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Primary Neuroendocrine Carcinoma of the Breast: Histopathological Criteria, Prognostic Factors, and Review of the Literature. Case Rep Pathol 2016; 2016:6762085. [PMID: 27840759 PMCID: PMC5093292 DOI: 10.1155/2016/6762085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/29/2016] [Accepted: 10/03/2016] [Indexed: 11/29/2022] Open
Abstract
We present here a case of a 42-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). We discuss the importance of histological criteria for primary neuroendocrine mammary carcinoma, established by WHO in 2003 and 2012. After an overview of different cases of primary neuroendocrine carcinoma of the breast published in the literature, we present information about differential diagnosis, prognostic factors, and surgical and adjuvant treatment. Prognosis of NECB is not different from that of other invasive breast carcinomas and the most important prognostic factor is tumor grade (G). There is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (not otherwise specified), whose choice of therapy depends on tumor's size, degree of differentiation, clinical stage, and hormonal status.
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52
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Jove M, Verghese E, Sharma N, Lane S. Residual mucin and response after neoadjuvant chemotherapy (NAC) in breast cancer. BMJ Case Rep 2016; 2016:bcr-2016-214509. [PMID: 27154986 DOI: 10.1136/bcr-2016-214509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Neoadjuvant chemotherapy (NAC) is the standard of care for patients with breast cancer with inoperable disease or smaller tumours who might benefit from a conservative surgery after downstaging of their disease. Nevertheless, evidence shows that preoperative and postoperative chemotherapy are equivalent in terms of long-term survival. Response and histological changes after NAC have been widely studied in invasive ductal carcinoma not otherwise specified, but there is a paucity of characterisation of patterns of response to chemotherapy in less frequent histological types. We report extensive residual mucin deposits after chemotherapy in a woman with locally advanced breast cancer and a prominent mucinous component at diagnosis. Interestingly, residual mucin was co-located with the initial tumour, in the breast as well as in the axillary lymph nodes. The distribution of mucin may be a valuable marker of the extent of mucinous carcinomas prior to NAC.
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Affiliation(s)
- Maria Jove
- Department of Medical Oncology, St James's Institute of Oncology, St James's University Hospital, Leeds, UK
| | - Eldo Verghese
- Pathology Department, St James's Institute of Oncology, St James' University Hospital, Leeds, Leeds, UK
| | - Nisha Sharma
- Radiology Department, St James's University Hospital, Leeds, UK
| | - Sally Lane
- Pathology Department, St James's Institute of Oncology, St James' University Hospital, Leeds, Leeds, UK
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53
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Massat NJ, Sasieni PD, Tataru D, Parmar D, Cuzick J, Duffy SW. Explaining the Better Prognosis of Screening-Exposed Breast Cancers: Influence of Tumor Characteristics and Treatment. Cancer Epidemiol Biomarkers Prev 2016; 25:479-87. [PMID: 26646361 DOI: 10.1158/1055-9965.epi-15-0804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/01/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In England, population mammographic screening has been offered to women for over 20 years. Overall decrease in breast cancer mortality rates and improvements in cancer awareness and organization of medical care over this period call for a more current evaluation of the mediators behind the better prognosis of screening-exposed breast cancers. METHODS A case-control study was conducted within the English National Breast Screening Program. Women who died from primary breast cancer in 2008 to 2009 were matched (by year of birth, screening invitation, and area) to controls that received a diagnosis of invasive breast cancer at the time of the case diagnosis but survived the case death. Data were analyzed by unconditional logistic regression with adjustment for matching factors. RESULTS The unadjusted OR for dying from breast cancer associated with ever having attended breast screening was 0.44 [95% confidence interval (CI), 0.33-0.58]. After adjustment for lead time, overdiagnosis, and self-selection, the OR increased to 0.69 (95% CI, 0.50-0.94). Adjusting for tumor size, lymph node status, stage, grade, histopathology, and laterality accounted for all the screening effect (OR, 1.00; 95% CI, 0.71-1.40). Further adjustment for treatment factors only had a minimal impact on the OR (OR, 1.02; 95% CI, 0.72-1.45). CONCLUSIONS Our results suggest that earlier diagnosis, as reflected by tumor characteristics, remains the major mediator of the improvement in breast cancer survival due to participation in mammographic screening. IMPACT Mammographic screening continues to prevent breast cancer-related deaths in the epoch of adjuvant systemic therapy.
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Affiliation(s)
- Nathalie J Massat
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Peter D Sasieni
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Daniela Tataru
- National Cancer Intelligence Network (NCIN), Public Health England, London, United Kingdom
| | - Dharmishta Parmar
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.
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54
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Romeira D, Cardoso D, Miranda H, Martins A. Adenoid cystic carcinoma: triple negative breast cancer with good prognosis. BMJ Case Rep 2016; 2016:bcr-2015-213704. [PMID: 26843221 DOI: 10.1136/bcr-2015-213704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Adenoid cystic carcinoma of the breast (ACCb) is a rare type of breast cancer. The treatment is not consensual. The authors report two cases of ACCb. Case 1: A 59-year-old woman with T1bN0M0, who went for lumpectomy and adjuvant radiation therapy (RT) (60 Gy in 30 fractions); Case 2: A 43-year-old woman, who went for modified radical mastectomy with T3N1M0, and underwent adjuvant chemotherapy, and a sequential regimen with antracyclin and taxane, prior to adjuvant RT (50 Gy/25 fractions).
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Affiliation(s)
- Daniel Romeira
- Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Débora Cardoso
- Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Helena Miranda
- Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Ana Martins
- Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
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55
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Wright L, Ng CE, Fasih T. Atypical breasts cancers. Int J Surg Case Rep 2016; 20:41-5. [PMID: 26812668 PMCID: PMC4818297 DOI: 10.1016/j.ijscr.2016.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 01/08/2016] [Accepted: 01/08/2016] [Indexed: 11/18/2022] Open
Abstract
Myoepithelial carcinomas comprise exclusively of tumour cells with myoepithelial differentiation and can be managed through surgical excision with radiotherapy. Mucinous carcinomas are difficult to diagnose but important to distinguish as survival rate between the types can vary. Invasive apocrine carcinomas are difficult to diagnose due to the variable presentation and lack of diagnostic criteria.
Introduction Method Conclusion
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Affiliation(s)
- Lucie Wright
- Surgical Department, Queen Elizabeth Hospital, Gateshead, NE9 6SX, United Kingdom.
| | - Cho Ee Ng
- Surgical Department, Queen Elizabeth Hospital, Gateshead, NE9 6SX, United Kingdom.
| | - Tarannum Fasih
- Surgical Department, Queen Elizabeth Hospital, Gateshead, NE9 6SX, United Kingdom.
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56
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Makki J. Diversity of Breast Carcinoma: Histological Subtypes and Clinical Relevance. Clin Med Insights Pathol 2015; 8:23-31. [PMID: 26740749 PMCID: PMC4689326 DOI: 10.4137/cpath.s31563] [Citation(s) in RCA: 264] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/27/2015] [Accepted: 10/29/2015] [Indexed: 02/06/2023] Open
Abstract
Mammary carcinoma is the most common malignant tumor in women, and it is the leading cause of mortality, with an incidence of >1,000,000 cases occurring worldwide annually. It is one of the most common human neoplasms, accounting for approximately one-quarter of all cancers in females worldwide and 27% of cancers in developed countries with a Western lifestyle. They exhibit a wide scope of morphological features, different immunohistochemical profiles, and unique histopathological subtypes that have specific clinical course and outcome. Breast cancers can be classified into distinct subgroups based on similarities in the gene expression profiles and molecular classification.
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Affiliation(s)
- Jaafar Makki
- Senior Pathologist, Pathology Department, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
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57
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Ratti V, Pagani O. Clear Cell Carcinoma of the Breast: A Rare Breast Cancer Subtype - Case Report and Literature Review. Case Rep Oncol 2015; 8:472-7. [PMID: 26600782 PMCID: PMC4649731 DOI: 10.1159/000441838] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Glycogen-rich clear cell breast carcinoma is a rare histological breast cancer subtype. Its prognosis may vary depending on specific clinical and pathological characteristics such as low grade, strong positivity of estrogen receptor (ER) expression and early diagnosis. Case Presentation We present the case of a 53-year-old woman with a bleeding 10-cm-diameter mass in the left breast. The histological examination showed a poorly differentiated tumor with malignant cells characterized by abundant clear cytoplasm. The diagnosis of clear cell carcinoma was based on the histological characteristics of the tumor, and a nonmammary origin was initially ruled out. The tumor was triple negative [i.e. ER, progesterone receptor (PR) and HER2 negative]. Four months after the initial locoregional treatment, the patient developed lung and distant lymph node metastases. Conclusions Glycogen-rich clear cell carcinoma of the breast is a rare tumor. Early diagnosis, absence of lymph node metastases and ER/PR positivity are associated with a better prognosis, as in other common breast cancer subtypes.
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Affiliation(s)
- Vilma Ratti
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Olivia Pagani
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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58
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Saghatchian M, Fadoukhair Z, Hofert K, Lanoy E, Mathieu MC, Mazouni C, Delaloge S. Uncovering Professional Attitudes Toward Treatment of Rare Carcinomas of the Breast: An International Practice e-Survey Involving 32 Countries. Breast J 2015; 22:96-100. [PMID: 26511594 DOI: 10.1111/tbj.12525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
World Health Organization classification has identified a dozen rare subtypes accounting for less than 10% of all breast cancers (BC), generally not taken into account in treatment guidelines. We evaluated professionals' attitudes toward decision-making regarding rare BC and consensus guidelines needs. In this international e-survey, 236 BC experts from all specialties were contacted through email to fill an online questionnaire about their practices. Eighty-six experts from 32 countries participated (36%); 50% medical oncologists, 21% surgeons, 17% pathologists, and 12% radiation oncologists. General BC care decisions were based on consensus guidelines in 77% of expert, whereas routine individual treatment decisions for BC were made by multi-disciplinary boards in 76%. Only 10% strongly considered rare BC should be treated following existing standard guidelines. Interestingly, 50-80% described individualizing treatment for rare BC according to pathologic subtype. More than 90% of experts would welcome international recommendations for rare BC. This large scale international multi-disciplinary survey revealed overarching concerns centered on several key themes: the lack of resources and data to address these less common BC; the heterogeneous management of rare BC depending on geographical location and specialist training; the demand for international consensus guidelines regarding their diagnosis and treatment.
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Affiliation(s)
- Mahasti Saghatchian
- Department of Medical Oncology, Breast Cancer Unit, Gustave Roussy, Villejuif, France
| | - Zouhour Fadoukhair
- Department of Medical Oncology, Breast Cancer Unit, Gustave Roussy, Villejuif, France
| | | | - Emilie Lanoy
- Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France
| | | | - Chafika Mazouni
- Department of Surgery, Unit of Breast and Plastic Surgery, Gustave Roussy, Villejuif, France
| | - Suzette Delaloge
- Department of Medical Oncology, Breast Cancer Unit, Gustave Roussy, Villejuif, France
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Abstract
Breast carcinoma is a heterogenous disease. Carcinomas lacking expression of estrogen, progesterone, and HER2/neu receptors by immunohistochemistry and Her2 amplification are designated as triple negative. This group of carcinomas comprises approximately 10% to 20% of all breast carcinomas and is characterized by an aggressive nature with shorter rates of disease-free and overall survival. This aggressive behavior is further compounded by the lack of available targeted therapies. Patients receive cytoxic chemotherapy regimens. Although tumors are initially sensitive to this therapy, drugs are toxic and ineffective in maintaining long-term response thereby providing limited benefit. Much effort is being spent on this group of cancers for the identification of appropriate molecular targets, an effort that is proving challenging due to the presence of marked heterogeneity, both at the morphologic and molecular levels. An understanding of the advances in this field is crucial for developing targeted therapies and tailored patient management protocols. This report summarizes the pathologic subtypes of breast cancer that are commonly of a triple-negative immunophenotype and recent molecular advances in this field.
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60
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Martelotto LG, De Filippo MR, Ng CKY, Natrajan R, Fuhrmann L, Cyrta J, Piscuoglio S, Wen HC, Lim RS, Shen R, Schultheis AM, Wen YH, Edelweiss M, Mariani O, Stenman G, Chan TA, Colombo PE, Norton L, Vincent-Salomon A, Reis-Filho JS, Weigelt B. Genomic landscape of adenoid cystic carcinoma of the breast. J Pathol 2015; 237:179-89. [PMID: 26095796 DOI: 10.1002/path.4573] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/24/2015] [Accepted: 06/10/2015] [Indexed: 12/31/2022]
Abstract
Adenoid cystic carcinoma (AdCC) is a rare type of triple-negative breast cancer (TNBC) characterized by the presence of the MYB-NFIB fusion gene. The molecular underpinning of breast AdCCs other than the MYB-NFIB fusion gene remains largely unexplored. Here we sought to define the repertoire of somatic genetic alterations of breast AdCCs. We performed whole-exome sequencing, followed by orthogonal validation, of 12 breast AdCCs to determine the landscape of somatic mutations and gene copy number alterations. Fluorescence in situ hybridization and reverse-transcription PCR were used to define the presence of MYB gene rearrangements and MYB-NFIB chimeric transcripts. Unlike common forms of TNBC, we found that AdCCs have a low mutation rate (0.27 non-silent mutations/Mb), lack mutations in TP53 and PIK3CA and display a heterogeneous constellation of known cancer genes affected by somatic mutations, including MYB, BRAF, FBXW7, SMARCA5, SF3B1 and FGFR2. MYB and TLN2 were affected by somatic mutations in two cases each. Akin to salivary gland AdCCs, breast AdCCs were found to harbour mutations targeting chromatin remodelling, cell adhesion, RNA biology, ubiquitination and canonical signalling pathway genes. We observed that, although breast AdCCs had rather simple genomes, they likely display intra-tumour genetic heterogeneity at diagnosis. Taken together, these findings demonstrate that the mutational burden and mutational repertoire of breast AdCCs are more similar to those of salivary gland AdCCs than to those of other types of TNBCs, emphasizing the importance of histological subtyping of TNBCs. Furthermore, our data provide direct evidence that AdCCs harbour a distinctive mutational landscape and genomic structure, irrespective of the disease site of origin.
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Affiliation(s)
| | - Maria R De Filippo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Charlotte K Y Ng
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Rachael Natrajan
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | | | - Joanna Cyrta
- Department of Tumour Biology, Institut Curie, Paris, France
| | | | - Huei-Chi Wen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Raymond S Lim
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Ronglai Shen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Anne M Schultheis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Y Hannah Wen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Marcia Edelweiss
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Odette Mariani
- Department of Tumour Biology, Institut Curie, Paris, France
| | - Göran Stenman
- Sahlgrenska Cancer Center, Department of Pathology, University of Gothenburg, Sweden
| | - Timothy A Chan
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Larry Norton
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Jorge S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
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61
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Yoshimura N, Sasada T, Yonehara S. Primary Large-Cell Neuroendocrine Carcinoma of the Breast Occurring in a Pre-Menopausal Woman. Breast Care (Basel) 2015; 10:281-3. [PMID: 26600766 DOI: 10.1159/000431070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Primary large-cell neuroendocrine carcinoma of the breast (LCNEC-breast) in pre-menopausal women is extremely rare. CASE REPORT A 34-year-old woman presented with a mass in the left breast that was diagnosed as neuroendocrine carcinoma by needle biopsy. Computed tomography revealed no lymph node swelling or distant organ metastasis. Left mastectomy and sentinel lymph node biopsy were performed and metastasis to the axial lymph node was detected. Left axillary lymph node dissection was performed and histopathological and immunohistochemical examination revealed that the tumor was an LCNEC-breast, which was 6.0 cm in size and positive for the neuroendocrine markers (neuron-specific enolase, chromogranin A, and synaptophysin). The tumor cells were hormone-receptor positive and HER2 negative. The patient refused any adjuvant hormonal therapy, chemotherapy or radiotherapy. She has been followed up for 4 years without medication, and no recurrence has been noted. CONCLUSION We present a case of LCNEC-breast in a 34-year-old woman. Our case represents the youngest woman with LCNEC-breast reported in the English literature.
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Affiliation(s)
- Noriko Yoshimura
- Department of Surgery, Onomichi General Hospital, Hiroshima, Japan
| | - Tatsunari Sasada
- Department of Surgery, Onomichi General Hospital, Hiroshima, Japan
| | - Shuji Yonehara
- Department of Pathology, Onomichi General Hospital, Hiroshima, Japan
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Hare F, Giri S, Patel JK, Hahn A, Martin MG. A population-based analysis of outcomes for small cell carcinoma of the breast by tumor stage and the use of radiation therapy. SPRINGERPLUS 2015; 4:138. [PMID: 25853028 PMCID: PMC4382500 DOI: 10.1186/s40064-015-0913-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 03/03/2015] [Indexed: 01/05/2023]
Abstract
Purpose Primary small cell carcinomas of the breast (SCCB) are rare tumors with limited data on outcomes and treatment strategies. Using a population based approach, we aimed to study outcomes of SCCB and determine whether the use of radiation therapy is associated with better survival among patients with SCCB. Methods Using the Surveillance, Epidemiology and End Results (SEER) registry, we identified patients with SCCB between1973 and 2010. We examined the stage specific survival of these patients and compared it to the stage specific survival of small cell lung cancer (SCLC) from the SEER database over the same accrual period. We further analyzed the impact of radiation therapy on overall survival for SCCB patients using a univariate and multivariate approach. Results A total of 199 patients with primary SCCB with staging were identified during the study period. Eighty-four patients (42%) had localized disease, 77 (39%) had regional disease and 38 (19%) had distant disease. For comparison, 81,933 patients with SCLC were identified. Outcomes were superior for patients with SCCB with localized (150 vs. 16 months, p < 0.01) and regional disease (56 vs. 13 months, p < 0.01), but not distant disease (7 vs. 7 months, p = 0.43). Use of radiation therapy was not associated with a significant difference in OS for patients with either localized (202 vs. 147 months, p = 0.48) or regional (52 vs. 75 months, p = 0.650) disease. Conclusions SCCB has a more favorable prognosis by stage for localized and regional disease than SCLC. Adjuvant radiation is not associated with an improvement in survival for patients with localized or regional SCCB in this dataset.
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Affiliation(s)
- Felicia Hare
- Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, USA
| | - Smith Giri
- Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, USA
| | - Jashmin K Patel
- Department of Hematology/Oncology, The West Cancer Center/University of Tennessee Health Science Center, 1588 Union Ave., Memphis, TN 38104 USA
| | - Andrew Hahn
- Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, USA
| | - Michael G Martin
- Department of Hematology/Oncology, The West Cancer Center/University of Tennessee Health Science Center, 1588 Union Ave., Memphis, TN 38104 USA
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63
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Malowany JI, Kundu U, Santiago L, Krishnamurthy S. Fine-needle aspiration detects primary neuroendocrine carcinoma of the breast in a patient with breast implants. Cytojournal 2015; 12:1. [PMID: 25685170 PMCID: PMC4325382 DOI: 10.4103/1742-6413.149844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/17/2014] [Indexed: 11/04/2022] Open
Abstract
Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling. Fine-needle aspiration biopsy (FNAB) is an excellent technique to sample suspicious lesions that are adjacent to fragile implants. We report a case of a 51-year-old woman with breast implants presenting with an initial diagnosis of fibroadenoma by imaging studies. A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy. Our case exemplifies the role of US-guided FNAB for the initial investigation of breast masses in patients with implants. In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.
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Affiliation(s)
- Janet I Malowany
- Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0053, Houston, TX 77030, USA
| | - Uma Kundu
- Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0053, Houston, TX 77030, USA
| | - Lumarie Santiago
- Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0053, Houston, TX 77030, USA
| | - Savitri Krishnamurthy
- Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0053, Houston, TX 77030, USA
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64
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Geetha R, Kalyani R, Srinivas MV, Shakthidasan C. A rare collision tumour of infiltrating ductal carcinoma and squamous cell carcinoma of skin overlying breast: a case report. J Clin Diagn Res 2015; 9:XD06-XD08. [PMID: 25738072 DOI: 10.7860/jcdr/2015/10437.5464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/24/2014] [Indexed: 11/24/2022]
Abstract
Collision tumour is the concrescence of two neighbouring independent neoplasm occurring in the same site. Collision tumours are rare and are reported in various organs. Collision tumours in breast are reported in various combinations. The treatment of these tumours is not tailored and prognosis depends on the histologic type and pathologic stage of the most aggressive component. We report a rare case of breast collision tumour of infiltrating ductal carcinoma and squamous cell carcinoma of skin overlying breast in a 44-year-old female.
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Affiliation(s)
- Rl Geetha
- Assistant Professor, Department of Pathology, ESIC Medical College and PGIMSR and Model Hospital , Rajajinagar, Bangalore, Karnataka, India
| | - R Kalyani
- Associate Professor, Department of Pathology, ESIC Medical College and PGIMSR and Model Hospital , Rajajinagar, Bangalore, Karnataka, India
| | - Murthy V Srinivas
- Professor & Head of Department, Department of Pathology, ESIC Medical College and PGIMSR and Model Hospital , Rajajinagar, Bangalore, Karnataka, India
| | - Chinnathambi Shakthidasan
- Resident, Department of Pathology, ESIC Medical College and PGIMSR and Model Hospital , Rajajinagar, Bangalore, Karnataka, India
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65
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Gudaviciene D, Steponaviciene L, Meskauskas R, Smailyte G, Aleknavicius E. Rare types of breast carcinoma. Open Med (Wars) 2014; 10:92-96. [PMID: 28352682 PMCID: PMC5152956 DOI: 10.1515/med-2015-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 09/26/2014] [Indexed: 11/15/2022] Open
Abstract
Breast cancer (BC) is a heterogeneous disease that encompasses several distinct entities with remarkably different characteristics. Histological type is one of important BC characteristics. Histological type is associated with differences in epidemiology, diagnostic issues, clinical course, prognosis. When we talk about BC, ductal and lobular carcinoma is usually what we have in mind. However, the other types that comprise less than 10% of BC are also very important. The rarity of many of these neoplasms does not allow large or randomized studies to define the optimal treatment. Many of the descriptions are from case reports and small series. The aim of this retrospective study was to analyze the data on rare breast cancers, to describe their main characteristics, and to calculate survival rates. We believe that the experience of our institution will contribute to the available data about these rare breast cancers and help in better understanding of this subgroup.
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Affiliation(s)
| | | | | | - Giedre Smailyte
- Scientific Research Center, Nacional Cancer Institute, Lithuania
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66
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Roessler J, Ammerpohl O, Gutwein J, Steinemann D, Schlegelberger B, Weyer V, Sariyar M, Geffers R, Arnold N, Schmutzler R, Bartram CR, Heinrich T, Abbas M, Antonopoulos W, Schipper E, Hasemeier B, Kreipe H, Lehmann U. The CpG island methylator phenotype in breast cancer is associated with the lobular subtype. Epigenomics 2014; 7:187-99. [PMID: 25347269 DOI: 10.2217/epi.14.74] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Aberrations in DNA methylation patterns are well-described in human malignancies. However, the existence of the 'CpG island methylator phenotype' (CIMP) in human breast cancer is still controversial. MATERIALS & METHODS Illumina's HumanMethylation 450K BeadChip was used to analyze genome-wide DNA methylation patterns. Chromosomal abnormalities were determined by array-based CGH. RESULTS Invasive lobular breast carcinomas exhibit the highest number of differentially methylated CpG sites and a strong inverse correlation of aberrant DNA hypermethylation and copy number alterations. Nine differentially methylated regions within seven genes discriminating the investigated subgroups were identified and validated in an independent validation cohort and correlated to a better relapse-free survival. CONCLUSION These results depict a clear difference between genetically and epigenetically unstable breast carcinomas indicating different ways of tumor progression and/or initiation, which strongly supports the association of CIMP with the lobular subtype and provide new options for detection and therapy.
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Affiliation(s)
- Jessica Roessler
- Institute of Pathology, Hannover Medical School, Carl-Neuber-Str. 1, D-30625 Hannover, Germany
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Zou A, Lambert D, Yeh H, Yasukawa K, Behbod F, Fan F, Cheng N. Elevated CXCL1 expression in breast cancer stroma predicts poor prognosis and is inversely associated with expression of TGF-β signaling proteins. BMC Cancer 2014; 14:781. [PMID: 25344051 PMCID: PMC4221705 DOI: 10.1186/1471-2407-14-781] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 10/14/2014] [Indexed: 12/30/2022] Open
Abstract
Background CXCL1 is a chemotactic cytokine shown to regulate breast cancer progression and chemo-resistance. However, the prognostic significance of CXCL1 expression in breast cancer has not been fully characterized. Fibroblasts are important cellular components of the breast tumor microenvironment, and recent studies indicate that this cell type is a potential source of CXCL1 expression in breast tumors. The goal of this study was to further characterize the expression patterns of CXCL1 in breast cancer stroma, determine the prognostic significance of stromal CXCL1 expression, and identify factors affecting stromal CXCL1 expression. Methods Stromal CXCL1 protein expression was analyzed in 54 normal and 83 breast carcinomas by immunohistochemistry staining. RNA expression of CXCL1 in breast cancer stroma was analyzed through data mining in http://www.Oncomine.org. The relationships between CXCL1 expression and prognostic factors were analyzed by univariate analysis. Co-immunofluorescence staining for CXCL1, α-Smooth Muscle Actin (α-SMA) and Fibroblast Specific Protein 1 (FSP1) expression was performed to analyze expression of CXCL1 in fibroblasts. By candidate profiling, the TGF-β signaling pathway was identified as a regulator of CXCL1 expression in fibroblasts. Expression of TGF-β and SMAD gene products were analyzed by immunohistochemistry and data mining analysis. The relationships between stromal CXCL1 and TGF-β signaling components were analyzed by univariate analysis. Carcinoma associated fibroblasts isolated from MMTV-PyVmT mammary tumors were treated with recombinant TGF-β and analyzed for CXCL1 promoter activity by luciferase assay, and protein secretion by ELISA. Results Elevated CXCL1 expression in breast cancer stroma correlated with tumor grade, disease recurrence and decreased patient survival. By co-immunofluorescence staining, CXCL1 expression overlapped with expression of α-SMA and FSP1 proteins. Expression of stromal CXCL1 protein expression inversely correlated with expression of TGF-β signaling components. Treatment of fibroblasts with TGF-β suppressed CXCL1 secretion and promoter activity. Conclusions Increased CXCL1 expression in breast cancer stroma correlates with poor patient prognosis. Furthermore, CXCL1 expression is localized to α-SMA and FSP1 positive fibroblasts, and is negatively regulated by TGF-β signaling. These studies indicate that decreased TGF-β signaling in carcinoma associated fibroblasts enhances CXCL1 expression in fibroblasts, which could contribute to breast cancer progression. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-781) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | - Nikki Cheng
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.
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Wang J, Zhang X, He J, Yang M, Tang J, Li X, Tang H, Xie X. Co-expression of EGFR and CK5/6 in primary squamous cell carcinoma of the breast. Med Oncol 2014; 31:172. [PMID: 25119504 DOI: 10.1007/s12032-014-0172-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 08/08/2014] [Indexed: 01/29/2023]
Abstract
Primary squamous cell carcinoma of the breast (PSCCB) is an extremely rare breast tumor lacking hormone receptors and HER2 expression. However, in comparison with triple-negative invasive ductal carcinoma (TN-IDC), little is known about the PSCCB. Twenty-nine patients with PSCCB in Sun Yat-sen University Cancer Center from 1995 to 2010 were recruited in this study, along with 681 cases of TN-IDC during the same period. The clinicopathologic features and prognosis of PSCCB compared to TN-IDC were assessed. Furthermore, biomarkers of EGFR, CK5/6, E-cadherin, VEGF, TOPII, and p53 were immunostained to investigate the prognostic determinant of PSCCB. Patients with PSCCB were older than those with TN-IDC (P = 0.009) and presented with lower lymph node involvement (P = 0.015). There was no difference in overall survival (OS) between PSCCB and TN-IDC. However, the disease-free survival (DFS) of PSCCB was poorer than that of TN-IDC (P = 0.007). Multivariate analysis revealed that combined over-expression of EGFR and CK5/6 was the only independent prognostic factor for OS of PSCCB (HR 6.08, 95 % CI 1.33-27.85, P = 0.020) and associated with lymphatic metastasis (P = 0.023) and p53 expression (P = 0.013). Other predictors for poorer OS and DFS were lymphatic metastasis and stage III, which failed to show significance after multivariate analysis. Furthermore, platinum-based chemotherapy was identified to improve the OS of PSCCB with EGFR + CK5/6+ (P = 0.027). The prognosis of PSCCB is poorer than that of TN-IDC. As the only independent prognostic factor for PSCCB, combined over-expression of EGFR and CK5/6 might be a potential indicator for the use of platinum-based chemotherapy.
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Affiliation(s)
- Jin Wang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China,
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Dieci MV, Orvieto E, Dominici M, Conte P, Guarneri V. Rare breast cancer subtypes: histological, molecular, and clinical peculiarities. Oncologist 2014; 19:805-13. [PMID: 24969162 DOI: 10.1634/theoncologist.2014-0108] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Breast cancer encompasses a collection of different diseases characterized by different biological and pathological features, clinical presentation, response to treatments, clinical behavior, and outcome. On the basis of cell morphology, growth, and architecture patterns, breast cancer can be classified in up to 21 distinct histological types. Breast cancer special types, including the classic lobular invasive carcinoma, represent 25% of all breast cancers. The histological diversity of breast carcinomas has relevant prognostic implications. Indeed, the rare breast cancer group includes subtypes with very different prognoses, ranging from the tubular carcinoma, associated with an indolent clinical course, to metaplastic cancer, whose outcome is generally unfavorable. New approaches based on gene expression profiling allow the identification of molecularly defined breast cancer classes, with distinct biological features and clinical behavior. In clinical practice, immunohistochemical classification based on the expression of human epidermal growth factor receptor 2 and Ki67 is applied as a surrogate of the intrinsic molecular subtypes. However, the identification of intrinsic molecular subtypes were almost completely limited to the study of ductal invasive breast cancer. Moreover, some good-prognosis triple-negative histotypes, on the basis of gene expression profiling, can be classified among the poor-prognosis group. Therefore, histopathological classification remains a crucial component of breast cancer diagnosis. Special histologies can be very rare, and the majority of information on outcome and treatments derives from small series and case reports. As a consequence, clear recommendations about clinical management are still lacking. In this review, we summarize current knowledge about rare breast cancer histologies.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Adenocarcinoma/therapy
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/therapy
- Biomarkers, Tumor/biosynthesis
- Breast Neoplasms/classification
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/therapy
- Carcinoma, Medullary/genetics
- Carcinoma, Medullary/pathology
- Carcinoma, Medullary/therapy
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Prognosis
- Rare Diseases/genetics
- Rare Diseases/pathology
- Receptor, ErbB-2/biosynthesis
- Receptors, Estrogen/metabolism
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Affiliation(s)
- Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; and Istituto Oncologico Veneto IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Padova, Italy; Department of Pathology, University Hospital of Padova, Padova, Italy; Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Orvieto
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; and Istituto Oncologico Veneto IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Padova, Italy; Department of Pathology, University Hospital of Padova, Padova, Italy; Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Dominici
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; and Istituto Oncologico Veneto IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Padova, Italy; Department of Pathology, University Hospital of Padova, Padova, Italy; Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - PierFranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; and Istituto Oncologico Veneto IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Padova, Italy; Department of Pathology, University Hospital of Padova, Padova, Italy; Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; and Istituto Oncologico Veneto IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Padova, Italy; Department of Pathology, University Hospital of Padova, Padova, Italy; Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy
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Krishnan K, Steptoe AL, Martin HC, Pattabiraman DR, Nones K, Waddell N, Mariasegaram M, Simpson PT, Lakhani SR, Vlassov A, Grimmond SM, Cloonan N. miR-139-5p is a regulator of metastatic pathways in breast cancer. RNA (NEW YORK, N.Y.) 2013; 19:1767-1780. [PMID: 24158791 PMCID: PMC3884652 DOI: 10.1261/rna.042143.113] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 09/12/2013] [Indexed: 05/29/2023]
Abstract
Metastasis is a complex, multistep process involved in the progression of cancer from a localized primary tissue to distant sites, often characteristic of the more aggressive forms of this disease. Despite being studied in great detail in recent years, the mechanisms that govern this process remain poorly understood. In this study, we identify a novel role for miR-139-5p in the inhibition of breast cancer progression. We highlight its clinical relevance by reviewing miR-139-5p expression across a wide variety of breast cancer subtypes using in-house generated and online data sets to show that it is most frequently lost in invasive tumors. A biotin pull-down approach was then used to identify the mRNA targets of miR-139-5p in the breast cancer cell line MCF7. Functional enrichment analysis of the pulled-down targets showed significant enrichment of genes in pathways previously implicated in breast cancer metastasis (P < 0.05). Further bioinformatic analysis revealed a predicted disruption to the TGFβ, Wnt, Rho, and MAPK/PI3K signaling cascades, implying a potential role for miR-139-5p in regulating the ability of cells to invade and migrate. To corroborate this finding, using the MDA-MB-231 breast cancer cell line, we show that overexpression of miR-139-5p results in suppression of these cellular phenotypes. Furthermore, we validate the interaction between miR-139-5p and predicted targets involved in these pathways. Collectively, these results suggest a significant functional role for miR-139-5p in breast cancer cell motility and invasion and its potential to be used as a prognostic marker for the aggressive forms of breast cancer.
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Affiliation(s)
- Keerthana Krishnan
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
| | - Anita L. Steptoe
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
| | - Hilary C. Martin
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
| | | | - Katia Nones
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
| | - Nic Waddell
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
| | - Mythily Mariasegaram
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, QLD, Australia 4029
| | - Peter T. Simpson
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, QLD, Australia 4029
| | - Sunil R. Lakhani
- The University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, QLD, Australia 4029
- The University of Queensland, School of Medicine, Herston, QLD, Australia 4029
- Pathology Queensland, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia 4029
| | | | - Sean M. Grimmond
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1BD, United Kingdom
| | - Nicole Cloonan
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD, Australia 4072
- QIMR Berghofer Medical Research Institute, Genomic Biology Laboratory, Herston, Australia 4006
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72
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Acevedo C, Amaya C, López-Guerra JL. Rare breast tumors: Review of the literature. Rep Pract Oncol Radiother 2013; 19:267-74. [PMID: 25061520 DOI: 10.1016/j.rpor.2013.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 07/31/2013] [Accepted: 08/22/2013] [Indexed: 12/31/2022] Open
Abstract
Breast cancer tumors have different morphological phenotypes and specific histopathological types with particular prognostic and clinical characteristics. The treatment of rare malignant lesions is frequently controversial due to the absence of trials to determine the optimal managements. This review describes the spectrum of rare breast tumors indicating the clinical, epidemiological and treatment characteristics.
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Affiliation(s)
- Catalina Acevedo
- Department of Radiation Oncology, Fundación Valle del Lili, Cali, Colombia
| | - Claudia Amaya
- Department of Radiation Oncology, Fundación Valle del Lili, Cali, Colombia
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Salemis NS. Intraductal glycogen-rich clear cell carcinoma of the breast: a rare presentation and review of the literature. ACTA ACUST UNITED AC 2013; 7:319-21. [PMID: 23904836 DOI: 10.1159/000341393] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Glycogen-rich clear cell carcinoma of the breast is a rare histological subtype of breast cancer, accounting for 0.9-2.8% of all breast cancer cases. Fewer than 100 cases have been reported in the literature. Most of these tumors are invasive carcinomas. The intraductal glycogen-rich clear cell carcinoma is a very rare occurrence. CASE REPORT Herein is described a case of a pure intraductal glycogen-rich clear cell carcinoma of the breast in a 42-year-old premenopausal woman. A literature review has also been carried out. Mammography was inconclusive due to the presence of dense breast tissue, but magnetic resonance imaging (MRI) showed several nodular lesions measuring 7 × 6 cm in diameter and involving the upper aspect of the right breast suggestive of multifocal malignancy. A modified radical mastectomy was performed. The patient started hormonal therapy with tamoxifen and is currently well 16 months after surgery. CONCLUSION A pure intraductal glycogen-rich clear cell carcinoma of the breast is a very rare occurrence. The case presented here exhibited uncommon MRI features, whereas the tumor size is one of the largest reported in the literature. Mammography may be inconclusive in the presence of dense breast tissue, but MRI is of great importance in the preoperative evaluation of the patient.
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Apocrine carcinoma of breast: a case report with review of the literature. Case Rep Pathol 2013; 2013:170918. [PMID: 23864975 PMCID: PMC3707272 DOI: 10.1155/2013/170918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 06/05/2013] [Indexed: 02/03/2023] Open
Abstract
Apocrine carcinoma is a very rare form of breast malignancy with an incidence of <1% of female invasive breast carcinoma. We report a case of apocrine carcinoma in a 42-year female with marked adenosis showing apocrine metaplasia and discuss the criteria to diagnose apocrine carcinoma with the emerging concept of androgen receptor positivity with its implication on treatment and management of the patient.
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75
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Abstract
Mucinous carcinoma of the breast is one of the rarer forms of intramammary cancer, often presenting as a lobulated, fairly well circumscribed mass on mammography, sonography, and gadolinium-enhanced magnetic resonance imaging. It accounts for 1% to 7% of all breast cancers and generally carries a better prognosis than other types of malignant breast cancers. Metastatic disease occurs at a lower frequency than in other types of invasive carcinoma. We present an atypical case of mucinous carcinoma in a woman who presented with a palpable intramammary lymph node metastasis from an unknown breast primary. Subsequent magnetic resonance imaging and percutaneous biopsy demonstrated histologic findings consistent with a mixed mucinous neoplasm with a micropapillary pattern.
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Affiliation(s)
- Kelli Y Ha
- Department of Radiology, Baylor University Medical Center at Dallas
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76
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Dobruch-Sobczak K, Roszkowska-Purska K, Chrapowicki E. Cribriform carcinoma mimicking breast abscess - case report. Diagnostic and therapeutic management. J Ultrason 2013; 13:222-9. [PMID: 26674469 PMCID: PMC4613582 DOI: 10.15557/jou.2013.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 04/30/2013] [Accepted: 05/16/2013] [Indexed: 11/22/2022] Open
Abstract
The authors presents a case of cribriform breast carcinoma in a cyst that clinically imitated an abscess. The case concerns a 71-year-old female patient treated for ankylosing spondylitis, with a positive family history of breast cancer. The patient presented at the surgical clinic for incision of an abscess of the mammary gland localized in the lower inner quadrant that was a consequence of previous trauma to the right breast. The abscess was incised and the serosanguineous contents were evacuated. The wound was drained and antibiotics (Dalacin with Metronidazol) were administered for the period of 10 days. During the treatment, a cutaneous fistula was formed. At the incision site, a hard thickening was palpable (tumor). Core needle biopsy of the clinically palpable tumor was performed and the purulent material from the fistula was collected for a culture test. Complete blood count did not reveal leucocytosis. In accordance with the obtained sensitivity report, the patient was started on antibiotics again. Breast ultrasound performed upon the completion of the antibiotic therapy, in the right breast, revealed two solidcystic oval lesions with thick echogenic walls and blurred margins. Both masses contained dense levels of fluid material and solid polycyclic structures. On sonoelastography, the lesions were heterogeneous with a high Young's modulus. In the right axillary fossa, ultrasound examination revealed three abnormal lymph nodes enlarged to 31 mm length, which were rounded, hypoechoic and without visible sinuses. Histopathology of the core needle biopsy performed at admittance and after the antibiotic therapy indicated a breast abscess (presence of fibrinous and partly fibrinopurulent material). The mass was finally resected to confirm histopathology. The resected material revealed the presence of an invasive, moderately differentiated cribriform carcinoma, which developed within a cyst, with a 40% necrotic component. Eighteen months after the commencement of treatment, the patient remains under oncological supervision and continues hormonal therapy. There are no signs of relapse or foci of distant metastases. The occurrence of breast carcinoma within an abscess emphasises the need for comprehensive assessment and correlation of the clinical picture with imaging and histopathological findings. It also highlights the necessity to include breast abscess in the differential diagnosis of rare forms of carcinomas.
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Affiliation(s)
- Katarzyna Dobruch-Sobczak
- Zakład Radiodiagnostyki, Pracownia USG, Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie, Warszawa, Polska
| | | | - Eryk Chrapowicki
- Oddział Chirurgii Kliniki Onkologicznej, Centrum Onkologii - Instytut, Warszawa, Polska
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Smith BA, Shelton DN, Kieffer C, Milash B, Usary J, Perou CM, Bernard PS, Welm BE. Targeting the PyMT Oncogene to Diverse Mammary Cell Populations Enhances Tumor Heterogeneity and Generates Rare Breast Cancer Subtypes. Genes Cancer 2013; 3:550-63. [PMID: 23486760 DOI: 10.1177/1947601913475359] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 12/30/2012] [Indexed: 01/11/2023] Open
Abstract
Human breast cancer is a heterogeneous disease composed of different histologies and molecular subtypes, many of which are not replicated in animal models. Here, we report a mouse model of breast cancer that generates unique tumor histologies including tubular, adenosquamous, and lipid-rich carcinomas. Utilizing a nononcogenic variant of polyoma middle T oncogene (PyMT) that requires a spontaneous base-pair deletion to transform cells, in conjunction with lentiviral transduction and orthotopic transplantation of primary mammary epithelial cells, this model sporadically induces oncogene expression in both the luminal and myoepithelial cell lineages of the normal mouse mammary epithelium. Microarray and hierarchical analyses using an intrinsic subtype gene set revealed that lentiviral PyMT generates both luminal and basal-like tumors. Cumulatively, these results show that low-level expression of PyMT in a broad range of cell types significantly increases tumor heterogeneity and establishes a mouse model of several rare human breast cancer subtypes.
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Affiliation(s)
- Brittni A Smith
- Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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78
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Dreyer G, Vandorpe T, Smeets A, Forceville K, Brouwers B, Neven P, Janssens H, Deraedt K, Moerman P, Van Calster B, Christiaens MR, Paridaens R, Wildiers H. Triple negative breast cancer: clinical characteristics in the different histological subtypes. Breast 2013; 22:761-6. [PMID: 23416046 DOI: 10.1016/j.breast.2013.01.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Revised: 12/19/2012] [Accepted: 01/18/2013] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To investigate the clinical behavior of triple negative breast cancer (TNC), including age distribution, occurrence of LN (lymph node) invasion and prognosis in different histological subtypes. METHODS For this cohort study we used data on 476 patients with newly diagnosed TNC at the University Hospitals Leuven (Belgium) between 1999 and 2009. Of these, 395 received upfront surgery, 68 neoadjuvant chemotherapy and 21 had metastases at diagnosis. RESULTS Apocrine and invasive lobular TNC occur more often in older patients compared to IDC-NOS. Of the primarily operated patients with TNC, 35.1% has pathological LN involvement. There were no significant differences in nodal invasion between different histological subtypes, but most subtypes contained few patients. In contrast to previous reports, 6/14 of apocrine TNC had LN involvement. Disease free survival (DFS) was different in different histological subtypes, but group sizes were insufficient to be able to draw firm conclusions. Within the histologically 'homogeneous' IDC-NOS group with primary surgery and outcome data (n = 300), DFS with 3.5 year median follow-up decreased with increasing age, but chemotherapy and radiotherapy were much less frequently given with increasing age. In multivariable analysis, lower age, presence of LN involvement, lack of administration of chemotherapy and radiotherapy were significant predictors of relapse. CONCLUSION TNC is not a uniform disease. Different histological subtypes have different age distribution and behavior. The prognosis of the most common histological subgroup, IDC-NOS, is better in older patients, but this is counterbalanced by significantly decreased use of chemotherapy and radiotherapy.
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Affiliation(s)
- Geertje Dreyer
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
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Baretta Z, Guindalini RSC, Khramtsova G, Olopade OI. Resistance to trastuzumab in HER2-positive mucinous invasive ductal breast carcinoma. Clin Breast Cancer 2012; 13:156-8. [PMID: 23276464 DOI: 10.1016/j.clbc.2012.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 11/12/2012] [Indexed: 01/13/2023]
Affiliation(s)
- Zora Baretta
- Department of Oncology, Istituto Oncologico Veneto (IOV - IRCCS), Padova, Italy
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Caldarella A, Buzzoni C, Crocetti E, Bianchi S, Vezzosi V, Apicella P, Biancalani M, Giannini A, Urso C, Zolfanelli F, Paci E. Invasive breast cancer: a significant correlation between histological types and molecular subgroups. J Cancer Res Clin Oncol 2012; 139:617-23. [PMID: 23269487 DOI: 10.1007/s00432-012-1365-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/12/2012] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The special types of breast cancer seem to have not only distinct morphological features but also distinct biological features. MATERIALS AND METHODS Women diagnosed with a first primary invasive breast cancer in the 2004-2005 period were identified through Tuscan Cancer Registry. Information on age, tumor size, lymph node status, histological type and grade, hormonal receptors, HER2 immunohistochemical expression were collected. Five subtypes were defined: luminal A, luminal B HER2+, luminal B HER2-, triple negative, and HER2 positive. The association between the histological type and molecular subgroups was assessed by a Fisher's exact test, and a multinomial logistic regression model was used. RESULTS Out of 1,487 patients, 34 % were luminal A subtype, 25 % luminal B HER2-, 11 % luminal B HER2+, 19 % triple negative, and 10.2 % HER2+; 58.5 % of cancers were ductal NOS types. With luminal A as reference, histological types distribution was significantly different between the subgroups. Mucinous, tubular, and cribriform histotypes were found among luminal A cancers more than in other subgroups; all medullary carcinomas were triple negative cancers. Pathological stage at diagnosis was more advanced, and histological grade was lower among subgroups other than luminal A. CONCLUSIONS Significant association between breast cancer histotypes and molecular subgroups was found.
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Affiliation(s)
- A Caldarella
- Clinical and Descriptive Epidemiology Unit, Institute for Study and Cancer Prevention (ISPO), Via delle Oblate 2, 50141 Florence, Italy.
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Jakubowski W, Dobruch-Sobczak K, Migda B. Errors and mistakes in breast ultrasound diagnostics. J Ultrason 2012; 12:286-98. [PMID: 26675358 PMCID: PMC4582529 DOI: 10.15557/jou.2012.0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 07/27/2012] [Accepted: 08/09/2012] [Indexed: 11/22/2022] Open
Abstract
Sonomammography is often the first additional examination performed in the diagnostics of breast diseases. The development of ultrasound imaging techniques, particularly the introduction of high frequency transducers, matrix transducers, harmonic imaging and finally, elastography, influenced the improvement of breast disease diagnostics. Nevertheless, as in each imaging method, there are errors and mistakes resulting from the technical limitations of the method, breast anatomy (fibrous remodeling), insufficient sensitivity and, in particular, specificity. Errors in breast ultrasound diagnostics can be divided into impossible to be avoided and potentially possible to be reduced. In this article the most frequently made errors in ultrasound have been presented, including the ones caused by the presence of artifacts resulting from volumetric averaging in the near and far field, artifacts in cysts or in dilated lactiferous ducts (reverberations, comet tail artifacts, lateral beam artifacts), improper setting of general enhancement or time gain curve or range. Errors dependent on the examiner, resulting in the wrong BIRADS-usg classification, are divided into negative and positive errors. The sources of these errors have been listed. The methods of minimization of the number of errors made have been discussed, including the ones related to the appropriate examination technique, taking into account data from case history and the use of the greatest possible number of additional options such as: harmonic imaging, color and power Doppler and elastography. In the article examples of errors resulting from the technical conditions of the method have been presented, and those dependent on the examiner which are related to the great diversity and variation of ultrasound images of pathological breast lesions.
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Affiliation(s)
- Wiesław Jakubowski
- Zakład Diagnostyki Obrazowej, II Wydział Lekarski, Warszawski Uniwersytet Medyczny, Warszawa, Polska
| | - Katarzyna Dobruch-Sobczak
- Zakład Radiodiagnostyki, Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie, Warszawa, Polska
| | - Bartosz Migda
- Zakład Diagnostyki Obrazowej, II Wydział Lekarski, Warszawski Uniwersytet Medyczny, Warszawa, Polska
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82
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Baloch AH, Shuja J, Daud S, Ahmed M, Ahmad A, Tareen M, Khan F, Kakar MA, Baloch DM, Kakar N, Naseeb HK, Ahmad J. Various Aspects, Patterns and Risk Factors in Breast Cancer Patients of Balochistan. Asian Pac J Cancer Prev 2012; 13:4013-6. [DOI: 10.7314/apjcp.2012.13.8.4013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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83
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Colleoni M, Russo L, Dellapasqua S. Adjuvant therapies for special types of breast cancer. Breast 2012; 20 Suppl 3:S153-7. [PMID: 22015285 DOI: 10.1016/s0960-9776(11)70315-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Recent developments in the adjuvant treatment of breast cancer include an increasing attention to systemic therapies prescribed in homogeneous groups of patients according to the higher chance of benefit. A clear consequence of the current adjuvant treatment strategy is the importance of accurate and reliable histopathological assessment. A proper pathological evaluation may effectively support the definition of prognosis and treatment choice in niches of patients diagnosed with special types of breast cancer. Through the identification of special types of breast cancer, that account for up to 25% of all invasive breast carcinomas, it is possible to select patients with a very good prognosis often close to that of the general population (e.g. tubular and pure cribriform carcinoma). Other features, such as those related with invasive classical lobular carcinoma, might have important correlates of responsiveness to therapy other than indicators of outcome. It was in fact demonstrated that the response to primary chemotherapy is significantly lower in invasive lobular carcinoma, if compared with the ductal histotype. However, the use of available information on special types of breast cancer has been limited in tailoring adjuvant therapy, owing to the absence of standardized criteria and partial reproducibility for diagnosis. Moreover, due to the relative rarity of the disease a large number of features that identify for special types of breast carcinomas have today no particular correlation with the prognosis, and limited data are available on the biology of a large number of breast cancer subtypes. The development of more effective therapies for patients with special types of breast cancer requires tailored treatment investigations through international cooperation and should not rely on information predominantly contributed from small retrospective analyses. Examination of patterns of relapse and treatment response within subpopulations in multiple randomized trials is also mandatory to make progress and reach consensus on how to treat individual patients with special types of breast cancer.
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Affiliation(s)
- Marco Colleoni
- Research Unit in Medical Senology, Department of Medicine, European Institute of Oncology, Milan, Italy.
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84
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Rosmaninho A, Velho G, Caetano M, Selores M. Breast cancer: 2 case reports. An Bras Dermatol 2012; 87:123-6. [PMID: 22481661 DOI: 10.1590/s0365-05962012000100016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 05/14/2011] [Indexed: 11/21/2022] Open
Abstract
Breast cancer is the most frequently diagnosed life-threatening cancer in women and the leading cause of cancer death among them worldwide. It includes a heterogeneous collection of diseases with various histologically defined subsets, clinical presentations, responses to treatment and outcomes. We describe 2 cases of female patients with ductal breast carcinoma. Dermatologists may have an important role in diagnosing such diseases.
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85
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Portier BP, Gruver AM, Huba MA, Minca EC, Cheah AL, Wang Z, Tubbs RR. From morphologic to molecular: established and emerging molecular diagnostics for breast carcinoma. N Biotechnol 2012; 29:665-81. [PMID: 22504737 DOI: 10.1016/j.nbt.2012.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/26/2012] [Accepted: 03/31/2012] [Indexed: 12/15/2022]
Abstract
Diagnostics in the field of breast carcinoma are constantly evolving. The recent wave of molecular methodologies, both microscope and non-microscope based, have opened new ways to gain insight into this disease process and have moved clinical diagnostics closer to a 'personalized medicine' approach. In this review we highlight some of the advancements that laboratory medicine technology is making toward guiding the diagnosis, prognosis, and therapy selection for patients affected by breast carcinoma. The content of the article is largely structured by methodology, with a distinct emphasis on both microscope based and non-microscope based diagnostic formats. Where possible, we have attempted to emphasize the potential benefits as well as limitations to each of these technologies. Successful molecular diagnostics, applied in concert within the morphologic context of a patient's tumor, are what will lay the foundation for personalized therapy and allow a more sophisticated approach to clinical trial stratification. The future of breast cancer diagnostics looks challenging, but it is also a field of great opportunity. Never before have there been such a plethora of new tools available for disease investigation or candidate therapy selection.
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Affiliation(s)
- Bryce P Portier
- Department of Molecular Pathology, Pathology and Laboratory Medicine Institute, Cleveland Clinic, Lerner College of Medicine, Cleveland, OH 44195, USA
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86
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Rubovszky G, Horváth Z, Tóth E, Láng I, Kásler M. Significance of histomorphology of early triple-negative breast cancer. Pathol Oncol Res 2012; 18:823-31. [PMID: 22415664 DOI: 10.1007/s12253-012-9510-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 02/20/2012] [Indexed: 01/03/2023]
Abstract
UNLABELLED Triple-negative breast cancer (TNBC) is a heterogeneous disease. Possibly genetic characterisation provides the most appropriate information on tumour biology and prognosis, but it is only limitedly available in clinical practice. The aim of this investigation was to explore what additional prognostic information could be gained from detailed histomorphologic report. PATIENTS AND METHOD patients were selected retrospectively operated from 2005 to 2009 in one institution and charts were revised. Beyond age, tumour and nodal status, histologic grade and therapy, the additional pathologic characteristics were also involved in analysis: necrosis, lymphocytic infiltration, peritumoural vascular invasion (PVI), perineural invasion, DCIS extent and grade, perinodal spread, mitotic activity index (MAI). RESULTS 295 early TNBC were involved. In univariate survival analysis with a mean follow-up of 3.57 years the tumour size, the nodal status, type of operation (conservation or mastectomy), irradiation, PVI and perinodal spread proved to be significantly connected with both disease free survival (DFS) and breast cancer specific overall survival (BSOS), and necrosis and chemotherapy with BSOS. Necrosis analysed together with lymphocytic infiltrate showed greater predicting power. In multivariate analysis nodal metastasis, necrosis positive/lymphacytic infiltration negative status and lack of irradiation has significant negative impact on DFS (p = <0.0001 HR:1.98 [1.4-2.77], p = <0.017 HR:2.1 [1.1-3.8], p = <0.001 HR:0.25 [0.11-0.57], respectively) and BSOS (p = <0.0001 HR:2.47 [1.8-3.4], p = <0.017 HR:3.7 [1.6-8.2], p = <0.0017 HR:0.24 [0.1-0.58], respectively). For DFS perivascular invasion also showed significant effect (p = <0.042 HR:2.5 [1.0-6.0]). Nodal status was the strongest prognostic parameter but other histomorphologic parameters can be used for prognosis prediction.
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87
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Nagao T, Kinoshita T, Hojo T, Tsuda H, Tamura K, Fujiwara Y. The differences in the histological types of breast cancer and the response to neoadjuvant chemotherapy: the relationship between the outcome and the clinicopathological characteristics. Breast 2012; 21:289-95. [PMID: 22277312 DOI: 10.1016/j.breast.2011.12.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 12/08/2011] [Accepted: 12/10/2011] [Indexed: 02/08/2023] Open
Abstract
UNLABELLED Although effective regimens have been established for invasive ductal carcinoma-not otherwise specified (IDC), the efficacy and prognosis of other minor types of breast cancer are unknown because of their rareness. The clinicopathological features and prognosis of other minor types concerning the response to neoadjuvant chemotherapy (NAC) were evaluated in this study. A total of 562 patients were classified according to the Japanese and the World Health Organization (WHO) classifications, and the number of IDC and other special types (SP) was 500 and 62. The SP patients had a significantly poorer clinicopathological response to NAC and less breast-conservative therapy than those with IDC. According to the WHO classification, mucinous carcinoma, metaplastic carcinomas and apocrine carcinoma also responded poorly, and patients with metaplastic carcinomas and invasive lobular carcinoma had a significantly poorer prognosis. Despite the poor response to chemotherapy, patients with mucinous carcinoma and apocrine carcinoma had a good prognosis. The response to NAC and the prognosis vary for each histological type. For some types, the prognosis was not related to the clinicopathological response to NAC. BACKGROUND In the treatment of breast cancer, neoadjuvant chemotherapy (NAC) has become the standard treatment modality for downstaging purposes. Although effective regimens have been established for the treatment of invasive ductal carcinoma-not otherwise specified (IDC), the data about the efficacy and prognosis for patients with other minor types of breast cancer are insufficient because of the rareness of these tumors. Defining the relationship between each histological type and the clinicopathological response to NAC is essential to optimizing individualized treatment. METHODS We retrospectively evaluated the clinicopathological features and classification of the histological types based on the Japanese and the World Health Organization (WHO) classifications before and after NAC in 562 patients with primary breast cancer who underwent curative treatment after NAC between 1998 and 2008. The prognosis was estimated for each histological type. RESULTS Of the 562 patients, the number of cases of IDC and other special types (SP) was 500 and 62. In the SP group, the clinicopathological response to NAC was significantly poorer, and the patients underwent breast-conservative therapy less frequently than did the IDC patients. According to the WHO classification, mucinous carcinoma, metaplastic carcinomas and apocrine carcinoma responded poorly to NAC. The disease-free survival and overall survival were significantly worse for patients with metaplastic carcinomas (p<0.001 and p<0.001) and with invasive lobular carcinoma (p=0.03 and p<0.001) than other cancers. Despite their poor response to treatment, patients with mucinous carcinoma and apocrine carcinoma had a good prognosis. CONCLUSIONS The response to standardized NAC and prognosis varies for each histological type. For some types, the prognosis was not associated with the clinicopathological response to NAC. Innovative regimens should therefore be investigated for each histological type to achieve the best response.
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Affiliation(s)
- Tomoya Nagao
- Department of Breast Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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88
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Matković B, Juretić A, Spagnoli GC, Separović V, Gamulin M, Separović R, Sarić N, Basić-Koretić M, Novosel I, Kruslin B. Expression of MAGE-A and NY-ESO-1 cancer/testis antigens in medullary breast cancer: retrospective immunohistochemical study. Croat Med J 2011; 52:171-7. [PMID: 21495200 PMCID: PMC3081216 DOI: 10.3325/cmj.2011.52.171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To immunohistochemically evaluate the expression of MAGE-A1, MAGE-A, and NY-ESO-1 cancer/testis (C/T) tumor antigens in medullary breast cancer (MBC) tumor samples and to analyze it in relation to the clinicopathological features. Methods This retrospective study included samples from 49 patients: 40 with typical MBC and 9 with atypical MBC. Tumor specimens were obtained from patients operated on in the University Hospital for Tumors and the Sisters of Mercy University Hospital, Zagreb, Croatia, from 1999 to 2005. Standard immunohistochemistry was used on archival paraffin-embedded MBC tissues. Results MAGE-A1, MAGE-A, and NY-ESO-1 antigens were expressed in 33% (16/49), 33% (16/49), and 22% (11/49) of patients, respectively. No difference between the groups with and without C/T tumor antigen expression in age at diagnosis, tumor size, axillary lymph node metastasis, adjuvant therapy, and HER-2 expression was identified. Significantly more patients died in the MAGE-A-positive group than in the MAGE-A-negative group (P = 0.010), whereas a borderline significance was found between MAGE-A1-positive and the MAGE-A1-negative group (P = 0.079) and between NY-ESO-1-positive and NY-ESO-1-negative group (P = 0.117). Overall survival, as evaluated by the Kaplan-Meier curves, was lower in MAGE-A1- (P = 0.031), MAGE-A- (P = 0.004), NY-ESO-1-positive groups (P = 0.077). Conclusion Expression of C/T antigens may represent a marker of potential prognostic relevance in MBC.
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Affiliation(s)
- Bozica Matković
- Zagreb University Hospital Center, Department of Oncology, Kispatićeva 12, Zagreb, Croatia
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89
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Kertmen N, Dogan E, Altundag K. Pure Mucinous Breast Carcinoma with Lung Metastasis in a Young Male Patient. Am Surg 2010. [DOI: 10.1177/000313481007600819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Neyran Kertmen
- Department of Medical Oncology Hacettepe University Faculty of Medicine Ankara, Turkey
| | - Erkan Dogan
- Department of Medical Oncology Hacettepe University Faculty of Medicine Ankara, Turkey
| | - Kadri Altundag
- Department of Medical Oncology Hacettepe University Faculty of Medicine Ankara, Turkey
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90
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Weigelt B, Geyer FC, Reis-Filho JS. Histological types of breast cancer: how special are they? Mol Oncol 2010; 4:192-208. [PMID: 20452298 PMCID: PMC5527938 DOI: 10.1016/j.molonc.2010.04.004] [Citation(s) in RCA: 295] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 04/11/2010] [Accepted: 04/12/2010] [Indexed: 12/16/2022] Open
Abstract
Breast cancer is a heterogeneous disease, comprising multiple entities associated with distinctive histological and biological features, clinical presentations and behaviours and responses to therapy. Microarray-based technologies have unravelled the molecular underpinning of several characteristics of breast cancer, including metastatic propensity and histological grade, and have led to the identification of prognostic and predictive gene expression signatures. Furthermore, a molecular taxonomy of breast cancer based on transcriptomic analysis has been proposed. However, microarray studies have primarily focused on invasive ductal carcinomas of no special type. Owing to the relative rarity of special types of breast cancer, information about the biology and clinical behaviour of breast cancers conveyed by histological type has not been taken into account. Histological special types of breast cancer account for up to 25% of all invasive breast cancers. Recent studies have provided direct evidence of the existence of genotypic-phenotypic correlations. For instance, secretory carcinomas of the breast consistently harbour the t(12;15) translocation that leads to the formation of the ETV6-NTRK3 fusion gene, adenoid cystic carcinomas consistently display the t(6;9) MYB-NFIB translocation and lobular carcinomas consistently show inactivation of the CDH1 gene through multiple molecular mechanisms. Furthermore, histopathological and molecular analysis of tumours from conditional mouse models has provided direct evidence for the causative role of specific genes in the genesis of specific histological special types of breast cancer. Here we review the associations between the molecular taxonomy of breast cancer and histological special types, discuss the possible origins of the heterogeneity of breast cancer and propose an approach for the identification of novel therapeutic targets based on the study of histological special types of breast cancer.
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Affiliation(s)
- Britta Weigelt
- Cancer Research UK, London Research Institute, Lincoln's Inn Fields Laboratories, London WC2A 3PX, UK
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