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Montagna G. Estimating the Benefit of Preoperative Systemic Therapy to Reduce the Extent of Breast Cancer Surgery: Current Standard and Future Directions. Cancer Treat Res 2023; 188:149-174. [PMID: 38175345 DOI: 10.1007/978-3-031-33602-7_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Once reserved for locally advanced tumors which were deemed inoperable at presentation, preoperative systemic therapy (PST) is nowadays increasingly used to treat early breast cancer. PST allows for in vivo assessment of tumor response, for tailoring of adjuvant systemic therapy and for de-escalation of breast and the axillary surgery. Increased rates of pathological complete response together with more accurate response assessment and surgical planning have led to a significant reduction in surgical morbidity. While surgical assessment remains the standard of care, ongoing studies are evaluating whether surgery can be omitted in patients who achieve a complete pathological response. In this chapter, I will review the impact of PST on surgical de-escalation and the data supporting the safety of this approach.
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Affiliation(s)
- Giacomo Montagna
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66Th Street, New York, NY, 10065, USA.
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Wang J, Ma S, Li L, Chen Y, Yang Q, Wang F, Zheng M, Miao S, Shi X. Investigation into the in vivo mechanism of diosmetin in patients with breast cancer and COVID-19 using bioinformatics. Front Pharmacol 2022; 13:983821. [PMID: 36060002 PMCID: PMC9433109 DOI: 10.3389/fphar.2022.983821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
Patients with breast cancer are prone to SARS-CoV-2 infection [the causative virus of coronavirus disease (COVID-19)] due to their lack of immunity. In the current study, we examined the mechanism of action of Diosmetin, a flavonoid with anti-inflammatory properties, in patients with BRCA infected with SARS-CoV-2.We used bioinformatics technology to analyze the binding ability, biological function, and other biological characteristics of Diosmetinin vivo and examine the core target and potential mechanism of action of Diosmetin in patients with patients with breast cancer infected with SARS-CoV-2. A prognostic model of SARS-COV-2–infected breast cancer patients was constructed, and the core genes were screened out, revealing the correlation between these core genes and clinicopathological characteristics, survival rate, and high-risk and low-risk populations. The docking results revealed that Diosmetin binds well to the core genes of patients with breast cancer with COVID-19. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggested that Diosmetin inhibited inflammation, enhanced immune function, and regulated the cellular microenvironment in patients with BRCA/COVID-19. For the first time, we reveal the molecular functions and potential targets of Diosmetin in patients with breast cancer infected with SARS-CoV-2, improving the reliability of the new drug and laying the foundation for further research and development.
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Affiliation(s)
- Jin Wang
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Shanbo Ma
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Long Li
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Yuhan Chen
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- School of Pharmacy, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China
| | - Qian Yang
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Feiyan Wang
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- School of Pharmacy, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China
| | - Meiling Zheng
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- School of Pharmacy, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China
| | - Shan Miao
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- *Correspondence: Shan Miao, ; Xiaopeng Shi,
| | - Xiaopeng Shi
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- *Correspondence: Shan Miao, ; Xiaopeng Shi,
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Dabbagh N, Abbasvandi F, Miripour ZS, Hoseinpour P, Jahanbakhshi F, Moradi A, Riazi H, Moradian F, Zanjani FS, Parniani M, Akbari ME, Abdolahad M. Accuracy of cancer diagnostic probe for intra-surgical checking of cavity side margins in neoadjuvant breast cancer cases: A human model study. Int J Med Robot 2021; 18:e2335. [PMID: 34571582 DOI: 10.1002/rcs.2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/07/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Background Recently, a real-time system, named cancer diagnostic probe (CDP), has been developed to diagnose the presence of pre-neoplastic/neoplastic cells in breast cavity side margins. Detecting mechanism is real-time determination of the ROS/H2 O2 released from cancer or atypical cells, through reverse Warburg effect and hypoxia glycolysis pathways. AIMS Here, we designed a human model study based on real-time checking of 387 internal margins (IM) from 39 neoadjuvant breast cancer cases by CDP. MATERIALS & METHODS: Each lesion was checked by entered needle sensor and electrical scores were recorded. The permanent pathology result of each tested lesion was our gold standard to evaluate CDP scoring. CDP results were compared with permanent pathology of tumour side margins (as a conventional margin evaluation procedure). RESULTS Results showed that the sensitivity of CDP in scoring the cavity side margins of those cases is 91%. A total of 18 involved IM which had been detected by CDP were declared as free margins in pathology section of tumour side samples. Just five involved IM were missed by CDP. DISCUSSIONS Such sensitivity revealed that metabolism based (here: hypoxia glycolysis) tracing of cancer cells show distinct electrochemical responses between clear and involved cavity side margin evaluation. CONCLUSION This human study showed the promising role of CDP to achieve clear margins after BCS of neoadjuvant cases.
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Affiliation(s)
- Najmeh Dabbagh
- Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Abbasvandi
- Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,ATMP Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.,SEPAS Pathology Laboratory, Tehran, Iran
| | - Zohreh Sadat Miripour
- Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Parisa Hoseinpour
- Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,SEPAS Pathology Laboratory, Tehran, Iran
| | - Fahimeh Jahanbakhshi
- ATMP Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Afshin Moradi
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hooman Riazi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Moradian
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Parniani
- SEPAS Pathology Laboratory, Tehran, Iran.,Pathology Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | | | - Mohammad Abdolahad
- Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,School of Medicine, Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.,UT-TUMS Cancer Electronics Research Center, Tehran, Iran
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Montagna G, Corso G, Di Micco R, Van Den Rul N, Rocco N. Axillary management after neoadjuvant treatment. MINERVA CHIR 2020; 75:400-407. [PMID: 33345526 DOI: 10.23736/s0026-4733.20.08600-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Since its introduction nearly 30 years ago, sentinel lymph node biopsy (SLNB) has become the standard technique to stage the axilla for the great majority of patients with early breast cancer. While the accuracy of SLNB in clinically node-negative patients who undergo neoadjuvant chemotherapy (NAC) is similar to the upfront surgery setting, modifications of the technique to improve the false negative rate are necessary in node-positive patients at presentation. Currently, patients who present with matted nodes, cN1 patients who fail to downstage to cN0 with NAC and those with pathological residual disease have an indication to undergo axillary lymph node dissection. Ongoing trials will confirm if extensive nodal irradiation can replace surgery in patients with residual nodal disease after NAC and if nodal radiotherapy can be omitted in patients who achieve nodal pathological complete response. The aim of this review was to focus on the open questions on the management of the axilla after NAC.
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Affiliation(s)
- Giacomo Montagna
- Breast Unit, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA - .,Breast Center, University Hospital of Basel, Basel, Switzerland -
| | - Giovanni Corso
- Division of Breast Surgery, IRCCS European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Rosa Di Micco
- Breast Surgery Unit, IRCCS San Raffaele Hospital, Milan, Italy.,Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Nicola Rocco
- Group for Reconstructive and Therapeutic Advancements (GRETA) Milan-Naples-Catania, Milan, Italy
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