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The Systemic Effects of Local Treatments (Surgery and Radiotherapy) of Breast Cancer

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Perioperative Inflammation as Triggering Origin of Metastasis Development

Abstract

In general, treatment of solid tumours has been compartmentalized as local treatment and systemic treatment. The only systemic oncological effect of local treatment is supposedly eradication of the primary cancer thereby reducing the probability of further systemic spread. However, as will be described here there are instances where local treatment could impact the outcome in diverse ways. We describe how the modulation of surgery by changing its extent or addition of intraoperative radiation appears greatly impact it systemic effects.

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References

  1. D'Souza N, Darmanin G, Fedorowicz Z (2011) Immediate versus delayed reconstruction following surgery for breast cancer. Cochrane Database Syst Rev 7:CD008674

    Google Scholar 

  2. Metcalfe KA, Semple J, Quan ML et al (2012) Changes in psychosocial functioning 1 year after mastectomy alone, delayed breast reconstruction, or immediate breast reconstruction. Ann Surg Oncol 19(1):233–241

    Article  PubMed  Google Scholar 

  3. Dikmans RE, Negenborn VL, Bouman MB et al (2017) Two-stage implant-based breast reconstruction compared with immediate one-stage implant-based breast reconstruction augmented with an acellular dermal matrix: an open-label, phase 4, multicentre, randomised, controlled trial. Lancet Oncol 18:251–258

    Article  PubMed  Google Scholar 

  4. Beecher SM, O'Leary DP, McLaughlin R, Sweeney KJ, Kerin MJ (2016) Influence of complications following immediate breast reconstruction on breast cancer recurrence rates. Br J Surg 103(4):391–398

    Article  CAS  PubMed  Google Scholar 

  5. Dillekas H, Demicheli R, Ardoino I, Jensen SA, Biganzoli E, Straume O (2016) The recurrence pattern following delayed breast reconstruction after mastectomy for breast cancer suggests a systemic effect of surgery on occult dormant micrometastases. Breast Cancer Res Treat 158(1):169–178

    Article  PubMed  PubMed Central  Google Scholar 

  6. Belletti B, Vaidya JS, D'Andrea S et al (2008) Targeted intraoperative radiotherapy impairs the stimulation of breast cancer cell proliferation and invasion caused by surgical wounding. Clin Cancer Res 14(5):1325–1332

    Article  CAS  PubMed  Google Scholar 

  7. Zaleska K, Suchorska WM, Przybyla A, Murawa D (2016) Effect of surgical wound fluids after intraoperative electron radiotherapy on the cancer stem cell phenotype in a panel of human breast cancer cell lines. Oncol Lett 12(5):3707–3714

    PubMed  PubMed Central  Google Scholar 

  8. Vaidya JS, Bulsara M, Wenz F (2013) Ischemic heart disease after breast cancer radiotherapy. N Engl J Med 368(26):2526–2527

    PubMed  Google Scholar 

  9. Vaidya JS, Bulsara M, Wenz F et al (2015) Pride, prejudice, or science – attitudes towards the results of the TARGIT-A trial of targeted intraoperative radiotherapy for breast cancer. Int J Radiat Oncol Biol Phys 92(3):494–500

    Article  Google Scholar 

  10. Vaidya JS, Wenz F, Bulsara M et al (2014) Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. Lancet 383(9917):603–613

    Article  PubMed  Google Scholar 

  11. Vaidya JS, Wenz F, Bulsara M, Tobias JS, Joseph D, Baum M (2014) Radiotherapy for breast cancer, the TARGIT-A trial – authors’ reply. Lancet 383(9930):1719–1720

    Article  PubMed  Google Scholar 

  12. Vaidya JS, Joseph DJ, Tobias JS et al (2010) Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. Lancet 376(9735):91–102

    Article  PubMed  Google Scholar 

  13. Vaidya JS, Wenz F, Bulsara M et al (2016) An international randomised controlled trial to compare targeted intra-operative radiotherapy (TARGIT) with conventional post-operative radiotherapy after conservative breast surgery for women with early stage breast cancer (the TARGIT-A trial). Health Technol Assess 20(73):1–188

    Article  PubMed  PubMed Central  Google Scholar 

  14. Vaidya JS, Bulsara M, Wenz F et al (2016) Reduced mortality with partial-breast irradiation for early breast cancer: a meta-analysis of randomized trials. Int J Radiat Oncol Biol Phys 96(2):259–265

    Article  PubMed  Google Scholar 

  15. Vaidya JS, Bulsara M, Wenz F et al (2013) The lower non-breast cancer mortality with TARGIT in the TARGIT-A trial could be a systemic effect of TARGIT on tumor microenvironment. Int J Radiat Oncol Biol Phys 87(2):S240

    Article  Google Scholar 

  16. Kolberg HC, Loevey G, Akpolat-Basci L et al (2017) Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy. Strahlenther Onkol 193(1):62–69

    Article  PubMed  Google Scholar 

  17. Forget P, Coulie PG, Retsky M, Demicheli R, Machiels JP, De Kock M (2013) Is there a rationale for an anesthesiologist’s role against cancer recurrence? Acta Anaesthesiol Belg 64(1):15–24. Review. PubMed PMID: 23767173

    CAS  PubMed  Google Scholar 

  18. Retsky MW, Demicheli R, Hrushesky WJM, Forget P, DeKock M, Gukas I, Rogers RA, Baum M, Sukhatme V, Vaidya JS (2013) Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: new findings and a review. Curr Med Chem 20:4163–4176

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Haloua MH, Krekel NM, Winters HA et al (2013) A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects. Ann Surg 257(4):609–620

    Article  PubMed  Google Scholar 

  20. Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou M (2003) Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg 237(1):26–34

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lavigne E, Holowaty EJ, Pan SY et al (2013) Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ 346:f2399

    Article  PubMed  Google Scholar 

  22. Petit JY, Lohsiriwat V, Clough KB et al (2011) The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study—Milan-Paris-Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg 128(2):341–346

    Article  CAS  PubMed  Google Scholar 

  23. Cordeiro PG (2011) Discussion: the oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study—Milan-Paris-Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg 128(2):347–348

    Article  CAS  PubMed  Google Scholar 

  24. Eichler C, Kolsch M, Sauerwald A, Bach A, Gluz O, Warm M (2013) Lumpectomy versus mastopexy—a post-surgery patient survey. Anticancer Res 33(2):731–736

    PubMed  Google Scholar 

  25. Staff NP, Engelstad J, Klein CJ, Amrami KK, Spinner RJ, Dyck PJ, Warner MA, Warner ME, Dyck PJ (2010) Post-surgical inflammatory neuropathy. Brain 133(10):2866–2880

    Article  PubMed  Google Scholar 

  26. Cifu AS, Prasad VK (2015) Ending medical reversals. Johns Hopkins University Press, Baltimore

    Google Scholar 

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Correspondence to Jayant S. Vaidya MBBS, MS, DNB, FRCS, PhD .

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Vaidya, J.S. (2017). The Systemic Effects of Local Treatments (Surgery and Radiotherapy) of Breast Cancer. In: Retsky, M., Demicheli, R. (eds) Perioperative Inflammation as Triggering Origin of Metastasis Development. Springer, Cham. https://doi.org/10.1007/978-3-319-57943-6_11

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