Integrating Biological Advances Into the Clinical Management of Breast Cancer Related Lymphedema
Por:
Invernizzi, M, Lopez, G, Michelotti, A, Venetis, K, Sajjadi, E, De Mattos-Arruda, L, Ghidini, M, Runza, L, de Sire, A, Boldorini, R and Fusco, N
Publicada:
2 abr 2020
Ahead of Print:
2 abr 2020
Resumen:
Breast cancer-related lymphedema (BCRL) occurs in a significant number of breast cancer survivors as a consequence of the axillary lymphatics' impairment after therapy (mainly axillary surgery and irradiation). Despite the recent achievements in the clinical management of these patients, BCRL is often diagnosed at its occurrence. In most cases, it remains a progressive and irreversible condition, with dramatic consequences in terms of quality of life and on sanitary costs. There are still no validated pre-surgical strategies to identify individuals that harbor an increased risk of BCRL. However, clinical, therapeutic, and tumor-specific traits are recurrent in these patients. Over the past few years, many studies have unraveled the complexity of the molecular and transcriptional events leading to the lymphatic system ontogenesis. Additionally, molecular insights are coming from the study of the germline alterations involved at variable levels in BCRL models. Regrettably, there is a substantial lack of predictive biomarkers for BCRL, given that our knowledge of its molecular milieu remains extremely puzzled. The purposes of this review were (i) to outline the biology underpinning the ontogenesis of the lymphatic system; (ii) to assess the current state of knowledge of the molecular alterations that can be involved in BCRL pathogenesis and progression; (iii) to discuss the present and short-term future perspectives in biomarker-based patients' risk stratification; and (iv) to provide practical information that can be employed to improve the quality of life of these patients.
Filiaciones:
Invernizzi, M:
Univ Piemonte Orientale, Dept Hlth Sci, Phys & Rehabil Med, Novara, Italy
Lopez, G:
Univ Milan, Sch Pathol, Milan, Italy
Osped Maggiore Policlin, Div Pathol, Fdn IRCCS Ca Granda, Milan, Italy
Michelotti, A:
Osped Maggiore Policlin, Div Pathol, Fdn IRCCS Ca Granda, Milan, Italy
Venetis, K:
Univ Milan, PhD Program Translat Med, Milan, Italy
IRCCS European Inst Oncol IEO, Div Pathol, Milan, Italy
Sajjadi, E:
Osped Maggiore Policlin, Div Pathol, Fdn IRCCS Ca Granda, Milan, Italy
:
Hosp Badalona Germans Trias & Pujol, IrsiCaixa Foudat, Badalona, Spain
Ghidini, M:
Osped Maggiore Policlin, Div Med Oncol, Fdn IRCCS Ca Granda, Milan, Italy
Runza, L:
Osped Maggiore Policlin, Div Pathol, Fdn IRCCS Ca Granda, Milan, Italy
de Sire, A:
Univ Piemonte Orientale, Dept Hlth Sci, Phys & Rehabil Med, Novara, Italy
Mons L Novarese Hosp, Rehabil Unit, Moncrivello, Italy
Boldorini, R:
Novara Med Sch, Dept Hlth Sci, Pathol Unit, Novara, Italy
Fusco, N:
IRCCS European Inst Oncol IEO, Div Pathol, Milan, Italy
Univ Milan, Dept Oncol & Hematooncol, Milan, Italy
gold, Green Published
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