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Biomedical subjects

Giles H Cunnick

Publications and source records attributed to Giles H Cunnick.

4 recordsLinked to original sources
PubMed2004

Skin-sparing mastectomy.

BACKGROUND: Skin-sparing mastectomy represents a new surgical approach that allows a mastectomy while preserving the natural skin envelope of the breast. It facilitates immediate breast reconstruction using an implant or myocutaneous flap, resulting in excellent cosmesis. DATA SOURCES: A PubMed database literature search was performed. CONCLUSIONS: Skin-sparing mastectomy is an oncologically safe technique in selected cases; T1/T2, multicentric tumors, ductal carcinoma in situ, and prophylactic mastectomies are particularly suited to this technique. Further research is required to confirm oncologic safety in T3 tumors. In selected cases, the nipple-areola complex can be preserved. A modification of skin-sparing mastectomy includes the removal of the nipple while preserving the areola. The balance of evidence suggests that skin-sparing mastectomy does not increase the risk of locoregional recurrence. Furthermore, it does not delay adjuvant therapies. Contraindications to skin-sparing mastectomy approaches include inflammatory breast cancer and extensive skin involvement by tumor. Preoperative and postoperative radiotherapy are not a contraindication to skin-sparing mastectomy.

Breast Neoplasms↗
PubMed2004

Levels of expression of endothelial markers specific to tumour-associated endothelial cells and their correlation with prognosis in patients with breast cancer.

Tumour endothelial markers (TEMs) are a newly discovered family of endothelial markers associated with tumour specific angiogenesis. This study sought to examine the levels of expression for TEMs in human breast cancer. Breast cancer tissues (n = 120) together with normal background tissues (n = 33) were obtained after surgery. RNA was extracted from frozen sections for gene amplification. The expression of TEMs was assessed using RT-PCR and the quantity of their transcripts was determined using real-time-quantitative PCR (Q-RT-PCR). TEM-7R (P = 0.05) and TEM-8 (P < 0.01) were significantly raised in breast cancer tissues compared with the levels detected in normal background tissues. After a median follow-up of 72.2 months it was found that patients who had recurrent disease and/or who had died from breast cancer had a significantly (P < 0.05) elevated level of TEM-1 compared to those patients who were disease free. In addition, elevated levels of TEM-4, TEM-5, TEM-6, TEM-7 and TEM-7R were also raised in breast cancer tissues. Patients who had developed nodal involvement exhibited significantly (P < 0.05) high levels of TEM-1 and TEM-7R compared to patients who were node negative. Furthermore, the levels of TEMs did not correlate with tumour or histological grade. We conclude that elevated levels of TEM-1, TEM-7R and TEM-8 (but not TEM-2, 4, 5, 6 and 7) are associated with either nodal involvement, and/or disease progression, and may therefore, have a prognostic value in breast cancer.

Base Sequence↗
PubMed2003

Prognostic value of rho GTPases and rho guanine nucleotide dissociation inhibitors in human breast cancers.

PURPOSE: Rho family members are small GTPases that are known to regulate malignant transformation and motility of cancer cells. The activities of Rhos are regulated by molecules such as guanine nucleotide dissociation inhibitors (GDIs). This study determined the levels of expression and the distribution of Rho-A, -B, -C, and -G, and Rho-6, -7, and -8, as well as Rho-GDI-beta, and Rho-GDI-gamma, in breast cancer and assessed their prognostic value. EXPERIMENTAL DESIGN: The distribution and location of Rhos and RhoGDIs were assessed using immunohistochemical staining of frozen sections. The levels of transcripts of these molecules were determined using a real-time quantitative PCR. Levels of expression were analyzed against nodal involvement and distant metastasis, grade, and survival over a 6-year follow-up period. RESULTS: The levels of Rho-C, Rho-6, and Rho-G were significantly higher in breast cancer tissues (n = 120) than in background normal tissues (n = 32). However, the level of Rho-A and -B and rho-7 and -8 was found to be similar in tumor and normal tissues. Immunohistochemical staining revealed the high level of staining of Rho-C protein in tumor cells. The levels of Rho-GDI-gamma transcripts were found to be significantly lower in tumor tissues than in normal tissues (P < 0.05 and P < 0.001, respectively). Node-positive tumors have significantly higher levels of Rho-C and Rho-G, and lower levels of Rho-GDI and Rho-GDI-gamma transcripts, than do node-negative tumors. Significantly higher levels of Rho-C and Rho-G were seen in patients who died of breast cancer than in those who remained disease free. Patients with recurrent disease, with metastasis or who died of breast cancer, also exhibited higher levels of Rho-6 but lower levels of Rho-GDI-gamma. Higher-grade tumors were also associated with low levels of Rho-GDI and Rho-GDI-gamma. CONCLUSIONS: Raised levels of Rho-C, Rho-G and Rho-6 and reduced expression of Rho-GDI and -GDI-gamma in breast tumor tissues are correlated with the nodal involvement and metastasis. This suggests that the expression of Rhos and Rho-GDIs in breast cancer is unbalanced and that this disturbance has clinical significance in breast cancer.

Breast Neoplasms↗