Special Issue "Breast Cancer"

Guest Editor
Dr. Tomoharu Sugie
Breast Surgery, Kyoto University Hospital, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan
E-Mail:
Interests: breast surgery; cancer immunology

Dear Colleagues,

Current topics in breast cancer include the novel imaging in cancer, the minimal invasive operation, and tailoring therapeutic approach on the basis of cancer biology. Regarding the imaging, possible topics of interest may include the functional imaging on PET, molecular imaging on targeting molecules. Regarding surgery, possible topics of interest may include sentinel lymph node biopsy, the minimal surgery after chemotherapy and/or endocrine therapy, the plastic surgery. Regarding of cancer biology, possible topics of interest may include cancer stem cell, EMT, circulating tumor cell, and disseminated tumor cell. In clinical practice, we may interest in biomarkers predicting prognosis and therapeutic effect, chemotherapy and endocrine therapy on the basis of the intrinstic subtype, and immunotherapy (i.e. cancer vaccine, transferring CTL).

Tomoharu Sugie, MD
Guest Editor

Submission Information

All manuscripts should be submitted to cancers@mdpi.org with a copy to the Guest Editor. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed Open Access monthly journal published by MDPI.

For the first two issues, to be published in 2009 and 2010, the Article Processing Charges (APC) will be waived for well-prepared manuscripts. English correction and/or formatting fees of 250 CHF (Swiss Francs) will be charged in certain cases for those articles accepted for publication that require extensive additional formatting and/or English corrections.

• cancer imaging
• minimal breast surgery
• cancer biology
• biomarker
• intrinstic subtype
• chemotherapy
• endocrine therapy
• immunotherapy

Type of Paper: Article
Title: A Novel Navigation Technique Based on Indocyanine Green Fluorescence for Sentinel Lymph Node Biopsy in Breast Cancer
Authors: Tomoharu Sugie ¹, Kassim Abdelazeem Kassim ¹, Takashi Hashimoto ², Kazuhiko Yamagami ², Yoshikazu Masai ³ and Masakazu Toi ¹
Affiliations: ¹ Kyoto University, Yoshida Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
² Shinko Hospital, Wakihama-cho, Chuo-ku, Kobe-shi 651-0041, Japan
³ Kobe City Medical Center General Hospital, Minatojimanakamachi, Chuo-ku, Kobe-city, Hyogo, 650-0046, Japan
Abstract: Background: Sentinel lymph node (SLN) biopsy is the standard method to assess the actual axillary lymph node status in breast cancer. Currently dye techniques, radioisotope techniques or combined techniques are usually used for SLN detection. Recently, near infrared fluorescence imaging has been applied clinically in a breast cancer patient to identify SLN. In this study, the feasibility of SLN biopsy using the indocyanine green (ICG) technique were evaluated. Methods: The study involved four hundreds eleven patients with clinically node negative early breast cancer who underwent SLN in three institutes. A combination of ICG as a fluorescence emitting source and blue dyes were injected subcutaneously in the subareolar area and lymphatic flows were traced with a charge coupled device camera and a real –time image guided surgery enabled to identify the florescence image of SLN after meticulous dissection. Results: The median age was 57.8 years (range, 30-91 years). Overall, 13.1% of patients (54 /411) had DCIS and 82.5 % (339 /411) had invasive ductal carcinoma. The subcutaneous lymphatic channels were detected precisely in all cases. The identification rate of SLN was 99%, (408/411) with a mean number of 2.3 nodes (rang, 1-9). Thirty nine cases (9.5%) had SLNs involved, all of them were ICG -positive and 30 out of 39 cases (77%) had one SLN involved. Conclusion: The ICG and patent blue dye technique gives high sensitivity and provides a comparable result to the dye and radioactive techniques.

Type of Paper: Article
Title: Viruses as the Cause of Breast Cancer
Author: Jim Lawson
Affiliation: University of New South wales, Sydney, Australia; E-Mail: s8700008@unsw.edu.au
Abstract: Viruses are the accepted cause of many important cancers including cancers of the cervix and anogenital area, the liver, some lymphomas, head and neck cancers and indirectly HIV associated cancers. For over 50 years, there have been serious attempts to identify viruses which may have a role in breast cancer. Despite these efforts the establishment of conclusive evidence for such a role has been elusive. However, the development of extremely sophisticated new experimental techniques has allowed the recent development of sound, but not conclusive evidence, that human papilloma viruses, Epstein-Barr viruses, mouse mammary tumor virus and bovine leukemia viruses may each have separate roles in the causation of human breast cancers. This is potentially good news as effective vaccines are already available to prevent infections by HPVs.

Type of Paper: Review
Title: Possible Viral Etiology of Human Breast Cancer
Authors: Chun-Ru Hsu ¹, Tsong-Ming Lu ², Lengsu William Chin ², Chi-Chiang Yang ^2,3,4,*
Affiliation: ¹ Department of Microbiology, National Taiwan University College of Medicine, Taipei, R.O.C., Taiwan
² Institute of Medicine, Chung Shan Medical University, Taichung, R.O.C., Taiwan
³ School of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, R.O.C., Taiwan
⁴ Department of Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, R.O.C., Taiwan
Abstract: Viruses are considered to be one of the high-risk factors closely related to human breast cancer. However, different studies of viruses in breast cancer present conflicting results and some of these works remain in dispute. Viruses, such as specific types of human papillomaviruses (HPV), Epstein–Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV), and human herpes virus type 8 (HHV-8), have been emerged as causal factors of some human cancers. These respective exogenous viruses, as well as mouse mammary tumor virus (MMTV) and human endogenous retrovirus (HERV), and the possibility of multiple viral factors are discussed in this review.

Type of Paper: Review
Title: Molecular Imaging in Breast Cancer Diagnosis and Treatment
Author: Edelhauser Gundula
Affiliation: Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, AKH, Waehringer Guertel 18-20, A-1090 Vienna, Austria; E-Mail: gundula.edelhauser@meduniwien.ac.at
Abstract: Traditionally breast cancer imaging has focused on physiologic and anatomic characteristics to detect breast cancer and determine its extent. These changes usually occur as late manifestations of the cellular and molecular alterations causing this disease. The visualization of the early changes on a molecular level allows for earlier detection and intervention. Consequently, molecular imaging has become a prioritized and rapidly emerging research area. In the animal model, receptor specific imaging of breast cancer is feasible with PET, MRI, and optical methods based on fluorescence. Using this method, the efficacy of chemotherapeutic treatment can be monitored at an earlier stage than the observance of size changes with conventional imaging would allow. Clinically, receptor imaging is feasible with PET and used in selecting receptor-positive patients for hormonal therapy. Ideally, future therapeutic regimens will be tailored to the molecular subtypes of the tumors, ultimately resulting in improved survival and better quality of life for patients with breast cancer.

Type of Paper: Article
Title: Improving Risk Assessment for BRCA1 Carriers Using Functional Analysis
Authors: Marcelo A. Carvalho and Alvaro N.A. Monteiro
Affiliation: Cancer Prevention & Control Program, H. Lee Moffitt Cancer Center & Research Institute, MRC 3 West,12902 Magnolia Drive,Tampa, FL 33612, USA; E-Mails: marcelo.carvalho@inca.gov.br, Alvaro.Monteiro@moffitt.org
Abstract: At present, genetic testing allows the identification of predisposing alleles of BRCA1 and BRCA2 linked to breast and ovarian cancer. Germline mutations in the tumor suppressor gene BRCA1 confer an estimated lifetime risk of 56-80% for breast cancers and 15-60% for ovarian cancer. Since 1994, when the gene was positionally cloned, more than 1600 different germline variants have been documented, but not for a significant number of these variants the association with cancer has not been determined. Many individuals undergoing genetic testing for BRCA1 receive testing results indicating the discovery of variants of unknown clinical significance, leading to problems in risk assessment, counseling and preventive care. Risk assessment for individuals carrying these rare variants, such as missense changes, are particularly difficult. Here we explore how biochemistry and cell biology can help to clarify these issues, using of functional assays to complement genetic data in the analysis of unclassified variants.

Type of Paper: Review
Title: Do All Patients Require Radiotherapy after Breast-conserving Surgery?
Authors: Anita R Skandarajah ^1,2 and G. Bruce Mann ²
Affiliations: ¹ Department of Surgery, The University of Melbourne, Parkville, 3050, Australia; E-Mail: anita.skandarajah@mh.org.au
² The Breast Service, The Royal Melbourne and Royal Women’s Hospital, Parkville 3050, Australia
Abstract: Background: Radiotherapy following breast conservation is routine in the treatment of breast cancer. This creates a large demand for radiotherapy services with implicit cost effects and potential morbidity to patients. Radiotherapy is administered to decrease local recurrence but is radiotherapy required for all breast cancers? Methods: A literature search using the Medline and Ovid databases was conducted between 1965 and 2010 using the terms ‘role of radiotherapy’, ‘early breast cancer’, and omission of radiotherapy’. Papers with clinical trials published in English in adult humans were included. Results: Fourteen randomised controlled trials were included. Local recurrence rates range from 0.8-35% in patients in whom radiotherapy was omitted. Low risk characteristics include older age, small tumour size, no lymphovascular invasion and low to moderate grade. Conclusion: At present, there is no clearly defined low risk group of patients in whom radiotherapy can be omitted.