Maralcan G, et al. J Korean Surg Soc. 2011 Sep;81(3):169-175. http://dx.doi.org/10.4174/jkss.2011.81.3.169

Objective: The correlation between lymphedema severity and stages determined by standard diagnostic methods and Bioimpedance Spectroscopy (BIS) technique was examined in breast cancer-related lymphedema (BCRL) patients. Material and Methods: The bioimpedance analyzer device was connected to the 1.0 cm disc electrodes which were connected to the affected and unaffected (healthy) arm of the patients. We evaluated the performance of the impedance (Z) at multiple frequencies (5-50-100-200 kHz) and phase angle (PA), resistance (R), and reactance (XC) at 50 kHz on the lymphedema severity and stages. Bioimpedance measurements were applied to all volunteers in cooperation with the Physical Therapy and Rehabilitation Department. In this study, the correlation between BCRL severity and stages and bioimpedance values was examined. Results: A total of 31 female patients were recruited to compare the BIS technique with standard diagnostic techniques. The severity of lymphedema was found among the patients as follows; mild 14 (45.2%), moderate 10 (32.3%), and severe 7 (22.6%). The stage distribution of volunteers was; 15 (48.4%) patients in Stage 0, 10 (32.3%) patients in Stage 1, 5 (16.1%) patients in Stage 2, and 1 (3.2%) patient in Stage 3. The ratio of affected and unaffected arm bioimpedance mean values were calculated. Although, this ratio at 50-100-200 kHz Z and 50kHz R were significantly correlated with the lymphedema stages (p< 0.05), there was no correlation and significant difference between the ratio of the bioimpedance values and lymphedema severity (p> 0.05). Conclusion: The BIS technique is timesaving and can determine lymphedema stages. We found a significant correlation between BCRL stages and BIS, and it appears that BIS is an appropriate, inexpensive, simple, and noninvasive technique for detecting the stages of BCRL.

Background and Objectives: Among breast cancer molecular types, HER2 positive and triple negative (TN) subtypes have the highest likelihood of pathological complete response (pCR), which is a surrogate marker for reduced recurrence and improved patient survival after neoadjuvant systemic treatment (NST). Preoperative pathological identification of these exceptional responders is a new era. Therefore, we aimed to determine the accuracy of trucut biopsy in identifying the exceptional responders in selected molecular subtypes of breast cancer patients. Materials and Methods: This two-centre, observational, single-arm, prospective, pilot study was conducted between January and September 2024. The patients with TN or HER2 positive breast cancer whose breast tumour had completely disappeared on the radiological assessment including MRI after neoadjuvant therapy were enrolled. To assess neoadjuvant treatment response, a standardised biopsy protocol was used, consisting of 10 samples from the marked tumour area per patient by 12 G core needle. Then, all patients underwent surgery. The pathological results of both postchemo-presurgical biopsy and surgical breast specimen were compared. Results: The study included 20 patients. The mean age of the patients was 47.3 years. The median tumour size at diagnosis was 23.1 mm. All biopsy results were concordant with the findings of surgical specimen. Seventeen patients had a complete response. The remaining 3 patients had residual disease. Conclusions: Along with thorough patient selection, post-chemo radiological assessment and the reliable biopsy technique are the key points in accurately predicting response to neoadjuvant treatment. If an image-guided core biopsy confirms elimination of tumour tissue at the marked tumour area with a radiological complete response on MRI after NST in breast cancer patients with selected molecular subtypes, these may be suitable patients as exceptional responders in whom we can omit breast surgery.

Objectives: Breast cancer is one of the most common malignancy for women and one of the most common causes of cancer related deaths for women. Genetic factors and family history play major roles in its etiology. For a possible genetic treatment genetic pathway should be illuminated. Materials and methods: Three miRNAs known to be involved in the regulation of SIRT1 were selected for review in this study. These were miRNA-34a, miRNA-9 and miRNA-132 miRNAs. The miRNeasy Mini Kit was used to isolate total RNA from both cancer tissues and normal breast tissues in patients with breast cancer who underwent mastectomy for treatment. Expression levels of miRNAs were measured and normalized with U6 gene. Results: After measurment of expression levels, normalizing with U6 gene and statistical analysis, we found that there was no statistically significant difference between breast cancer tissues and normal breast tissues. Conclusion: Limited number of studies reported that the levels of all three micro RNAs were found to be lower in breast cancer tissues than in normal breast tissue. In this study, no statistically significant difference was found between normal breast tissue and breast cancer tissues in terms of levels of these micro RNAs for all three micro RNAs. The existence of conflicting and incomplete information about the SIRT1 enzyme did not surprise us with a result that is not compatible with the literature. Further studies are needed to clearly elucidate the mechanisms of SIRT1 and its regulating micro-RNAs. In the studies to be done, the determination of the microRNA levels simultaneously with SIRT1’s own expression levels can be enlightening on this issue.