DNCB and PPD skin testing in breast cancer

Area of Science:

• Immunology
• Oncology
• Dermatology

Background:

• Cell-mediated immunity is crucial in cancer progression and patient outcomes.
• Assessing immune status in breast cancer patients can inform prognosis and treatment strategies.

Purpose of the Study:

• To evaluate cellular immune responses in breast cancer patients at different stages using standardized skin testing.
• To determine if immune reactivity correlates with breast cancer stage and nodal involvement.

Main Methods:

• 152 breast cancer patients underwent skin testing with 2,4-dinitrochlorobenzene (DNCB) and purified protein derivative (PPD).
• Testing was performed at diagnosis, prior to treatment, following Bates' standardized protocol.
• Reactivity was analyzed based on cancer stage (I-IV) and nodal status (N0, N1).

Main Results:

• No significant differences in DNCB or PPD reactivity were observed between Stage I and II breast cancer patients, irrespective of nodal involvement (N0 vs. N1).
• Patients with locoregionally advanced disease (Stage III) exhibited similar immune responses to those in Stage I and II.
• Stage IV breast cancer patients demonstrated significantly reduced responsiveness to both DNCB and PPD, with a more pronounced decrease to DNCB.

Conclusions:

• Immune responsiveness remains largely intact in early to locoregionally advanced breast cancer stages.
• Metastatic breast cancer (Stage IV) is associated with a significant impairment of cellular immune function.
• Skin testing with DNCB and PPD can identify immune deficits in advanced breast cancer, potentially aiding in monitoring disease progression.