Evaluation of KISS1 Receptor Gene Expression in Egyptian Female Patients with Breast Cancer.

OBJECTIVE: Breast cancer is the second most common cancer in the world. Many metastasis suppressor genes were identified, including the KISS1 gene which encodes for a 145 amino acid protein (kisspeptin-145), which undergoes proteolytic cleavage resulting in kisspeptin-14, -13 and -10. All of these proteins can activate KISS1 receptor (KISS1R). The role of KP/KISS1R signaling in breast cancer remains controversial. The present study aimed to measure mRNA gene expression of KISS1 receptor in healthy and cancerous breast tissue and to evaluate the association of its level with the available molecular subtypes and the traditional clinico-pathological variables. METHODS: The study was done on 41 operable primary breast cancer patients. Biopsies from both tumor tissue and surrounding healthy mammary tissue were taken from all patients. KISS1R mRNA expression level was measured using a quantitative real time PCR.   Results: KISS1R mRNA expression was significantly higher in stage III patients compared to stage II patients. At a cut-off value for KISS1R mRNA expression of 1.75, stage II was discriminated from stage III. A significant positive correlation was found between KISS1R mRNA expression and tumor size as well as lymph nodes metastasis. KISS1R mRNA was highly expressed in ER negative cases compared to ER positive ones, and in PR negative cases compared to PR positive ones. There was a statistically significant difference in KISS1R mRNA expression levels and different molecular subtypes being over-expressed in HER2 and triple negative cancer cases. CONCLUSION: This study supports other studies suggesting that KISS1/KISS1R may not be acting as a metastasis suppressor in breast cancer. KISS1R mRNA is over expressed in advanced stages of breast cancer and hence it can be used as a prognostic marker for aggressiveness of breast cancer. Also being over expressed in triple negative patients, KISS1R could represent a promising therapeutic target in triple negative cases.

Immediate Lipo-Filling as a Novel Technique for Volume Replacement in Oncoplastic Breast Conservative Surgery.

BACKGROUND: We aimed to evaluate the feasibility of immediate lipofilling as a volume replacement technique in breast conservative surgery (BCS) in terms of the volume of fat graft resorption after radiotherapy, patient satisfaction, and oncological safety. PATIENTS AND METHODS: This was a prospective study that included female patients with breast cancer, with small- or medium-sized breasts. The patients underwent BCS followed by lipofilling into the deformed areas away from the tumor site that resulted from direct closure of the tumor cavity. They were followed up for early and late postoperative complications, including recurrence. Volumetric computed tomography was performed before and after radiotherapy to determine percentage fat resorption. Postoperative patient satisfaction was assessed using the Kyungpook National University Hospital Breast Reconstruction Satisfaction Questionnaire. RESULTS: The study included 54 female patients with a mean age of 47.57 ± 9.26 years. The mean follow-up period was 31.02 ± 4.47 months. Local recurrence was observed in three patients (5.56%). The volume reduction of the injected fat graft ranged from 10.15% to 55.67%, with a mean of 29.27 ± 10.06%. Fifty-two patients (96.30%) reported postoperative satisfaction, and nine of them expressed satisfaction only after a second lipofilling session. CONCLUSIONS: Immediate lipofilling as a volume replacement technique in BCS is a safe and simple technique without major complications. It has a locoregional recurrence rate similar to BCS alone, with an acceptable fat resorption percentage and high postoperative patient satisfaction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A new oncoplastic technique for removal of centrally located malignant tumors and reconstruction by a local dermo-glandular flap in conservative breast surgery.

AIM: To evaluate the local dermo-glandular flap as a new reconstructive oncoplastic technique after removal of central malignant tumors of the breast, in terms of patient satisfaction and local recurrence. PATIENTS AND METHODS: This study included 60 females with centrally located breast cancer who underwent central quadrantectomy and local dermo-glandular flap with either sentinel lymph node biopsy or axillary clearance. RESULTS: The mean age of the patients was 49.68 ± 8.52 years. The duration of the operation ranged from 68-105 minutes, with a mean of 79.77 ± 9.41 minutes. Local recurrence was observed in three patients (5.00%) with no distant metastasis. Forty-seven patients (78.33%) reported satisfaction after the operation. Ugly scarring and the existence of tissue defects were the main factors affecting patient satisfaction. Correction of these complications increased overall satisfaction to 88.33%. CONCLUSIONS: For small- and medium-sized breasts, the use of a local dermo-glandular flap for the management of centrally located malignant tumors seems to be a simple and easy technique with good oncological outcomes and acceptable few minor complications. This technique offers an immediate reconstruction of a new areola with fewer scars that will be hidden later after areola tattooing. Most of the patients reported satisfaction three months after areola reconstruction.