ABSTRACT
The molecular basis of metastatic potential of human breast carcinoma cells can be useful information to determine the practical implications in the diagnosis, determining prognosis and treatment of breast cancer. The aim of this study was to identify predictors of aggressive biological behavior and metastatic potential in breast carcinoma among a number of intrinsic biomarkers of tumor cells. We used routine formalin fixed, paraffin embedded tumor samples; sections were stained immunohistochemically to determine the expression of estrogen receptor [ER], progesterone receptor [PR], HER2/neu, Ki67, p53 and cathepsin D in 66 breast carcinoma patients. The result of the quantitative immunohistochemical assays were correlated with clinical and histological data such as patient age, tumor size, axillary lymph node status, tumor grade, the therapeutic regimens and survival rates. Univariate analysis revealed a statistically significant relation between tumor size and overexpression of p53, and between tumor grade and PR status, p53 status and Ki67. In multivariate analysis the independent factors predicting for tumor grade were Ki67 and PR status. Among patients with ER expression, negative p53 or Ki67 status, tumors with lower grades and negative axillary lymph nodes [or < 4 involved lymph nodes], there was a higher survival rate [either disease free or overall]; however, relationship was not statistically significant, most probably due to the low number of studied patients. In conclusion, Ki67 was an independent factor to predict tumor grade in our study; the use of this proliferation activity marker in routine approach to patients with breast cancer is recommended, at least to evaluate the accuracy of tumor grading by mitotic count
ABSTRACT
Acute radiation dermatitis is a very common side effect of radiation therapy for many cancers, including breast cancer. Despite the high prevalence of acute radiation dermatitis as well as wet desquamation, only a few trials studying the prophylaxis of this complication using topical treatment have been conducted. In spite of these studies, some controversy still exists about regarding treatments for acute radiation dermatitis, as does some concern about their long-term complications. For this reason, we conducted a clinical trial for a new treatment with the same effectiveness as corticosteroids, but fewer complications. This trial included 60 patients with pathologic diagnoses of breast cancer for whom radiotherapy had been planned. Patients were 30-73 years old. Patients with radical mastectomy received 5000 cGy over five weeks, and those with conservative surgery received 6000 cGy over six weeks divided in 200 cGy fractions. Patients were divided randomly into two groups: one group received a moderately-potent glucocorticoid steroid, 0.1% betamethasone ointment [30], and the other received the new treatment, 0.1% calendula ointment [30]. All patients applied their respective drugs twice daily within the tangential field from the first day of radiation treatment until one month after treatment was completed. Starting one week after radiation therapy commenced, patients were monitored weekly for symptoms of dermatitis and the degree of severity as well as possible adverse drug effects, in addition to such monitoring on the days of their appointments. Four weeks after termination of therapy, patients were again examined, at which time they completed a questionnaire about dermatologic complications. The mean time to develop dermatitis was 3.7 weeks for the betamethasone group and 3.87 weeks for the calendula group. Maximal dermatitis intensity during treatment in the betamethasone group was: 0, 6.7%; I, 73.3%; II, 16.7%; III, 0%; IV, 3.3%. Dermatitis intensity in the calendula group was: 0, 13.3%; I, 67%; II, 16.7%; III, 0%; IV, 3.3%. No significant differences were observed in the incidence of symptoms such as burning, pruritus and pain between the two groups [p=0.762]. Calendula ointment is as effective as betamethasone in reducing acute radiation dermatitis