Biological and clinical review of IORT-induced wound fluid in breast cancer patients

Shabnam Jeibouei; Forough Shams; Fariba Mohebichamkhorami; Davood Sanooghi; Bahareh Faal; Mohammad Esmaeil Akbari; Hakimeh Zali

doi:10.3389/fonc.2022.980513

Biological and clinical review of IORT-induced wound fluid in breast cancer patients

Front Oncol. 2022 Nov 21:12:980513. doi: 10.3389/fonc.2022.980513. eCollection 2022.

Authors

Shabnam Jeibouei^{1

2}, Forough Shams³, Fariba Mohebichamkhorami⁴, Davood Sanooghi¹, Bahareh Faal⁵, Mohammad Esmaeil Akbari¹, Hakimeh Zali⁴

Affiliations

¹ Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Future Foods Lab, Virginia Seafood Agricultural Research and Extension Center, Virginia Tech, Hampton, VA, United States.
³ Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

Abstract

Intraoperative radiotherapy (IORT) has become a growing therapy for early-stage breast cancer (BC). Some studies claim that wound fluid (seroma), a common consequence of surgical excision in the tumor cavity, can reflect the effects of IORT on cancer inhibition. However, further research by our team and other researchers, such as analysis of seroma composition, affected cell lines, and primary tissues in two-dimensional (2D) and three-dimensional (3D) culture systems, clarified that seroma could not address the questions about IORT effectiveness in the surgical site. In this review, we mention the factors involved in tumor recurrence, direct or indirect effects of IORT on BC, and all the studies associated with BC seroma to attain more information about the impact of IORT-induced seroma to make a better decision to remove or remain after surgery and IORT. Finally, we suggest that seroma studies cannot decipher the mechanisms underlying the effectiveness of IORT in BC patients. The question of whether IORT-seroma has a beneficial effect can only be answered in a trial with a clinical endpoint, which is not even ongoing.

Keywords: IORT; breast cancer; personalized medicine; seroma; tumor microenvironment.

Publication types

Review