Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast. BJS 2019; 106: 563-573.
Published: 25th February 2019
Authors: A. Lindegren, I. Schultz, I. Sinha, L. Cheung, A. A. Khan, M. Tekle et al.
Radiation‐induced fibrosis, an adverse effect of breast cancer treatment, is associated with functional and cosmetic impairment as well as surgical complications. Clinical reports suggest improvement following autologous fat transplantation, but the mechanisms underlying this effect are unknown. A global gene expression analysis was undertaken to identify genetic pathways dysregulated by radiation and evaluate the impact of autologous fat transplantation on gene expression.
Adipose tissue biopsies were taken synchronously from irradiated and contralateral non‐irradiated breasts, before and 1 year after autologous fat transplantation. Whole‐genome gene expression analyses were performed, and Hallmark gene set analysis used to explore the effect of radiotherapy and autologous fat transplantation on gene expression.
Forty microarrays were analysed, using bilateral biopsies taken from ten patients before and after autologous fat transplantation. Forty‐five pathways were identified among the 3000 most dysregulated transcripts after radiotherapy in irradiated compared with non‐irradiated breast (P ≤ 0·023; false discovery rate (FDR) no higher than 0·026). After autologous fat transplantation, 575 of the 3000 genes were again altered. Thirteen pathways (P ≤ 0·013; FDR 0·050 or less) were identified; the top two canonical pathways were interferon‐γ response and hypoxia. Correlative immunohistochemistry showed increased macrophage recruitment in irradiated tissues.
The present findings contribute to understanding of how autologous fat transplantation can ameliorate radiation‐induced fibrosis. This further supports the use of autologous fat transplantation in the treatment of radiation‐induced fibrosis. Clinical studies have indicated that autologous fat transplantation (AFT) stimulates regression of chronic inflammation and fibrosis caused by radiotherapy in skin and subcutaneous fat. However, there is a paucity of biological evidence and the underlying processes are poorly understood. Human data are scarce, whereas experimental studies have focused mainly either on the effect of irradiation or AFT alone.
Clinical studies have indicated that autologous fat transplantation (AFT) stimulates regression of chronic inflammation and fibrosis caused by radiotherapy in skin and subcutaneous fat. However, there is a paucity of biological evidence and the underlying processes are poorly understood. Human data are scarce, whereas experimental studies have focused mainly either on the effect of irradiation or AFT alone.Full text
You may also be interested in
Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence. BJS 2019; 106: 574-585.
Authors: I. G. M. Poodt, G. Vugts, R. J. Schipper, R. M. H. Roumen, H. J. T. Rutten, A. J. G. Maaskant‐Braat et al.
Notes: No impact
Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study). BJS 2019; 106: 720-728.
Authors: A. Karakatsanis, A.‐F. Hersi, L. Pistiolis, R. Olofsson Bagge, P. M. Lykoudis, S. Eriksson et al.
Short‐term cost‐effectiveness of one‐stage implant‐based breast reconstruction with an acellular dermal matrix versus two‐stage expander‐implant reconstruction from a multicentre randomized clinical trial. BJS 2019; 106: 586-595.
Authors: V. L. Negenborn, J. M. Smit, R. E. G. Dikmans, H. A. H. Winters, J. W. R. Twisk, P. Q. Ruhé et al.
Authors: F. Magnoni, G. Massari, G. Santomauro, V. Bagnardi, E. Pagan, G. Peruzzotti et al.
Authors: Y. Grant, R. Al‐Khudairi, E. St John, M. Barschkett, D. Cunningham, R. Al‐Mufti et al.
Notes: Reoperations expensive
Meta‐analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy‐proven node‐positive breast cancer. BJS 2018; 105: 1541-1552.
Authors: S. R. Tee, L. A. Devane, D. Evoy, J. Rothwell, J. Geraghty, R. S. Prichard et al.
Notes: In selected patients using dual tracer
Feasibility study of combined dynamic imaging and lymphaticovenous anastomosis surgery for breast cancer‐related lymphoedema. BJS 2019; 106: 100-110.
Authors: A. A. Khan, I. Hernan, J. A. Adamthwaite, K. W. D. Ramsey
Notes: Effective in selected patients
Randomized clinical trial
INTEND II randomized clinical trial of intraoperative duct endoscopy in pathological nipple discharge. BJS 2018; 105: 1583-1590.
Authors: G. Gui, A. Agusti, D. Twelves, S. Tang, M. Kabir, C. Montgomery et al.
Notes: Identifies causative lesion
Aesthetic outcome following breast‐conserving surgery assessed by three evaluation modalities in relation to health‐related quality of life. BJS 2019; 106: 90-99.
Authors: C. Dahlbäck, A. Ringberg, J. Manjer
Notes: Better methods needed
Current practice and short‐term outcomes of therapeutic mammaplasty in the international TeaM multicentre prospective cohort study. BJS 2018; 105: 1778-1792.
Authors: R. L. O'Connell, E. Baker, A. Trickey, T. Rattay, L. Whisker, R. D. Macmillan et al.
Notes: Reduces mastectomy rates
Nationwide population‐based study of trends and regional variation in breast‐conserving treatment for breast cancer. BJS 2018; 105: 1768-1777.
Authors: M. C. van Maaren, L. J. A. Strobbe, L. B. Koppert, P. M. P. Poortmans, S. Siesling
Notes: Regional differences remain
Survival and risk of breast cancer recurrence after breast reconstruction with deep inferior epigastric perforator flap. BJS 2018; 105: 1446-1453.
Authors: A. Svee, M. Mani, K. Sandquist, T. Audolfsson, Y. Folkvaljon, A. E. Isern et al.