cytokines, especially in the luminal A subtype of BC.

Impact of the molecular pathology of breast cancer on mortality rates and overall survival in a Haitian cancer clinic.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13588-e13588
Author(s):  
Joseph Bernard ◽  
Rebecca Henderson ◽  
Lynn Gabrielle Alexis ◽  
Doukens Patrick Gilbert ◽  
Lenz Sacha Christyl Pierre ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Mortality Rate ◽  
Molecular Subtype ◽  
Metastatic Breast ◽  
Molecular Classification ◽  
Luminal A ◽  
Luminal B ◽  
The Impact ◽  
Cancer Clinic

e13588 Background: Breast cancer in the most common malignancy among women in Haiti and is mostly diagnosed at an advanced stage. While it is well known that molecular subtype is a prognostic factor, it needs to be investigated among Haitian patients with breast cancer. This study aimed to evaluate the impact of molecular classification of breast cancer on the survival of patients managed in Haiti’s largest cancer clinic. Methods: A retrospective study was conducted on the breast cancer patients of Innovating Health International (IHI) in Port-au-Prince, Haiti from January 2014 to December 2018. Chart review included all patients with breast cancer and tested for molecular classification. Data on variables such as date of admission, age, TNM staging, molecular classification, outcome and date of death were collected for the analysis. Mortality rate and median overall survival (OS) were estimated as of December 31st, 2019 and stratified according to molecular subtypes. Results: Among the 948 breast cancer cases diagnosed for the study period, 234 (24.7%) of them had a complete molecular classification. The mean age was 51.5 years [range: 23-94]. 55.1% of the patients were ER-positive, among them 33.7% ER+/PR+/HER2-, 15.4% ER+/PR-/HER2-, 2.1% ER+/PR-/HER2+ and 3.8% ER+/PR+/HER+ (triple positive). There were overall 25.6% of luminal A and 29.5% of luminal B cases. 44.9% were ER-negative, among them 14.1% ER-/PR-/HER2+ (HER2-enriched) and 29.1% ER-/PR-/HER2- (triple-negative). 92.2% of the patients had advanced breast cancer (stages IIB to IV). 29.5% had metastatic breast cancer, 22.8% for luminal A cases, 27.0% for luminal B, 36.7% for HER2-enriched and 32.8% for TNBC. Overall mortality rate was 42.3%, respectively 33.3% for luminal A cases, 37.7% for luminal B, 42.4% for HER2-enriched cases and 55.9% for TNBC. Median OS was not yet reached for luminal A, luminal B and HER2-enriched breast cancer, with a respective mean survival of 52.4 months, 51.3 months and 51.6 months. However, OS was 30.6 months for triple-positive breast cancer and 23.7 months for TNBC. Conclusions: Patients with luminal A breast cancer were less likely to have metastatic disease and thus had lower mortality rate and better overall survival. This was likely due to its less aggressive biology and the availability of hormone therapy. Poor availability and inaccessibility of HER2-targeted drugs were the main cause of the higher mortality rate among HER2-enriched patients. TNBC remains the most aggressive subtype.

scholarly journals Perineal Wound Identification With Maternity Cool Gel Pad (MCGP) Care Interventions

2021 ◽  
Vol 8 (4) ◽  
pp. 279
Author(s):  
Bina Melvia Girsang ◽  
Eqlima Elfira ◽  
Farida Linda Sari Siregar
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Healing Process ◽  
Perineal Wound ◽  
Wound Healing Process ◽  
Post Intervention ◽  
Short Period ◽  
Perineal Wounds ◽  
Postpartum Mothers ◽  
The Impact

<em>Postpartum mothers with an indication of episiotomy will experience a higher level of pain. This birth canal trauma is acute and is expected to recover in a short period of time, can be measured, and without serious complications. The aim of this study was to identify the healing process of postpartum maternal perineal wounds. The intervention was carried out on 31 postpartum mothers with the selection using purposive sampling technique. Maternity cool gel pad (MCGP) which was applied to the perineal wound care intervention on the 2nd and 3rd day after delivery showed the wound healing process was observed using the REEDA measuring instrument and analyzed using the T one sample test. The repair of the wound repair scale from the mean REEDA score (10.81 ± 2.98) occurred in all wounds of the study respondents at post intervention (5.32 ± 1.73). Maternity cool gel pad intervention assisted the wound healing process in post intervention data (P &lt;0.005). The results of this study can be indicative of an inflammatory response locally in perineal wounds, but further research is needed to observe the impact of perineal wound healing with a combination of methods that can help evaluate the perineal wound repair process that can be done by mothers independently at home.</em>

scholarly journals Stromal vascular fraction promotes migration of fibroblasts and angiogenesis through regulation of extracellular matrix in the skin wound healing process

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Hongsen Bi ◽  
Hui Li ◽  
Chen Zhang ◽  
Yiqing Mao ◽  
Fangfei Nie ◽  
...  
Keyword(s):  
Wound Healing ◽  
Endothelial Cells ◽  
Molecular Mechanisms ◽  
Umbilical Vein ◽  
Healing Process ◽  
Stromal Vascular Fraction ◽  
Wound Healing Process ◽  
Matrix Remodeling ◽  
Skin Defect ◽  
The Impact

Abstract Background A refractory wound is a typical complication of diabetes and is a common outcome after surgery. Current approaches have difficulty in improving wound healing. Recently, non-expanded stromal vascular fraction (SVF), which is derived from mature fat, has opened up new directions for the treatment of refractory wound healing. The aim of the current study is to systematically investigate the impact of SVF on wound healing, including the rate and characteristics of wound healing, ability of fibroblasts to migrate, and blood transport reconstruction, with a special emphasis on their precise molecular mechanisms. Methods SVF was isolated by digestion, followed by filtration and centrifugation, and then validated by immunocytochemistry, a MTS proliferation assay and multilineage potential analysis. A wound model was generated by creating 6-mm-diameter wounds, which include a full skin defect, on the backs of streptozocin-induced hyperglycemic mice. SVF or human adipose-derived stem cell (hADSC) suspensions were subcutaneously injected, and the wounds were characterized over a 9-day period by photography and measurements. A scratch test was used to determine whether changes in the migratory ability of fibroblasts occurred after co-culture with hADSCs. Angiogenesis was observed with human umbilical vein endothelial cells. mRNA from fibroblasts, endotheliocyte, and skin tissue were sequenced by high-throughput RNAseq, and differentially expressed genes, and pathways, potentially regulated by SVF or hADSCs were bioinformatically analyzed. Results Our data show that hADSCs have multiple characteristics of MSC. SVF and hADSCs significantly improved wound healing in hyperglycemic mice. hADSCs improve the migratory ability of fibroblasts and capillary structure formation in HUVECs. SVF promotes wound healing by focusing on angiogenesis and matrix remodeling. Conclusions Both SVF and hADSCs improve the function of fibroblast and endothelial cells, regulate gene expression, and promote skin healing. Various mechanisms likely are involved, including migration of fibroblasts, tubulogenesis of endothelial cells through regulation of cell adhesion, and cytokine pathways.

The effect of margin status and molecular subtype on women with invasive breast cancer treated with breast-conservation therapy.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 83-83
Author(s):  
Jared Forrester ◽  
Adam D. Currey ◽  
Bonifride Tuyishimire ◽  
Jonathan Lin ◽  
Amanda L. Kong
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Molecular Subtype ◽  
Tumor Biology ◽  
Breast Conservation ◽  
Margin Status ◽  
Stage I ◽  
Luminal A ◽  
Luminal B ◽  
The Impact

83 Background: A consensus statement was recently published by SSO/ASTRO on margins for stage I and II invasive breast cancer treated with breast conserving surgery (BCS). We examined patients with invasive breast cancer who underwent BCS to determine if margin status and molecular subtype influence outcomes. Methods: We the reviewed charts of 754 Stage I-III breast cancer patients treated with BCS from 2003-2010. Margin status was defined as negative ≥ 2mm, close < 2mm and positive as tumor on ink. Conventional receptor analyses were used as markers for molecular subtype classification (luminal A, luminal B, Her2 positive, and basal). Clinicopathologic variables were tested using the Fisher’s exact, Chi-square, ANOVA F-test, and Kruskal-Wallis tests. A Cox proportional - Hazards model was used to measure the impact of these variables on locoregional recurrence (LRR), breast cancer-specific (BCSS) and overall survival (OS). Results: The median age of the cohort was 58 (range 27-89 years). Most were white (88%), had T1 tumors (76%), luminal A tumors (66%), invasive ductal histology (80%), and were node negative (76%). Of the 754 patients, 26% had close margins, 2% positive margins, and 9% unknown margins. With a median follow-up of 5.2 years, OS was 92%. Twenty eight patients had a LRR with a median time to recurrence of 5.1 years. On multivariate analysis, molecular subtype, pathologic grade (p=0.01), and use of radiation (p<0.0001) were the only significant predictors of LRR. Unknown subtype, compared to Luminal A, was less likely to have a LRR (p=0.04). Basal (p=0.0002), Her2+ (p=0.03), Luminal B (p=0.002) and unknown subtype (p=0.04) had worse BCSS compared to Luminal A tumors. Margins had no impact on LRR or BCSS but those with close margins and unknown margins had worse OS compared to negative margins (p=0.01, p=0.007). Variables predictive of OS were margins, age, race, node status, chemotherapy, anti-endocrine therapy, and radiation. Conclusions: In this cohort treated with BCS, molecular subtype was a predictor of LRR and BCSS but not OS. Margin status did not impact LRR and BCSS. Although margin status was a predictor of OS, tumor biology remains the significant determinant of outcome.

Towards cancer mega-cohorts: A novel homogenization algorithm applied to diverse breast cancer RNA-Seq datasets.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13507-e13507
Author(s):  
Talal Ahmed ◽  
Mark Carty ◽  
Stephane Wenric ◽  
Raphael Pelossof
Keyword(s):  
Breast Cancer ◽  
Molecular Subtype ◽  
Breast Cancer Subtype ◽  
Model Performance ◽  
Test Results ◽  
Rna Seq ◽  
Luminal A ◽  
Test Set ◽  
Luminal B ◽  
Cancer Subtype

e13507 Background: Recent advances in transcriptomics have resulted in the emergence of several publicly available breast cancer RNA-Seq datasets, such as TCGA, SCAN-B, and METABRIC. However, molecular predictors cannot be applied across datasets without the correction of batch differences. In this study, we demonstrate a homogenization algorithm that allows the transfer of molecular subtype predictors from one RNA-Seq cohort to another. The algorithm only uses cohort-level RNA-Seq summary statistics, and therefore, does not require joint normalization of both datasets nor the transfer of patient information. Using this approach, we transferred a breast cancer subtype (Luminal A, Luminal B, HER2+, Basal) predictor trained on SCAN-B data to accurately predict subtypes from TCGA. Methods: First, we randomly split the TCGA cohort (n = 481 Luminal A, n = 189 Luminal B, n = 73 Her2+, n = 168 Basal) into two sets: TCGA-train and held-out TCGA-test (n = 455 and n = 456, respectively). Second, the SCAN-B cohort (n = 837) was homogenized with the TCGA-train set. Third, a molecular subtype predictor, based on a logistic regression model, was trained on homogenized SCAN-B RNA-Seq samples and used to predict the subtypes of TCGA-test RNA-Seq samples. For baseline comparison, a similar predictor trained on the non-homogenized SCAN-B cohort was tested on the TCGA-test set. The experimental framework was iterated 250 times. Reported P-values reflect a paired one-sided t-test. Results: To quantify model performance, we measured the average F1 score for each tumor subtype prediction from the held-out TCGA test set with and without cohort homogenization. The average F1 scores with vs. without homogenization were: Luminal A, 0.88 vs. 0.85 ( P< 1e-69); Luminal B, 0.74 vs. 0.51 ( P< 1e-183); Her2+, 0.73 vs. 0.53 ( P< 1e-99); Basal, 0.98 vs. 0.97 ( P< 1e-53). Overall, homogenization significantly outperformed no homogenization. Conclusions: We developed a novel homogenization algorithm that accurately transfers subtype predictors across diverse, independent breast cancer cohorts.

scholarly journals The Impact of Stress on Pressure Ulcer Wound Healing Process and on the Psychophysiological Environment of the Individual Suffering from them

2018 ◽  
Vol 72 (3) ◽  
pp. 362 ◽  
Author(s):  
Charalambos Charalambous ◽  
Aristides Vassilopoulos ◽  
Agoritsa Koulouri ◽  
Siamaga Eleni ◽  
Sotiropoulou Popi ◽  
...  
Keyword(s):  
Wound Healing ◽  
Pressure Ulcer ◽  
Healing Process ◽  
Wound Healing Process ◽  
The Individual ◽  
The Impact

Does Breast Cancer Subtype Impact Margin Status in Patients Undergoing Partial Mastectomy?

2022 ◽  
pp. 000313482110697
Author(s):  
Ileana Horattas ◽  
Andrew Fenton ◽  
Joseph Gabra ◽  
Amanda Mendiola ◽  
Fanyong Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Molecular Subtype ◽  
Breast Cancer Subtype ◽  
Positive Margin ◽  
Margin Status ◽  
Partial Mastectomy ◽  
Positive Margin Rate ◽  
Cancer Subtype ◽  
The Impact

Background Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy. Methods Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. Patients were classified as luminal if they were ER and/or PR positive; HER2 enriched if they were ER and PR negative but HER2 positive; and TN if they were negative for all 3 receptors. The impact of subtype on the margin status was evaluated at completion of standard PM, prior to randomization to CSM versus no CSM. Non-parametric statistical analyses were performed using SPSS Version 26. Results Molecular subtype was significantly correlated with race ( P = .011), palpability ( P = .007), and grade ( P < .001). Subtype did not correlate with Hispanic ethnicity ( P = .760) or lymphovascular invasion ( P = .756). In this cohort, the overall positive margin rate was 33.7%. This did not vary based on molecular subtype (positive margin rate 33.7% for patients with luminal tumors vs 36.4% for those with TN tumors, P = .425). Discussion Molecular subtype does not predict margin status. Therefore, molecular subtype should not, independent of other factors, influence surgical decision-making.

Hard-to-heal wounds, biofilm and wound healing: an intricate interrelationship

2020 ◽  
Vol 29 (5) ◽  
pp. S6-S13 ◽  
Author(s):  
Maria-Manuel Azevedo ◽  
Carmen Lisboa ◽  
Luís Cobrado ◽  
Cidália Pina-Vaz ◽  
Acácio Rodrigues
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Public Health Problem ◽  
Wound Healing Process ◽  
Major Public Health Problem ◽  
Normal Wound Healing ◽  
Efficient Management ◽  
Acute Wound ◽  
Reparative Process ◽  
The Impact

Hard-to-heal wounds are a major public health problem that incur high economic costs. A major source of morbidity, they can have an overwhelming impact on patients, caregivers and society. In contrast to acute wound healing, which follows an ‘orderly and timely reparative process', the healing of hard-to-heal wounds is delayed because the usual biological progression is interrupted. This article discusses hard-to-heal wounds, the impact they have on patients and healthcare systems, and how biofilms and other factors affect the wound-healing process. Controlling and preventing infection is of utmost importance for normal wound healing. Rational use of anti-infectious agents is crucial and is particularly relevant in the context of rising healthcare costs. Knowledge of the complex relationship between hard-to-heal wounds, biofilm formation and wound healing is vital for efficient management of hard-to-heal wounds.

scholarly journals What Is the Impact of Depletion of Immunoregulatory Genes on Wound Healing? A Systematic Review of Preclinical Evidence

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Bárbara Cristina Félix Nogueira ◽  
Artur Kanadani Campos ◽  
Raul Santos Alves ◽  
Mariáurea Matias Sarandy ◽  
Rômulo Dias Novaes ◽  
...  
Keyword(s):  
Wound Healing ◽  
Methodological Quality ◽  
Healing Process ◽  
Heterogeneous Data ◽  
Skin Wound ◽  
Wound Healing Process ◽  
Extracellular Molecules ◽  
Knockout Animals ◽  
The Impact

Cytokines and growth factors are known to play an important role in the skin wound closure process; however, in knockout organisms, the levels of these molecules can undergo changes that result in the delay or acceleration of this process. Therefore, we systematically reviewed evidence from preclinical studies about the main immunoregulatory molecules involved in skin repair through the analysis of the main mechanisms involved in the depletion of immunoregulatory genes, and we carried out a critical analysis of the methodological quality of these studies. We searched biomedical databases, and only original studies were analyzed according to the PRISMA guidelines. The included studies were limited to those which used knockout animals and excision or incision wound models without intervention. A total of 27 studies were selected; data for animal models, gene depletion, wound characteristics, and immunoregulatory molecules were evaluated and compared whenever possible. Methodological quality assessments were examined using the ARRIVE and SYRCLE’s bias of risk tool. In our review, the extracellular molecules act more negatively in the wound healing process when silenced and the metabolic pathway most affected involved in these processes was TGF-β/Smad, and emphasis was given to the importance of the participation of macrophages in TGF-β signaling. Besides that, proinflammatory molecules were more evaluated than anti-inflammatory ones, and the main molecules evaluated were, respectively, TGF-β1, followed by VEGF, IL-6, TNF-α, and IL-1β. Overall, most gene depletions delayed wound healing, negatively influenced the concentrations of proinflammatory cytokines, and consequently promoted a decrease of inflammatory cell infiltration, angiogenesis, and collagen deposition, compromising the formation of granulation tissue. The studies presented heterogeneous data and exhibited methodological limitations; therefore, mechanistic and highly controlled studies are required to improve the quality of the evidence.

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