Objectives. Some chemotherapy drugs can damage the nerves and cause peripheral neuropathy which is accompanied by severe neuropathic pain or gait impairment. The purpose of this study was to assess the feasibility and the safety of acupuncture for the treatment of peripheral neuropathy following chemotherapy in Korean breast cancer patients. Design. This study was a prospective single‐arm observational study using before and after measurements in breast cancer patients presenting with taxane‐induced peripheral neuropathy. Settings/Location. This study was performed at East‐West Medical Center at Daegu Catholic University Hospital, Daegu, South Korea. Interventions. Acupuncture was administered 3 times a week for 4 consecutive weeks, for 25 ± 5 minutes at each session. Outcome Measures. The primary outcome measure was severity of CIPN using the Neuropathic Pain Symptom Inventory (NPSI) assessed by a self‐administered questionnaire and Nerve Conduction Study (NCS) of extremities. The secondary outcome measure was quality of life (QoL) assessed by a self‐administered questionnaire using the 36‐Item Short From Health Survey (SF‐36). Results. Acupuncture significantly reduced the severity of CIPN assessed by NPSI score. Four weeks after the last treatment, the symptoms were not aggravated. According to NCS, 42.9% of participants showed improvement of sensory neuropathy. At the end of the treatment, SF‐36 scores were significantly increased for variables including physical functioning, role limitations due to physical health problems, social functioning, and general health perceptions compared to those of baseline measurement. Conclusions. Acupuncture improved symptoms of CIPN and QoL in Korean women suffering from peripheral neuropathy after chemotherapy using taxane for breast cancer. The effects of acupuncture lasted for at least 1 month after the treatment.

Inflammation and cancer stem cells (CSCs) are becoming increasingly recognized as components of tumorigenesis in breast cancer. In the present study, the association between inflammation and BCSC phenotype was evaluated in human breast cancer tissue. Immunohistochemical staining for cluster of differentiation (CD)24, 44, 4, 8 and 68 was performed using tissue microarray blocks containing 47 consecutive cases of invasive breast carcinoma and 10 normal breast tissue samples. The levels of inflammatory modulators and cytokines, and intratumoral or peritumoral lymphocyte infiltration, were assessed. BCSCs were defined as CD44(+)/CD24(-) tumor cells. In total, 21.3% of samples exhibited the CD44(+)/CD24(-) phenotype. This phenotype was identified to be significantly inversely associated with lymph node metastasis. In addition, the CD44(+)/CD24(-) phenotype was significantly associated with the molecular subtype of breast cancer, and was particularly increased in the basal-like subtype. Furthermore, the CD44(+)/CD24(-) phenotype was significantly associated with intratumoral inflammation and tumor-infiltrating CD4(+) T cell counts. Notably, tumor-infiltrating CD4+ T cells were significantly increased in patients with the basal-like molecular subtype of breast cancer. In conclusion, the present study identified a significant association between inflammation and the CD44(+)/CD24(-) phenotype in breast cancer. These results suggest that the interaction between inflammation and CSCs may affect the tumorigenesis and progression of breast cancer. Further studies are required to clarify the role of inflammation and CSCs in breast cancer.

Jeon EJ, et al. J Korean Med Sci. 2016 Mar;31(3):397-402. http://dx.doi.org/10.3346/jkms.2016.31.3.397

Epigenetic analyses have shown that aberrant DNA methylation signatures are associated with breast cancer molecular subtypes. In this study, we analyzed the methylation status of breast cancer-related genes in relation to the molecular subtypes and investigated whether the basal-like subtype displays distinct methylation profiles. By using pyrosequencing, we analyzed the DNA methylation status of 5 candidate genes in 60 breast cancer samples. We compared the methylation frequency across the molecular subtypes and analyzed the correlation between methylation levels and clinicopathological characteristics. A total of 59 cases displayed aberrant methylation. Amplification during polymerase chain reaction analysis failed in 1 case. The median methylation levels of the secreted frizzled-related protein 1 (SFRP1) gene were significantly lower in the basal-like subtype compared to the luminal A, luminal B and human epidermal growth factor receptor 2 (HER2) subtypes. Cadherin 13 (H-cadherin; CDH13) methylation levels were significantly higher in the HER2 tumors compared to the luminal A and basal-like subtypes. A comparison of the methylation status with clinicopathological characteristics revealed that the expression of bcl-2, progesterone receptor and epidermal growth factor receptor were associated with SFRP1 gene methylation status. Our results indicate that the basal-like subtype is associated with low methylation levels of the SFRP1 gene, suggesting that the methylation levels of specific breast cancer genes may potentially serve as epigenetic biomarkers and prognostic factors.

Aberrant DNA methylation has been recognized to contribute to breast carcinogenesis, and promoter hypermethylation of several tumor suppressor genes has been correlated with decreased gene expression. The fragile histidine triad (FHIT) gene is a putative tumor suppressor gene in breast and other types of cancer, and loss of Fhit expression has been observed in breast cancer. The aim of the present study was to evaluate the association between methylation of the FHIT gene and its expression in breast cancer, and to investigate whether methylation and expression of the FHIT gene correlates with clinicopathological characteristics in relation to human epidermal growth factor receptor 2 (HER2) status. Pyrosequencing of bisulfite-treated DNA was performed to study the methylation status of the FHIT gene in 60 breast cancer samples. We examined the expression of Fhit using tissue microarrays by immunohistochemical staining. FHIT methylation was detected in 96.7% and the positive expression rate of Fhit was 87.3% of the patients. The mean methylation level of the FHIT gene was associated with intratumoral inflammation. Methylation level of the FHIT gene had no significant differences according to molecular subtypes. Loss of Fhit expression was associated with large tumor size, basal-like subtype and positive expression of EGFR. In HER2-negative breast cancer, loss of Fhit expression was significantly associated with tumor size, estrogen receptor status and Ki-67 proliferation index. No significant correlation between methylation of the FHIT gene and its expression was observed in the present study. Our results suggest that loss of Fhit expression in breast cancer is associated with poor prognostic features, and it is also relevant to the results in HER2-negative breast cancer. Further studies with larger sample sizes and longer follow-up are required to clarify the predictive and prognostic value of Fhit expression and the FHIT gene methylation status in breast cancer.