Surgical Oncology

The use of the selective estrogen receptor modulator tamoxifen in the treatment of breast cancer is associated with adverse effects on the endometrium such as discharge, bleeding, and endometrial cancer. Angiogenesis in the endometrium is under hormonal control. One of the most potent inducers of angiogenesis is vascular endothelial growth factor (VEGF), a protein which is increased in breast cancer tumors. Tamoxifen is also associated with higher plasma VEGF levels in patients whose breast cancer is in remission. Vitamin E succinate (VES) has been identified as an inhibitor of VEGF expression in breast, melanoma, and prostate cell lines. The objective of this project is to test the hypothesis that the addition of vitamin E succinate (VES), a putative inhibitor of angiogenesis, to tamoxifen therapy further decreases the size of estrogen receptor-positive human tumors in xenografted nude mice. VES is expected to have a similar effect on VEGF expression in ER-negative breast cancers and, if so, may offer an alternative to tamoxifen as a form of maintenance therapy. Lastly, co-adminstration of VES and tamoxifen may decrease the potential carcinogenic effect of tamoxifen on the uterus. Having demonstrated that VES reduced tumor growth and angiogenesis in the subcutaneously engrafted tumor models, we established a murine model of breast cancer metastatic to bone by arterial injection of tumor cells. This model will in turn use the treatment groups described above to evaluate the role of VES in prevention and treatment of breast cancer metastasis, particularly as an alternative to tamoxifen in estrogen receptor-negative tumors. An affirmative result would motivate clinical trials addressing a major problem in the adjuvant treatment of breast cancer.

Surgical Oncology Research

1. Interaction of Vitamin E Succinate and Tamoxifen in the Modulation of Angiogenesis in Breast Cancer
2. SIU Surgery Subspecialty - Family Practice Telehealth Collaboration
3. A Prospective Study to Evaluate The Risk of Local Relapse in Sentinel Lymph Node Negative Patients With Breast Cancer