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Wang W, Belosay A, Yang X, Hartman JA, Song H, Iwaniec UT, Turner RT, Churchwell MI, Doerge DR, Helferich WG. Effects of letrozole on breast cancer micro-metastatic tumor growth in bone and lung in mice inoculated with murine 4T1 cells. Clin Exp Metastasis 2016; 33:475-85. [PMID: 27209469 DOI: 10.1007/s10585-016-9792-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 04/11/2016] [Indexed: 12/11/2022]
Abstract
Breast cancer (BC) is the leading cancer in women worldwide. Metastasis occurs in stage IV BC with bone and lung being common metastatic sites. Here we evaluate the effects of the aromatase inhibitor letrozole on BC micro-metastatic tumor growth in bone and lung metastasis in intact and ovariectomized (OVX) mice with murine estrogen receptor negative (ER-) BC cells inoculated in tibia. Forty-eight BALB/c mice were randomly assigned to one of four groups: OVX, OVX + Letrozole, Intact, and Intact + Letrozole, and injected with 4T1 cells intra-tibially. Letrozole was subcutaneously injected daily for 23 days at a dose of 1.75 µg/g body weight. Tumor progression was monitored by bioluminescence imaging (BLI). Following necropsy, inoculated tibiae were scanned via µCT and bone response to tumor was scored from 0 (no ectopic mineralization/osteolysis) to 5 (extensive ectopic mineralization/osteolysis). OVX mice had higher tibial pathology scores indicative of more extensive bone destruction than intact mice, irrespective of letrozole treatment. Letrozole decreased serum estradiol levels and reduced lung surface tumor numbers in intact animals. Furthermore, mice receiving letrozole had significantly fewer tumor colonies and fewer proliferative cells in the lung than OVX and intact controls based on H&E and Ki-67 staining, respectively. In conclusion, BC-inoculated OVX animals had higher tibia pathology scores than BC-inoculated intact animals and letrozole reduced BC metastases to lungs. These findings suggest that, by lowering systemic estrogen level and/or by interacting with the host organ, the aromatase inhibitor letrozole has the potential to reduce ER- BC metastasis to lung.
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Affiliation(s)
- Wendan Wang
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 574 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Aashvini Belosay
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 574 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Xujuan Yang
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 574 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - James A Hartman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 574 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Huaxin Song
- Health Sciences Center, School of Nursing, Texas Tech University, Lubbock, TX, USA
| | - Urszula T Iwaniec
- Skeletal Biology Laboratory, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.,Center for Healthy Aging Research, Oregon State University, Corvallis, OR, USA
| | - Russell T Turner
- Skeletal Biology Laboratory, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.,Center for Healthy Aging Research, Oregon State University, Corvallis, OR, USA
| | - Mona I Churchwell
- Division of Biochemical Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA
| | - Daniel R Doerge
- Division of Biochemical Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, Jefferson, AR, 72079, USA
| | - William G Helferich
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, 574 Bevier Hall, 905 South Goodwin Avenue, Urbana, IL, 61801, USA.
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Riegger C, Koeninger A, Hartung V, Otterbach F, Kimmig R, Forsting M, Bockisch A, Antoch G, Heusner TA. Comparison of the diagnostic value of FDG-PET/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients. Acta Radiol 2012; 53:1092-8. [PMID: 23002144 DOI: 10.1258/ar.2012.110635] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND FDG-PET/CT is increasingly being used for breast cancer staging. Its diagnostic accuracy in comparison to ultrasound as the standard non-invasive imaging modality for the evaluation of axillary lymph nodes has yet not been evaluated. PURPOSE To retrospectively compare the diagnostic value of full-dose, intravenously contrast-enhanced FDG-PET/CT and ultrasound for the detection of lymph node metastases in breast cancer patients. MATERIAL AND METHODS Ninety patients (one patient with a bilateral carcinoma) (89 women, one man; mean age, 55.5 +/- 16.6 years) suffering from primary breast cancer underwent whole-body FDG-PET/CT and axillary ultrasound. The ipsilateral axillary fossa (n = 91) was evaluated for metastatic spread. The sensitivity, specificity, the positive predictive value (PPV), negative predictive value (NPV), and accuracy of both methods were calculated. The sensitivity and accuracy were statistically compared using the McNemar Test (P <0.05). Analyses were made on a patient basis. The number of patients with extra-axillary locoregional lymph node metastases exclusively detected by FDG-PET/CT was evaluated. For axillary lymph node metastases histopathology served as the reference standard. RESULTS The sensitivity, specificity, PPV, NPV, and accuracy of FDG-PET/CT for the detection of axillary lymph node metastases were 54%, 89%, 77%, 74%, and 75%, respectively. For ultrasound it was 38%, 78%, 54%, 65%, and 62%, respectively. FDG-PET/CT was significantly more accurate than ultrasound for the detection of axillary lymph node metastases (P = 0.019). There was no statistically significant difference between the sensitivity of both modalities (P = 0.0578). FDG-PET/CT detected extra-axillary locoregional lymph node metastases in seven patients (8%) that had not been detected by another imaging modality. CONCLUSION Though more accurate compared to ultrasound for evaluating the axillary lymph node status FDG-PET/CT is only as sensitive as ultrasound when it comes to the detection of axillary lymph node metastases. Due to the low sensitivity FDG-PET/CT cannot act as a substitute for Sentinel lymph node biopsy. FDG-PET/CT is able to detect previously unknown locoregional extra-axillary lymph node metastases.
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Affiliation(s)
- Carolin Riegger
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf
- Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen
| | - Angela Koeninger
- Univ Duisburg-Essen, Medical Faculty, Department of Gynecology and Obstetrics, Essen
| | - Verena Hartung
- Univ Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen
| | - Friedrich Otterbach
- Univ Duisburg-Essen, Institute of Pathology and Neuropathology, Essen, Germany
| | - Rainer Kimmig
- Univ Duisburg-Essen, Medical Faculty, Department of Gynecology and Obstetrics, Essen
| | - Michael Forsting
- Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen
| | - Andreas Bockisch
- Univ Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen
| | - Gerald Antoch
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf
| | - Till A Heusner
- Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf
- Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen
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Mouridsen HT, Lønning P, Beckmann MW, Blackwell K, Doughty J, Gligorov J, Llombart-Cussac A, Robidoux A, Thürlimann B, Gnant M. Use of aromatase inhibitors and bisphosphonates as an anticancer therapy in postmenopausal breast cancer. Expert Rev Anticancer Ther 2010; 10:1825-36. [PMID: 20883112 DOI: 10.1586/era.10.160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Breast cancer is a major cause of morbidity and mortality in postmenopausal women worldwide. Reducing the risk of distant disease recurrence is a primary goal of adjuvant endocrine therapy. As we await data from ongoing Phase III comparison trials, an emerging body of evidence demonstrates important differences between third-generation aromatase inhibitors, particularly with respect to potency and prevention of early distant metastases. Furthermore, a growing body of evidence demonstrates anticancer benefits of bisphosphonates in adjuvant breast cancer and other settings. This article outlines the proceedings from an Expert Panel meeting of regionally diverse breast cancer specialists regarding the appropriate use of aromatase inhibitors in postmenopausal hormone-responsive early breast cancer and bisphosphonates as anticancer therapy in adjuvant breast cancer.
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Affiliation(s)
- Henning T Mouridsen
- Danish Breast Cancer Cooperative Group, Rigshospitalet, Department of Oncology 2501, Blegdamsvej 9, Kobenhavn O 2100, Denmark.
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