Immune system and tumor microenvironment in early-stage breast cancer: different mechanisms for early recurrence after mastectomy and chemotherapy on ductal and lobular types [version 2; peer review: 1 approved, 1 approved with reservations]

• Published in: F1000 research Vol. 12; p. 841
• Main Authors: Andrianto, Andreas, Sudiana, I Ketut, Suprabawati, Desak Gede Agung, Notobroto, Hari Basuki
• Format: Journal Article
• Language: English
• Published: England Faculty of 1000 Ltd 2023; F1000 Research Limited; F1000 Research Ltd
• Subjects: Anthracycline; Apoptosis; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Cancer therapies; Carcinoma, Ductal, Breast - drug therapy; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Carcinoma, Lobular - drug therapy; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; CD95 antigen; Chemotherapy; Consent; Cross-Sectional Studies; Ductal Carcinoma; Early Breast Carcinoma; eng; Ethics; Female; Fibroblasts; Hospitals; Humans; Immune System; Immunohistochemistry; Lobular Carcinoma; Local Recurrence; Mastectomy; Matrix Metalloproteinase 1; Medical records; Metastasis; Patients; Platelet-derived growth factor; Retrospective Studies; Stem cells; Surgery; Tumor Microenvironment; Vimentin; Indonesia; Local Recurrence; Early Breast Carcinoma; Ductal Carcinoma; Lobular Carcinoma
• ISSN: 2046-1402; 2046-1402
• DOI: 10.12688/f1000research.134302.2

Background: The most common type of breast cancer is the ductal type (IDC), followed by lobular type (ILC). Surgery is the main therapy for early-stage breast cancer. Adjuvant chemotherapy might be given to those at high risk of recurrence. We aimed to determine the mechanisms in early local recurrence in both types. Methods: An observational case-controlled study was used. Early-stage IDC and ILC patients who received modified radical mastectomy (MRM) and adjuvant taxan and anthracycline base chemotherapy had recurrence within two years. We examined vimentin, α-smooth muscle actin (SMA), matrix metalloproteinase (MMP1), platelet-derived growth factor (PDGF), and clustered differentiation (CD95) Results: In the ductal type group, there were 25 samples revealing local recurrence and 25 samples that did not recur. The lobular type group comprised six participants who did not have a recurrence, while seven subjects had a recurrence. There were significant differences in the expression of vimentin (p = 0.000 and 0.021, respectively), PDGF (p = 0.000 and 0.002), and CD95 (p = 0.000 and 0.045) in ductal and lobular cancer types, respectively. MMP1 (p = 0.000) and α-SMA (p = 0.000) only showed a significant difference in the ductal type. The pathway analysis showed that in the ductal type, the mechanism of recurrence was enabled by two factors: α-SMA and CD95. Meanwhile, for the lobular type, the recurrence mechanism was through the CD95 pathway. Conclusions: The tumor microenvironment and immune system both affect recurrence in IDC, whereas the immune system is more important in ILC. This study suggests that immune system enhancement may be an option for treating cancer.