Apoptosis evasion and local recurrence after mastectomy and chemotherapy in lobular type breast cancer. A cross-sectional study in a single-center

Abstract

Link of Video Abstract: https://www.youtube.com/watch?v=Ws-SVwmrhs0Background: Lobular type breast cancer (ILC) was the second most common type after ductal breast cancer. Chemotherapy may be used to lower the risk of recurrence in addition to surgery, which is the main treatment for early-stage breast cancer. Apoptosis is one of the body's techniques for killing cancer cells; thus, cancer cells must be able to evade it to survive. Due to the rarity of the disease, it is uncommon for researchers to investigate ILC, especially at an early stage. This study aimed to determine the mechanism of apoptosis evasion in ILC after mastectomy and chemotherapy who got local recurrence within two years after surgery by analyzing the expression of vimentin, IL 10, and CD 95. Methods: This research was a cross-sectional study of medical records in a single center. The sampling method was total sampling, i.e., all patients underwent a mastectomy and received chemotherapy from January 2014 to December 2019 (5 years). Immunohistochemistry analysis was used to check the vimentin, α-IL10, and CD 95 levels in paraffin blocks from surgical tissues. A chi-square test and a path analysis with a linear regression test were the statistical tests used in this study. Results: Seven samples contained local recurrence, while only six did not. According to statistical tests, the expression of vimentin, IL10, and CD95 between the recurrence and non-recurrence groups was significantly different. The chi-square test showed CD95 is a protective factor for local recurrence (odds ratio [OR] = 0.03, 95% confidence interval [CI] = 0.002-0.68 p =0.001). The multivariate analysis showed that vimentin expression has a significantly strong correlation with IL10 expression (p=0.000); the IL10 expression has a significant negative correlation to CD95 expression (p=0.03); and the CD95 expression was strongly correlated with the local recurrence (p=0.001). Conclusion: Apoptosis evasion had an important role in the local recurrence of ILC after mastectomy and chemotherapy.