Metastasis from endometrial carcinoma to bilateral breasts presenting as inflammatory breast lesions

BACKGROUND

Endometrial carcinoma rarely metastasizes to the bilateral breasts and presents as an inflammatory breast lesion. In this paper, we report a case of bilateral breast metastatic endometrial carcinoma and describe the clinical and pathological features. It is the second case of this kind of disease and the first case report with full clinical data.

CASE REPORT

A 56-year-old Chinese woman (G3, P3) with endometrial carcinoma received cytoreductive surgery and chemotherapy. Approximately 22 months later, she presented with pain in the right axillary region and edema of the right breast. The pathology report confirmed multifocal invasive papillary adenocarcinoma of the right mammary gland, consistent with endometrial carcinoma metastasis. Although she received many lines of chemotherapy, the disease still progressed and metastasized to the contralateral breast. Gefitinib (Iressa) improved symptoms temporarily.

CONCLUSIONS

Bilateral breasts metastasis of endometrial carcinoma is rare and difficult to treat. Molecular targeted therapy may be an effective treatment for breast metastasis.

Abstract P1-04-03: A Role for Cyclin D1 in Neoplastic Transformation in MCF-7 Breast Cancer Cells Post p14ARF-p53 Induced Senescence

Many years of oncogenic insult and hormonal flux have important long-term implications for breast cancer emergence and progression. Premature-induced senescence is proposed to be a protective response against cancer development. We hypothesize that the senescence response can be subverted in some breast carcinomas, which exhibit latent hormone-dependent proliferative capacity.

The ARF-p53 pathway has long been known to play an important role in tumour surveillance halting cell cycle progression to transiently or permanently stop aberrant cells from proliferating. It is well documented that disruption of this pathway is involved in tumourigenesis, in part, through inactivation of cyclin D1. Cyclin D1 plays an important role in breast cancer progression as a regulator of CDK4/6. In addition cyclin D1 has been reported to stimulate estrogen receptor (ER) activity independent of CDK4/6.

Our initial observations showed that reactivation of ARF-p53-p21 is indeed a potent rapid inhibitor of cell proliferation in MCF-7 breast cancer cells with a senescent phenotype, however controversially cyclin D1 expression was increased and predominantly located in the nucleus. High expression of nuclear cyclin D1 and p14ARF inversely correlated with cell proliferation. Our studies showed that p14ARF regulated cyclin D1 at the post-transcriptional level. Furthermore, we have evidence from microRNA array analysis that microRNAs known to bind to the cyclin D1 3'UTR sequence were down regulated upon induction of p14ARF, contributing to cyclin D1 stability.

We found that long-term exposure to p14ARF was not a failsafe barrier to tumour progression, senescent-like cells re-entering the cell cycle correlated with reduction of nuclear cyclin D1. Conversely, continuous p14ARF expression resulted in chaotic multinucleation and preceded neoplasia. These aberrant nuclei co-stained with cyclin D1 and Ki-67, a well-known marker of cell proliferation.

These results suggest that induction of the p14ARF-p53 pathway does not entirely remove the threat of cancer resulting from hyperproliferative oncogenic signals and cyclin D1 plays a promiscuous role in prevention and progression. Arguably, in some breast cancers premature senescent cells may be precursor, or latent cancer cells.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-04-03.

Role of sphingolipids in the cytoplasmic signaling of estrogens

Recent studies have clearly demonstrated that estrogen signaling is not limited by the canonical 'genomic' pathway. Estrogens have been shown to interact with multiple cytoplasmic signaling networks including that of growth factors, cytokines, and the most recently recognised participants, sphingolipids. Sphingosine kinase (SphK), a key enzyme in metabolic pathways of sphingolipids, plays an important role in cell signaling and regulates a wide range of biological functions, including the actions of estrogens. Herein we briefly review current experimental evidence showing a critical involvement of sphingolipids in estrogen signaling, especially in breast cancer and vascular endothelial cells. In the current review we mainly focus on the SphK pathway and discuss the potential role of SphK and sphingolipids in the cellular biology of estrogens.

New technologies in the radiotherapy clinic

What are the limitations to the accuracy of our current technologies in radiation oncology? The immobilization of the patient, definition of the target, motion of the target and localization of the target are the major concerns that must be addressed. Current approaches to meet these needs have brought new technical systems with greater precision and new clinical procedures with higher expectations of practice. This text offers discussions on these issues, including advances in intensity-modulated radiotherapy planning, clinical target definition for the major tumor sites, management of organ motion, target localization and image guidance systems, and the expanding applications of high-precision treatment with stereotactic body radiotherapy.