negating the possible adverse effects of surgery on bc spread

[Lani]

I have previously posted on the theoretical reasoning regarding the more recent approach to minimizing surgeries ie having the smallest operation to do the job 1) the apparent relationship between inflammation and breast cancer
when studying gene expression profiles and 2) the fact that tumors tend to reoccur x months (what x is depends on the tumor type) after surgery rather than x months after a lump is discovered (some don't have surgery right away due to fear, government health systems with long waits, lack of access to medical care in remote areas, etc)

Here is an article discussing the merits of a type of intraoperative radiation therapy which appears to reverse the changes caused by surgery in such a way that the gene expression and cytokine profiles is different without impeding healing

Clin Cancer Res. 2008 Mar 1;14(5):1325-1332. Links
Targeted Intraoperative Radiotherapy Impairs the Stimulation of Breast Cancer Cell Proliferation and Invasion Caused by Surgical Wounding.

Belletti B, Vaidya JS, D'Andrea S, Entschladen F, Roncadin M, Lovat F, Berton S, Perin T, Candiani E, Reccanello S, Veronesi A, Canzonieri V, Trovò MG, Zaenker KS, Colombatti A, Baldassarre G, Massarut S.
Authors' Affiliations: Experimental Oncology 2, Breast Surgery Unit, Radiation Oncology, Pathology, Medical Oncology C, and Department of Breast Cancer Research, Centro di Riferimento Oncologico, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy.
PURPOSE: After apparently successful excision of breast cancer, risk of local recurrence remains high mainly in the area surrounding the original tumor, indicating that wound healing processes may be implicated. The proportional reduction of this risk by radiotherapy does not depend on the extent of surgery, suggesting that radiotherapy, in addition to killing tumor cells, may influence the tumor microenvironment. EXPERIMENTAL DESIGN: We studied how normal and mammary carcinoma cell growth and motility are affected by surgical wound fluids (WF), collected over 24 h following breast-conserving surgery in 45 patients, 20 of whom had received additional TARGeted Intraoperative radioTherapy (TARGIT), immediately after the surgical excision. The proteomic profile of the WF and their effects on the activation of intracellular signal transduction pathways of breast cancer cells were also analyzed. RESULTS: WF stimulated proliferation, migration, and invasion of breast cancer cell lines. The stimulatory effect was almost completely abrogated when fluids from TARGIT-treated patients were used. These fluids displayed altered expression of several cytokines and failed to properly stimulate the activation of some intracellular signal transduction pathways, when compared with fluids harvested from untreated patients. CONCLUSIONS: Delivery of TARGIT to the tumor bed alters the molecular composition and biological activity of surgical WF. This novel antitumoral effect could, at least partially, explain the very low recurrence rates found in a large pilot study using TARGIT. It also opens a novel avenue for identifying new molecular targets and testing novel therapeutic agents.
PMID: 18316551 [PubMed - as supplied by publisher]

[TSund]

I'm trying to interpret this. Does this say (or theorize) that it was actually the radiation and not the "smaller" surgery that made for the better outcomes regarding post-surgery stress on the body (probably inflammatory processes)?