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Chamandi G, El-Hajjar L, El Kurdi A, Le Bras M, Nasr R, Lehmann-Che J. ER Negative Breast Cancer and miRNA: There Is More to Decipher Than What the Pathologist Can See! Biomedicines 2023; 11:2300. [PMID: 37626796 PMCID: PMC10452617 DOI: 10.3390/biomedicines11082300] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer (BC), the most prevalent cancer in women, is a heterogenous disease. Despite advancements in BC diagnosis, prognosis, and therapeutics, survival rates have drastically decreased in the metastatic setting. Therefore, BC still remains a medical challenge. The evolution of high-throughput technology has highlighted gaps in the classification system of BCs. Of particular interest is the notorious triple negative BC, which was recounted as being heterogenous itself and it overlaps with distinct subtypes, namely molecular apocrine (MA) and luminal androgen (LAR) BCs. These subtypes are, even today, still misdiagnosed and poorly treated. As such, researchers and clinicians have been looking for ways through which to refine BC classification in order to properly understand the initiation, development, progression, and the responses to the treatment of BCs. One tool is biomarkers and, specifically, microRNA (miRNA), which are highly reported as associated with BC carcinogenesis. In this review, the diverse roles of miRNA in estrogen receptor negative (ER-) and androgen receptor positive (AR+) BC are depicted. While highlighting their oncogenic and tumor suppressor functions in tumor progression, we will discuss their diagnostic, prognostic, and predictive biomarker potentials, as well as their drug sensitivity/resistance activity. The association of several miRNAs in the KEGG-reported pathways that are related to ER-BC carcinogenesis is presented. The identification and verification of accurate miRNA panels is a cornerstone for tackling BC classification setbacks, as is also the deciphering of the carcinogenesis regulators of ER - AR + BC.
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Affiliation(s)
- Ghada Chamandi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, 11-0236 Beirut, Lebanon; (G.C.); (L.E.-H.)
- Pathophysiology of Breast Cancer Team, INSERM U976, Immunologie Humaine, Pathophysiologie, Immunothérapie (HIPI), Université Paris Cité, 75010 Paris, France;
| | - Layal El-Hajjar
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, 11-0236 Beirut, Lebanon; (G.C.); (L.E.-H.)
- Office of Basic/Translational Research and Graduate Studies, Faculty of Medicine, American University of Beirut, 11-0236 Beirut, Lebanon
| | - Abdallah El Kurdi
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, 11-0236 Beirut, Lebanon;
| | - Morgane Le Bras
- Pathophysiology of Breast Cancer Team, INSERM U976, Immunologie Humaine, Pathophysiologie, Immunothérapie (HIPI), Université Paris Cité, 75010 Paris, France;
| | - Rihab Nasr
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, 11-0236 Beirut, Lebanon; (G.C.); (L.E.-H.)
| | - Jacqueline Lehmann-Che
- Pathophysiology of Breast Cancer Team, INSERM U976, Immunologie Humaine, Pathophysiologie, Immunothérapie (HIPI), Université Paris Cité, 75010 Paris, France;
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Feng Y, McGuire N, Walton A, Fox S, Papa A, Lakhani SR, McCart Reed AE. Predicting breast cancer-specific survival in metaplastic breast cancer patients using machine learning algorithms. J Pathol Inform 2023; 14:100329. [PMID: 37664452 PMCID: PMC10470383 DOI: 10.1016/j.jpi.2023.100329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
Metaplastic breast cancer (MpBC) is a rare and aggressive subtype of breast cancer, with data emerging on prognostic factors and survival prediction. This study aimed to develop machine learning models to predict breast cancer-specific survival (BCSS) in MpBC patients, utilizing a dataset of 160 patients with clinical, pathological, and biological variables. An in-depth variable selection process was carried out using gain ratio and correlation-based methods, resulting in 10 variables for model estimation. Five models (decision tree with bagging; logistic regression; multilayer perceptron; naïve Bayes; and, random forest algorithms) were evaluated using 10-fold cross-validation. Despite the constraints posed by the absence of therapeutic information, the random forest model exhibited the highest performance in predicting BCSS, with an ROC area of 0.808. This study emphasizes the potential of machine learning algorithms in predicting prognosis for complex and heterogeneous cancer subtypes using clinical datasets, and their potential to contribute to patient management. Further research that incorporates additional variables, such as treatment response, and more advanced machine learning techniques will likely enhance the predictive power of MpBC prognostic models.
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Affiliation(s)
- Yufan Feng
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4029, Australia
| | - Natasha McGuire
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4029, Australia
| | - Alexandra Walton
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4029, Australia
- Pathology Queensland, The Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
| | | | - Stephen Fox
- Peter MacCallum Cancer Centre and University of Melbourne, Melbourne 3000, Australia
| | - Antonella Papa
- Monash Biomedicine Discovery Institute, Monash University, Melbourne 3800, Australia
| | - Sunil R. Lakhani
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4029, Australia
- Pathology Queensland, The Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia
| | - Amy E. McCart Reed
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4029, Australia
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Antonarelli G, Corti C, Tarantino P, Salimbeni BT, Zagami P, Marra A, Trapani D, Tolaney S, Cortes J, Curigliano G. Management of patients with HER2-positive metastatic breast cancer after trastuzumab deruxtecan failure. ESMO Open 2023; 8:101608. [PMID: 37467660 PMCID: PMC10372550 DOI: 10.1016/j.esmoop.2023.101608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/11/2023] [Accepted: 06/20/2023] [Indexed: 07/21/2023] Open
Abstract
The current treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer (ABC) has been greatly impacted in the past decade by the introduction of antibody-drug conjugates (ADCs), which represent a relatively novel therapeutic class with the peculiar ability to deliver otherwise overtly toxic chemotherapeutics to tumor sites by exploiting the specificities of monoclonal antibodies. Indeed, drug engineering refinements in ADC design, such as through the introduction of cleavable linkers and hydrophobic payloads, resulted in improved patient outcomes in recent years. Two different ADCs, namely trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd), have already entered clinical practice for the treatment of HER2-positive ABC. In this scenario, T-DXd has shown to portend better survival outcomes compared to T-DM1, while leaving a large unsought area of unmet medical need upon T-DXd failure. Treatment decision and benefit of cancer drugs following T-DXd still represent an area of clinical controversy, where a preclinical investigation and clinical development should be prioritized. As the pace of innovation is currently accelerating, and with novel ADC formulations advancing in early-phase clinical trials, the whole BC field is changing at an unprecedented rate, with potential broadenings of therapeutic indications. In this review, we present the clinical landscape of HER2-positive advanced BC and discuss our vision on how to tackle T-DXd resistance, providing a perspective on the priority areas of the cancer research in this setting.
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Affiliation(s)
- G Antonarelli
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy. https://twitter.com/GabrAnton
| | - C Corti
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy. https://twitter.com/CCortiMD
| | - P Tarantino
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA. https://twitter.com/PTarantinoMD
| | - B T Salimbeni
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
| | - P Zagami
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy. https://twitter.com/paolazagam
| | - A Marra
- Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy. https://twitter.com/antoniomarraMD
| | - D Trapani
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy. https://twitter.com/darioT_
| | - S Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA. https://twitter.com/stolaney1
| | - J Cortes
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Barcelona; Medical Scientia Innovation Research (MedSIR), Barcelona; Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain.
| | - G Curigliano
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan; Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy.
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Mremi A, Gnanamuttupulle M, Ntundu SH, Henke O, Chilonga K, Msuya D. Invasive breast carcinoma of no special type with medullary pattern: A case report at a tertiary facility in Tanzania. Clin Case Rep 2023; 11:e7844. [PMID: 37621722 PMCID: PMC10444943 DOI: 10.1002/ccr3.7844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
Key Clinical Message Describes a rare form of invasive breast cancer of no special type.Not a distinct morphological subtype.Characterized by dense lymphoid infiltrate, syncytial growth, pushing borders, and cells with high-grade nuclei.Clinically aggressive but carries a better prognosis than other more frequent invasive breast carcinomas. Abstract Invasive breast carcinoma of no special type with medullary pattern (BCNST-MP) is a rare form of breast tumor, accounting for less than 5% of all invasive breast carcinomas. Its diagnosis is based on histologic criteria. Historically, this tumor was known as medullary carcinoma. Poor morphological reproducibility led to re-classification. Despite having an aggressive biological behavior, these tumors usually carry a better prognosis compared with other more frequent forms of invasive breast carcinomas. Herein, we present a case of BCNST-MP in a 58-year-old African female, successfully treated in our institution through chemo-radiation, hormonal therapy and surgery.
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Affiliation(s)
- Alex Mremi
- Department of PathologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Marianne Gnanamuttupulle
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
| | | | - Oliver Henke
- Cancer Care CanterKilimanjaro Christian Medical CentreMoshiTanzania
- Section Global Health, Institute for Hygiene and Public HealthUniversity Hospital BonnBonnGermany
| | - Kondo Chilonga
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
| | - David Msuya
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical CentreMoshiTanzania
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Cosar R, Sut N, Topaloglu S, Tastekin E, Nurlu D, Ozler T, Şenödeyici E, Dedeli M, Chousein M, Cicin I. Classifying invasive lobular carcinoma as special type breast cancer may be reducing its treatment success: A comparison of survival among invasive lobular carcinoma, invasive ductal carcinoma, and no-lobular special type breast cancer. PLoS One 2023; 18:e0283445. [PMID: 37428725 DOI: 10.1371/journal.pone.0283445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/08/2023] [Indexed: 07/12/2023] Open
Abstract
PURPOSE The literature contains different information about the prognosis of invasive lobular carcinoma of breast cancer (BC). We aimed to address the inconsistency by comparatively examining the clinical features and prognosis of invasive lobular carcinoma patients in our university and to report our experience by dividing our patients into various subgroups. PATIENTS AND METHODS Records of patients with BC admitted to Trakya University School of Medicine Department of Oncology between July 1999 and December 2021 were reviewed. The patients were divided into three groups (No-Special Type BC, Invasive Lobular Special Type BC, No-Lobular Special Type BC). Patient characteristics, treatment methods and oncological results are presented. Survival curves were generated using the Kaplan-Meier method. Statistical significance of survival among the selected variables was compared by using the log-rank test. RESULTS The patients in our study consisted of 2142 female and 15 male BC patients. There were 1814 patients with No-Special Type BC, 193 patients with Invasive Lobular Special Type BC, and 150 patients with No-Lobular Special Type BC. The duration of disease-free survival (DFS) was 226.5 months for the No-Special Type BC group, 216.7 months for the No-Lobular Special Type BC group, and 197.2 months for the Invasive Lobular Special Type BC group, whereas the duration of overall survival (OS) was 233.2 months for the No-Special Type BC group, 227.9 for the No-Lobular Special Type BC group, and 209.8 for the Invasive Lobular Special Type BC group. The duration of both DFS and OS was the lowest in the Invasive Lobular Special Type BC group. Multivariate factors that were significant risk factors for OS were Invasive Lobular Special Type BC histopathology (p = .045), T stage, N stage, stage, skin infiltration, positive surgical margins, high histological grade, and mitotic index. Modified radical mastectomy, chemotherapy, radiotherapy and use of tamoxifen and aromatase inhibitors for more than 5 years were significant protective factors for overall survival. CONCLUSION The histopathological subgroup with the worst prognosis in our study was Invasive Lobular Special Type BC. Duration of DFS and OS were significantly shorter in Invasive Lobular Special Type BC than No-Lobular Special Type BC group. The classification of Invasive Lobular BC under the title of Special Type BC should be reconsidered and a more accurate treatment and follow-up process may be required.
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Affiliation(s)
- Rusen Cosar
- Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Necdet Sut
- Department of Biostatistics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Sernaz Topaloglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Ebru Tastekin
- Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Dilek Nurlu
- Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Talar Ozler
- Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | | | - Melisa Dedeli
- Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Mert Chousein
- Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Irfan Cicin
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Gautam N, Kaur S, Kashyap S. EZH2 Expression and Survival for ER+/tamoxifen Treated Breast Cancer Patients with rs2302427 C>G: A Novel Prognostic and Risk Predictive Biomarker. Arch Med Res 2023:102852. [PMID: 37438214 DOI: 10.1016/j.arcmed.2023.102852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 04/30/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Overexpression of the EZH2 gene silences several genes involved in DNA repair, cell-cell adhesion, and tumor suppressor genes, resulting in the development of several types of cancers. In the present study, a genetic polymorphism analysis was performed by selecting three SNPs (rs.2302427C>G, rs.3757441C>T, and rs.6950683T>C) of the EZH2 gene based on our previous in silico studies. METHODS A total of 250 breast cancer patients and 250 healthy individuals were recruited for the study. Patients with pre-operative breast cancer with different clinical-pathological variables and age-matched healthy women were recruited for the EZH2 gene expression analysis. RESULTS The genetic polymorphism analysis revealed two SNPs (rs.2302427C>G and rs.6950683T>C) of the three studied SNPs of the EZH2 gene have a protective role in all three genetic models. The haplotype analysis predicted that two haplotypes ACGT and ACGC were significantly associated with a lower risk of breast cancer. INTERPRETATION AND CONCLUSIONS Three significant findings of the SNP rs.2302427C>G (Asp193His) i.e., protective role against breast cancer, survival advantage in ER+/tamoxifen treated breast cancer patients, and decreased expression due to the presence of mutant GG genotype, suggests considering it as an important prognostic biomarker for a good survival outcome of breast cancer patients treated with ER+/tamoxifen. Compared with other studies, the other SNP rs.3757441T>C was observed to have a protective effect in breast cancer biology but plays an antagonistic role in colorectal cancer (CRC) biology. To our knowledge, this is the first detailed study on computationally validated EZH2 SNPs in breast cancer.
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Affiliation(s)
- Nisha Gautam
- Laboratory of Molecular Genetics, Department of Human Genetics, Punjabi University, Patiala, India.
| | - Satbir Kaur
- Laboratory of Molecular Genetics, Department of Human Genetics, Punjabi University, Patiala, India
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Meng X, Morita M, Kuba S, Hayashi H, Otsubo R, Matsumoto M, Yamanouchi K, Kobayashi K, Soyama A, Hidaka M, Kanetaka K, Nagayasu T, Eguchi S. Association of quantitative analysis of intratumoral reduced E-cadherin expression with lymph node metastasis and prognosis in patients with breast cancer. Sci Rep 2023; 13:10434. [PMID: 37369698 PMCID: PMC10300190 DOI: 10.1038/s41598-023-37012-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Loss of E-cadherin expression is a poor prognostic factor in patients with breast cancer. Breast cancer cells co-cultured with adipocytes reportedly promote E-cadherin attenuation and tumor progression. The current study aimed to investigate the association of reduced E-cadherin expression with adipose tissue invasion (ATI) and prognosis in breast cancer. Surgical specimens were collected from 188 women with invasive ductal carcinoma of the breast who had undergone surgery without neoadjuvant treatment. We compared E-cadherin expression in ATI and invasive front (IF) using immunohistochemistry with ImageJ. Reduced E-cadherin expression was detected not only in the ATI area but also in the IF, and the degree of reduced E-cadherin expression was positively correlated with both areas. In patients with lymph node metastasis compared to those without, E-cadherin expression was reduced and this reduction was associated with poor recurrence-free survival. We concluded that E-cadherin expression is reduced not only at the ATI area but also at the IF of the tumor. Reduced E-cadherin expression is a clear prognostic factor for breast cancer. Hence, future research is warranted for establishing an objective and quantitative E-cadherin staining assay that will allow clinical use of E-cadherin as a prognostic factor.
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Affiliation(s)
- Xiangyue Meng
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan.
| | - Hiroko Hayashi
- Department of Pathology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
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Wang R, Xu K, Chen Q, Hu Q, Zhang J, Guan X. Cuproptosis engages in c-Myc-mediated breast cancer stemness. J Transl Med 2023; 21:409. [PMID: 37353799 PMCID: PMC10288777 DOI: 10.1186/s12967-023-04204-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/15/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Intra-tumoral heterogeneity (ITH) is a distinguished hallmark of cancer, and cancer stem cells (CSCs) contribute to this malignant characteristic. Therefore, it is of great significance to investigate and even target the regulatory factors driving intra-tumoral stemness. c-Myc is a vital oncogene frequently overexpressed or amplified in various cancer types, including breast cancer. Our previous study indicated its potential association with breast cancer stem cell (BCSC) biomarkers. METHODS In this research, we performed immunohistochemical (IHC) staining on sixty breast cancer surgical specimens for c-Myc, CD44, CD24, CD133 and ALDH1A1. Then, we analyzed transcriptomic atlas of 1533 patients with breast cancer from public database. RESULTS IHC staining indicated the positive correlation between c-Myc and BCSC phenotype. Then, we used bioinformatic analysis to interrogate transcriptomics data of 1533 breast cancer specimens and identified an intriguing link among c-Myc, cancer stemness and copper-induced cell death (also known as "cuproptosis"). We screened out cuproptosis-related characteristics that predicts poor clinical outcomes and found that the pro-tumoral cuproptosis-based features were putatively enriched in MYC-targets and showed a significantly positive correlation with cancer stemness. CONCLUSION In addition to previous reports on its oncogenic roles, c-Myc showed significant correlation to stemness phenotype and copper-induced cell toxicity in breast cancer tissues. Moreover, transcriptomics data demonstrated that pro-tumoral cuproptosis biomarkers had putative positive association with cancer stemness. This research combined clinical samples with large-scale bioinformatic analysis, covered description and deduction, bridged classic oncogenic mechanisms to innovative opportunities, and inspired the development of copper-based nanomaterials in targeting highly heterogeneous tumors.
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Affiliation(s)
- Runtian Wang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Kun Xu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qin Chen
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qin Hu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China
| | - Jian Zhang
- Phase I Clinical Trial Center, Fudan University Shanghai Cancer Center, Shanghai, China.
| | - Xiaoxiang Guan
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, 211166, China.
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Motyka J, Kicman A, Kulesza M, Ławicki S. CXC ELR-Positive Chemokines as Diagnostic and Prognostic Markers for Breast Cancer Patients. Cancers (Basel) 2023; 15:3118. [PMID: 37370728 DOI: 10.3390/cancers15123118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
As the most common type of malignant lesison, breast cancer is a leading challenge for clinicians. Currently, diagnosis is based on self-examination and imaging studies that require confirmation by tissue biopsy. However, there are no easily accessible diagnostic tools that can serve as diagnostic and prognostic markers for breast cancer patients. One of the possible candidates for such markers is a group of chemokines that are closely implicated in each stage of tumorigenesis. Many researchers have noted the potential of this molecule group to become tumor markers and have tried to establish their clinical utility. In this work, we summarize the results obtained by scientists on the usefulness of the ELR-positive CXC group of chemokines in ancillary diagnosis of breast cancer.
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Affiliation(s)
- Joanna Motyka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Aleksandra Kicman
- Department of Aesthetic Medicine, Medical University of Bialystok, 15-267 Bialystok, Poland
| | - Monika Kulesza
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Sławomir Ławicki
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland
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110
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de Heer EC, Zois CE, Bridges E, van der Vegt B, Sheldon H, Veldman WA, Zwager MC, van der Sluis T, Haider S, Morita T, Baba O, Schröder CP, de Jong S, Harris AL, Jalving M. Glycogen synthase 1 targeting reveals a metabolic vulnerability in triple-negative breast cancer. J Exp Clin Cancer Res 2023; 42:143. [PMID: 37280675 PMCID: PMC10242793 DOI: 10.1186/s13046-023-02715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Hypoxia-induced glycogen turnover is implicated in cancer proliferation and therapy resistance. Triple-negative breast cancers (TNBCs), characterized by a hypoxic tumor microenvironment, respond poorly to therapy. We studied the expression of glycogen synthase 1 (GYS1), the key regulator of glycogenesis, and other glycogen-related enzymes in primary tumors of patients with breast cancer and evaluated the impact of GYS1 downregulation in preclinical models. METHODS mRNA expression of GYS1 and other glycogen-related enzymes in primary breast tumors and the correlation with patient survival were studied in the METABRIC dataset (n = 1904). Immunohistochemical staining of GYS1 and glycogen was performed on a tissue microarray of primary breast cancers (n = 337). In four breast cancer cell lines and a mouse xenograft model of triple-negative breast cancer, GYS1 was downregulated using small-interfering or stably expressed short-hairpin RNAs to study the effect of downregulation on breast cancer cell proliferation, glycogen content and sensitivity to various metabolically targeted drugs. RESULTS High GYS1 mRNA expression was associated with poor patient overall survival (HR 1.20, P = 0.009), especially in the TNBC subgroup (HR 1.52, P = 0.014). Immunohistochemical GYS1 expression in primary breast tumors was highest in TNBCs (median H-score 80, IQR 53-121) and other Ki67-high tumors (median H-score 85, IQR 57-124) (P < 0.0001). Knockdown of GYS1 impaired proliferation of breast cancer cells, depleted glycogen stores and delayed growth of MDA-MB-231 xenografts. Knockdown of GYS1 made breast cancer cells more vulnerable to inhibition of mitochondrial proteostasis. CONCLUSIONS Our findings highlight GYS1 as potential therapeutic target in breast cancer, especially in TNBC and other highly proliferative subsets.
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Affiliation(s)
- E C de Heer
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - C E Zois
- Department of Oncology, Weatherall Institute of Molecular Medicine, University of Oxford, Hypoxia and Angiogenesis Group, Cancer Research UK Molecular Oncology Laboratories, Oxford, OX3 9DS, UK.
- Department of Radiotherapy and Oncology, School of Health, Democritus University of Thrace, Alexandroupolis, Greece.
- Department of Oncology, MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Molecular Oncology Laboratories, Oxford University, Oxford, OX3 9DS, UK.
| | - E Bridges
- Department of Oncology, Weatherall Institute of Molecular Medicine, University of Oxford, Hypoxia and Angiogenesis Group, Cancer Research UK Molecular Oncology Laboratories, Oxford, OX3 9DS, UK
| | - B van der Vegt
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H Sheldon
- Department of Oncology, Weatherall Institute of Molecular Medicine, University of Oxford, Hypoxia and Angiogenesis Group, Cancer Research UK Molecular Oncology Laboratories, Oxford, OX3 9DS, UK
| | - W A Veldman
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - M C Zwager
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - T van der Sluis
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S Haider
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - T Morita
- Tokushima University Graduate School, 3-18-15, Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - O Baba
- Tokushima University Graduate School, 3-18-15, Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - C P Schröder
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
- Department of Medical Oncology, Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - S de Jong
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - A L Harris
- Department of Oncology, Weatherall Institute of Molecular Medicine, University of Oxford, Hypoxia and Angiogenesis Group, Cancer Research UK Molecular Oncology Laboratories, Oxford, OX3 9DS, UK
| | - M Jalving
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
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Ismail Y, Kamal A, Allam R, Zakaria AS. The conundrum of metaplastic breast cancer: a single Egyptian institution retrospective 10-year experience (2011-2020). J Egypt Natl Canc Inst 2023; 35:16. [PMID: 37271778 DOI: 10.1186/s43046-023-00178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/14/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Metaplastic breast cancer (MetBC) still represents a conundrum owing to its peculiar histogenesis and molecular drivers that render it extremely resistant to standard chemotherapy with ultimate dismal survival. AIM Describe the Egyptian National Cancer Institute's (NCI-E) experience with MetBC regarding its clinicopathologic features, treatment, and survival outcomes. PATIENTS AND METHODS Between 2011 and 2020, all MetBC patients presented to NCI-E were retrospectively evaluated. Original clinicopathologic data, therapeutic modalities, pathologic response to neoadjuvant chemotherapy (NACT), recurrence, and date of last follow-up/death were obtained from archived charts. RESULTS A cohort of 135 females, the median age was 52 years, and median follow-up period was 40 months (range: 2.6-130.8). Two-thirds were triple negative (TN). Squamous carcinoma was prevalent in 74.8% followed by carcinoma with osseous/chondroid differentiation, spindle cell, and low-grade adenosquamous carcinoma encountered in 13.3, 7.4, and 4.5%, respectively. Modified radical mastectomy was done in 59.3%, and positive nodes (pN+) were depicted in 37.7%. Median Ki-67 was 45% (range: 10-88); grade III and lymphovascular invasion (LVI) were observed in 83.7 and 43.7%, respectively. Stage II was the most common (49%), whereas initial stage IV was encountered in 8.1%. Anthracyclines/taxane combinations were rampant in adjuvant/neoadjuvant settings. The latter was employed in 41 patients, with only 3 cases (7.3%) achieving pathologic complete response (pCR), while moderate/significant residual tumor burden was found in 83%. The 5-year DFS and OS were 56.4 and 57.6%, respectively. Spindle cell carcinoma showed the worst survival parameters in univariate analysis. On the multivariate level, higher tumor stage (pT3 & 4), Ki-67 ≥ 45%, and TN subtype were independent variables for worse DFS and OS; age ≥ 52 years and the presence of LVI were independent features for worse DFS, whereas pN+ was an independent parameter for worse OS. CONCLUSIONS This study further solidifies the dreadful response of MetBC to conventional chemotherapy regimens employed in common non-metaplastic pathologies. A radical shift in treatment standards tailored to combat the molecular landscape of this distinctive tumor is urgently needed. Immunotherapy and molecularly targeted agents demonstrated promising results in phase I and II trials with hopeful sooner implementation in phase III studies.
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Affiliation(s)
- Yahia Ismail
- Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, 11796, Egypt.
| | - Amr Kamal
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, 11796, Egypt
| | - Rasha Allam
- Cancer Epidemiology & Biostatistics Department, National Cancer Institute, Cairo University, Cairo, 11796, Egypt
| | - Al-Shimaa Zakaria
- Pathology Department, National Cancer Institute, Cairo University, Cairo, 11796, Egypt
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Vegni F, D'Alessandris N, Santoro A, Angelico G, Scaglione G, Carlino A, Arciuolo D, Valente M, Sfregola S, Natale M, Sanchez AM, Masciullo V, Zannoni GF, Mulè A. Primary Mucinous Cystadenocarcinoma of the Breast Intermixed with Pleomorphic Invasive Lobular Carcinoma: The First Report of This Rare Association. J Pers Med 2023; 13:948. [PMID: 37373937 DOI: 10.3390/jpm13060948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Primary mucinous cystadenocarcinoma (MCA) is a rare breast carcinoma subtype showing overlapping histopathological features with mucinous cystadenocarcinoma of the ovary and pancreas. Current literature data suggest a favorable prognosis of breast MCAs despite its immunoprofile usually revealing lack of expression of estrogen receptor, progesterone receptor and HER-2 and high Ki67. As far as we know, only 36 cases have been reported in the literature to date. Its ambiguous morpho-phenotypic profile makes histological diagnosis very challenging. It must be distinguished from typical mucin-producing breast carcinomas and, above all, metastases from the same histotype in other sites (ovary, pancreas, appendix). Herein, we report the case of a primary breast MCA occurring in a 41-year-old female with peculiar histological features.
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Affiliation(s)
- Federica Vegni
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Nicoletta D'Alessandris
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Angela Santoro
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Giuseppe Angelico
- Department of Medical and Surgical Sciences and Advanced Technologies G. F. Ingrassia, Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Giulia Scaglione
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Angela Carlino
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Damiano Arciuolo
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Michele Valente
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Stefania Sfregola
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Maria Natale
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Valeria Masciullo
- Division of Gynecologic Surgery, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Sacred Heart, 00168 Rome, Italy
| | - Gian Franco Zannoni
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Pathology Institute, Catholic University of Sacred Heart, 00168 Rome, Italy
| | - Antonino Mulè
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Jagannathan G, White MJ, Xian RR, Emens LA, Cimino-Mathews A. A New Landscape of Testing and Therapeutics in Metastatic Breast Cancer. Clin Lab Med 2023; 43:299-321. [PMID: 37169447 DOI: 10.1016/j.cll.2023.03.004] [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: 05/13/2023]
Abstract
Predictive biomarker testing on metastatic breast cancer is essential for determining patient eligibility for targeted therapeutics. The National Comprehensive Cancer Network currently recommends assessment of specific biomarkers on metastatic tumor subtypes, including hormone receptors, HER2, and BRCA1/2 mutations, on all newly metastatic breast cancers subtypes; programmed death-ligand 1 on metastatic triple-negative carcinomas; and PIK3CA mutation status on estrogen receptor-positive carcinomas. In select circumstances mismatch repair protein deficiency and/or microsatellite insufficiency, tumor mutation burden, and NTRK translocation status are also testing options. Novel biomarker testing, such as detecting PIK3CA mutations in circulating tumor DNA, is expanding in this rapidly evolving arena.
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Affiliation(s)
- Geetha Jagannathan
- Department of Pathology, The Johns Hopkins University School of Medicine, 401 N Broadway, Weinberg 2242, Baltimore, MD 21287, USA
| | - Marissa J White
- Department of Pathology, The Johns Hopkins University School of Medicine, 401 N Broadway, Weinberg 2242, Baltimore, MD 21287, USA
| | - Rena R Xian
- Department of Pathology, The Johns Hopkins University School of Medicine, 401 N Broadway, Weinberg 2242, Baltimore, MD 21287, USA; Department of Oncology, The Johns Hopkins University School of Medicine, 401 N Broadway, Weinberg 2242, Baltimore, MD 21287, USA
| | - Leisha A Emens
- Department of Oncology, UPMC Hillman Cancer Center/Magee Women's Hospital, 5117 Centre Avenue, Room 1.46e, Pittsburgh, PA 15213, USA
| | - Ashley Cimino-Mathews
- Department of Pathology, The Johns Hopkins University School of Medicine, 401 N Broadway, Weinberg 2242, Baltimore, MD 21287, USA; Department of Oncology, The Johns Hopkins University School of Medicine, 401 N Broadway, Weinberg 2242, Baltimore, MD 21287, USA.
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Plaza-Diaz J, Álvarez-Mercado AI. The Interplay between Microbiota and Chemotherapy-Derived Metabolites in Breast Cancer. Metabolites 2023; 13:703. [PMID: 37367861 DOI: 10.3390/metabo13060703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
The most common cancer in women is breast cancer, which is also the second leading cause of death in this group. It is, however, important to note that some women will develop or will not develop breast cancer regardless of whether certain known risk factors are present. On the other hand, certain compounds are produced by bacteria in the gut, such as short-chain fatty acids, secondary bile acids, and other metabolites that may be linked to breast cancer development and mediate the chemotherapy response. Modeling the microbiota through dietary intervention and identifying metabolites directly associated with breast cancer and its complications may be useful to identify actionable targets and improve the effect of antiangiogenic therapies. Metabolomics is therefore a complementary approach to metagenomics for this purpose. As a result of the combination of both techniques, a better understanding of molecular biology and oncogenesis can be obtained. This article reviews recent literature about the influence of bacterial metabolites and chemotherapy metabolites in breast cancer patients, as well as the influence of diet.
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Affiliation(s)
- Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Ana Isabel Álvarez-Mercado
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Institute of Nutrition and Food Technology, Biomedical Research Center, University of Granada, 18016 Armilla, Spain
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Sain B, Gupta A, Ghose A, Halder S, Mukherjee V, Bhattacharya S, Mondal RR, Sen AN, Saha B, Roy S, Boussios S. Clinico-Pathological Factors Determining Recurrence of Phyllodes Tumors of the Breast: The 25-Year Experience at a Tertiary Cancer Centre. J Pers Med 2023; 13:jpm13050866. [PMID: 37241036 DOI: 10.3390/jpm13050866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Phyllodes tumors (PTs) of the breast are rare fibroepithelial tumors that are generally more prone to recurrence. AIMS AND OBJECTIVES This study aimed to assess the clinicopathological features, diagnostic modalities, and therapeutic interventions, along with their respective outcomes, to identify the factors associated with a recurrence of PTs of the breast. METHODOLOGY A retrospective cohort and observational study was conducted, which entailed analyzing the clinicopathological data of patients who were previously diagnosed or presented with PTs of the breast between 1996 and 2021. Data included the total number of patients diagnosed with PTs of the breast and their ages, tumor grade on initial biopsy, tumor location (left or right breast), tumor size, therapeutic interventions carried out (including surgery-either mastectomy or lumpectomy-and adjuvant radiotherapy), final tumor grade, recurrence status, type of recurrence, and time to recurrence. RESULTS We analyzed data on a total of 87 patients who were pathologically proven to have PTs, and 46 patients (52.87%) were found to have recurrences. All patients were female, with a mean age at diagnosis of 39 years (range 15-70). Patients aged <40 years had the highest incidence of recurrence, with a rate of 54.35% (n = 25/46), followed by patients aged >40 years, with a rate of recurrence of 45.65% (n = 21/46). A total of 55.4% of patients presented with primary PTs and 44.6% had recurrent PTs at presentation. The average time to local recurrence (LR) from the completion of treatment was 13.8 months, whereas for systemic recurrence (SR), it was 15.29 months. Surgery (mastectomy/lumpectomy) was the major determinant for local recurrence (p < 0.05). CONCLUSION Patients who received adjuvant radiotherapy (RT) had a minimal recurrence of PTs. Patients who were found to have a malignant biopsy on initial diagnosis (triple assessment) had a higher incidence of PTs and were more prone to SR than LR. Surgery was a determining factor in the increased rate of LR, with lumpectomy associated with a higher incidence of LR than mastectomy.
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Affiliation(s)
- Baijaeek Sain
- Department of Trauma & Orthopaedics, Imperial College London Healthcare NHS Trust, London W2 1NY, UK
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Arnab Gupta
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Aruni Ghose
- Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London SG1 4AB, UK
- Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London E1 1BB, UK
- Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, UK
| | - Sudip Halder
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Vishal Mukherjee
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Samir Bhattacharya
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Radha Raman Mondal
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Aditya Narayan Sen
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Bijan Saha
- Department of Surgical Oncology, Saroj Gupta Cancer Center and Research Institute, Kolkata 700063, India
| | - Shravasti Roy
- Department of Pathology, Saroj Gupta Cancer Centre and Research Institute, Kolkata 700001, India
| | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, UK
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King's College London, London SE1 9RT, UK
- Kent Medway Medical School, University of Kent, Canterbury CT2 7LX, UK
- AELIA Organization, 9th Km Thessaloniki-Thermi, 57001 Thessaloniki, Greece
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116
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Panico A, Gatta G, Salvia A, Grezia GD, Fico N, Cuccurullo V. Radiomics in Breast Imaging: Future Development. J Pers Med 2023; 13:jpm13050862. [PMID: 37241032 DOI: 10.3390/jpm13050862] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/02/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Breast cancer is the most common and most commonly diagnosed non-skin cancer in women. There are several risk factors related to habits and heredity, and screening is essential to reduce the incidence of mortality. Thanks to screening and increased awareness among women, most breast cancers are diagnosed at an early stage, increasing the chances of cure and survival. Regular screening is essential. Mammography is currently the gold standard for breast cancer diagnosis. In mammography, we can encounter problems with the sensitivity of the instrument; in fact, in the case of a high density of glands, the ability to detect small masses is reduced. In fact, in some cases, the lesion may not be particularly evident, it may be hidden, and it is possible to incur false negatives as partial details that may escape the radiologist's eye. The problem is, therefore, substantial, and it makes sense to look for techniques that can increase the quality of diagnosis. In recent years, innovative techniques based on artificial intelligence have been used in this regard, which are able to see where the human eye cannot reach. In this paper, we can see the application of radiomics in mammography.
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Affiliation(s)
- Alessandra Panico
- Radiology Division, Department of Precision Medicine, Università della Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Gianluca Gatta
- Radiology Division, Department of Precision Medicine, Università della Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Antonio Salvia
- Radiology Division, Department of Precision Medicine, Università della Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | | | - Noemi Fico
- Department of Physics "Ettore Pancini", Università di Napoli Federico II, 80126 Naples, Italy
| | - Vincenzo Cuccurullo
- Nuclear Medicine Unit, Department of Precision Medicine, Università della Campania "Luigi Vanvitelli", 80138 Naples, Italy
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Salemme V, Centonze G, Avalle L, Natalini D, Piccolantonio A, Arina P, Morellato A, Ala U, Taverna D, Turco E, Defilippi P. The role of tumor microenvironment in drug resistance: emerging technologies to unravel breast cancer heterogeneity. Front Oncol 2023; 13:1170264. [PMID: 37265795 PMCID: PMC10229846 DOI: 10.3389/fonc.2023.1170264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/28/2023] [Indexed: 06/03/2023] Open
Abstract
Breast cancer is a highly heterogeneous disease, at both inter- and intra-tumor levels, and this heterogeneity is a crucial determinant of malignant progression and response to treatments. In addition to genetic diversity and plasticity of cancer cells, the tumor microenvironment contributes to tumor heterogeneity shaping the physical and biological surroundings of the tumor. The activity of certain types of immune, endothelial or mesenchymal cells in the microenvironment can change the effectiveness of cancer therapies via a plethora of different mechanisms. Therefore, deciphering the interactions between the distinct cell types, their spatial organization and their specific contribution to tumor growth and drug sensitivity is still a major challenge. Dissecting intra-tumor heterogeneity is currently an urgent need to better define breast cancer biology and to develop therapeutic strategies targeting the microenvironment as helpful tools for combined and personalized treatment. In this review, we analyze the mechanisms by which the tumor microenvironment affects the characteristics of tumor heterogeneity that ultimately result in drug resistance, and we outline state of the art preclinical models and emerging technologies that will be instrumental in unraveling the impact of the tumor microenvironment on resistance to therapies.
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Affiliation(s)
- Vincenzo Salemme
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Giorgia Centonze
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Lidia Avalle
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Dora Natalini
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Alessio Piccolantonio
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Pietro Arina
- UCL, Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, United Kingdom
| | - Alessandro Morellato
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Ugo Ala
- Department of Veterinary Sciences, University of Turin, Grugliasco, TO, Italy
| | - Daniela Taverna
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
| | - Emilia Turco
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Paola Defilippi
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Molecular Biotechnology Center (MBC) “Guido Tarone”, Turin, Italy
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Chopra S, Khosla M, Vidya R. Innovations and Challenges in Breast Cancer Care: A Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050957. [PMID: 37241189 DOI: 10.3390/medicina59050957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Breast cancer care has seen tremendous advancements in recent years through various innovations to improve early detection, diagnosis, treatment, and survival. These innovations include advancements in imaging techniques, minimally invasive surgical techniques, targeted therapies and personalized medicine, radiation therapy, and multidisciplinary care. It is essential to recognize that challenges and limitations exist while significant advancements in breast cancer care exist. Continued research, advocacy, and efforts to address these challenges are necessary to make these innovations accessible to all patients while carefully considering and managing the ethical, social, and practical implications.
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Affiliation(s)
- Sharat Chopra
- Aneurin Bevan University Health Board, The Royal Gwent Hospital, Newport NP20 2UB, UK
| | - Muskaan Khosla
- The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
| | - Raghavan Vidya
- The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
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Popović M, Silovski T, Križić M, Dedić Plavetić N. HER2 Low Breast Cancer: A New Subtype or a Trojan for Cytotoxic Drug Delivery? Int J Mol Sci 2023; 24:ijms24098206. [PMID: 37175916 PMCID: PMC10179462 DOI: 10.3390/ijms24098206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Despite the great progress made in the understanding of the biological behavior of certain types of invasive breast cancer, there is still no single histological or molecular classification that encompasses such diversity and accurately predicts the clinical course of distinct breast cancer subtypes. The long-lasting classification of breast cancer as HER2-positive vs. HER2-negative has recently come into question with the discovery of new antibody drug conjugates (ADC), which are proven to be remarkably efficient in treating HER2-low breast cancer. The HER2-low paradigm has challenged the traditional understanding of HER2 overexpression and emphasized the need for more robust HER2 testing in order to encompass HER2 intratumoral heterogeneity and spatial distribution more accurately. It is yet to be seen if low HER2 will remain merely a marker of HER2-equipped tumors targetable with ADCs or if distinctive molecular and phenotypic groups within HER2-low tumors will eventually be discerned.
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Affiliation(s)
- Marina Popović
- Department of Oncology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Tajana Silovski
- Department of Oncology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Marija Križić
- Department of Oncology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Natalija Dedić Plavetić
- Department of Oncology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Granja A, Lima-Sousa R, Alves CG, de Melo-Diogo D, Nunes C, Sousa CT, Correia IJ, Reis S. Multifunctional targeted solid lipid nanoparticles for combined photothermal therapy and chemotherapy of breast cancer. BIOMATERIALS ADVANCES 2023; 151:213443. [PMID: 37146526 DOI: 10.1016/j.bioadv.2023.213443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 05/07/2023]
Abstract
Photothermal therapy has emerged as a new promising strategy for the management of cancer, either alone or combined with other therapeutics, such as chemotherapy. The use of nanoparticles for multimodal therapy can improve treatment performance and reduce drug doses and associated side effects. Here we propose the development of a novel multifunctional nanosystem based on solid lipid nanoparticles co-loaded with gold nanorods and mitoxantrone and functionalized with folic acid for dual photothermal therapy and chemotherapy of breast cancer. Nanoparticles were produced using an economically affordable method and presented suitable physicochemical properties for tumor passive accumulation. Upon Near-Infrared irradiation (808 nm, 1.7 W cm-2, 5 min), nanoparticles could effectively mediate a temperature increase of >20 °C. Moreover, exposure to light resulted in an enhanced release of Mitoxantrone. Furthermore, nanoparticles were non-hemolytic and well tolerated by healthy cells even at high concentrations. The active targeting strategy was found to be successful, as shown by the greater accumulation of the functionalized nanoparticles in MCF-7 cells. Finally, the combined effects of chemotherapy, light-induced drug release and photothermal therapy significantly enhanced breast cancer cell death. Overall, these results demonstrate that the developed lipid nanosystem is an efficient vehicle for breast cancer multimodal therapy.
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Affiliation(s)
- Andreia Granja
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal
| | - Rita Lima-Sousa
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
| | - Cátia G Alves
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
| | - Duarte de Melo-Diogo
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
| | - Cláudia Nunes
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal
| | - Célia T Sousa
- IFIMUP and Departamento de Física e Astronomia da Faculdade de Ciências da Universidade do Porto, Rua do Campo Alegre 687, 4169-007 Porto, Portugal; Departamento de Física Aplicada, Facultad de Ciencias, Universidad Autónoma de Madrid (UAM), Campus de Cantoblanco, C/ Francisco Tomás y Valiente, 7, M 12 604 - 28049 Madrid, Spain
| | - Ilídio J Correia
- CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal; CIEPQPF - Departamento de Engenharia Química, Universidade de Coimbra, Rua Sílvio Lima, 3030-790 Coimbra, Portugal.
| | - Salette Reis
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal.
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Nicosia L, Bozzini AC, Pesapane F, Rotili A, Marinucci I, Signorelli G, Frassoni S, Bagnardi V, Origgi D, De Marco P, Abiuso I, Sangalli C, Balestreri N, Corso G, Cassano E. Breast Digital Tomosynthesis versus Contrast-Enhanced Mammography: Comparison of Diagnostic Application and Radiation Dose in a Screening Setting. Cancers (Basel) 2023; 15:cancers15092413. [PMID: 37173880 PMCID: PMC10177523 DOI: 10.3390/cancers15092413] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
This study aims to evaluate the Average Glandular Dose (AGD) and diagnostic performance of CEM versus Digital Mammography (DM) as well as versus DM plus one-view Digital Breast Tomosynthesis (DBT), which were performed in the same patients at short intervals of time. A preventive screening examination in high-risk asymptomatic patients between 2020 and 2022 was performed with two-view Digital Mammography (DM) projections (Cranio Caudal and Medio Lateral) plus one Digital Breast Tomosynthesis (DBT) projection (mediolateral oblique, MLO) in a single session examination. For all patients in whom we found a suspicious lesion by using DM + DBT, we performed (within two weeks) a CEM examination. AGD and compression force were compared between the diagnostic methods. All lesions identified by DM + DBT were biopsied; then, we assessed whether lesions found by DBT were also highlighted by DM alone and/or by CEM. We enrolled 49 patients with 49 lesions in the study. The median AGD was lower for DM alone than for CEM (3.41 mGy vs. 4.24 mGy, p = 0.015). The AGD for CEM was significantly lower than for the DM plus one single projection DBT protocol (4.24 mGy vs. 5.55 mGy, p < 0.001). We did not find a statistically significant difference in the median compression force between the CEM and DM + DBT. DM + DBT allows the identification of one more invasive neoplasm one in situ lesion and two high-risk lesions, compared to DM alone. The CEM, compared to DM + DBT, failed to identify only one of the high-risk lesions. According to these results, CEM could be used in the screening of asymptomatic high-risk patients.
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Affiliation(s)
- Luca Nicosia
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Anna Carla Bozzini
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Filippo Pesapane
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Anna Rotili
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Irene Marinucci
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Giulia Signorelli
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, 20126 Milan, Italy
| | - Daniela Origgi
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Paolo De Marco
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Ida Abiuso
- Radiology Department, Università Degli Studi di Torino, 10124 Turin, Italy
| | - Claudia Sangalli
- Data Management, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Nicola Balestreri
- Department of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Giovanni Corso
- Division of Breast Surgery, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- European Cancer Prevention Organization, 20122 Milan, Italy
| | - Enrico Cassano
- Breast Imaging Division, Radiology Department, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
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Bhattarai S, Saini G, Li H, Duanmu H, Seth G, Fisher TB, Janssen EAM, Kiraz U, Kong J, Aneja R. Predicting neoadjuvant treatment response in triple-negative breast cancer using machine learning. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.17.536459. [PMID: 37131688 PMCID: PMC10153161 DOI: 10.1101/2023.04.17.536459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Neoadjuvant chemotherapy (NAC) is the standard treatment for early-stage triple negative breast cancer (TNBC). The primary endpoint of NAC is a pathological complete response (pCR). NAC results in pCR in only 30%â€"40% of TNBC patients. Tumor-infiltrating lymphocytes (TILs), Ki67 and phosphohistone H3 (pH3) are a few known biomarkers to predict NAC response. Currently, systematic evaluation of the combined value of these biomarkers in predicting NAC response is lacking. In this study, the predictive value of markers derived from H&E and IHC stained biopsy tissue was comprehensively evaluated using a supervised machine learning (ML)-based approach. Identifying predictive biomarkers could help guide therapeutic decisions by enabling precise stratification of TNBC patients into responders and partial or non-responders. Methods Serial sections from core needle biopsies (n=76) were stained with H&E, and immunohistochemically for the Ki67 and pH3 markers, followed by whole slide image (WSI) generation. The resulting WSI triplets were co-registered with H&E WSIs serving as the reference. Separate mask region-based CNN (MRCNN) models were trained with annotated H&E, Ki67 and pH3 images for detecting tumor cells, stromal and intratumoral TILs (sTILs and tTILs), Ki67 + , and pH3 + cells. Top image patches with a high density of cells of interest were identified as hotspots. Best classifiers for NAC response prediction were identified by training multiple ML models, and evaluating their performance by accuracy, area under curve, and confusion matrix analyses. Results Highest prediction accuracy was achieved when hotspot regions were identified by tTIL counts and each hotspot was represented by measures of tTILs, sTILs, tumor cells, Ki67 + , and pH3 + features. Regardless of the hotspot selection metric, a complementary use of multiple histological features (tTILs, sTILs) and molecular biomarkers (Ki67 and pH3) resulted in top ranked performance at the patient level. Conclusions Overall, our results emphasize that prediction models for NAC response should be based on biomarkers in combination rather than in isolation. Our study provides compelling evidence to support the use of ML-based models to predict NAC response in patients with TNBC.
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123
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Hacking SM, Yakirevich E, Wang Y. Defining triple-negative breast cancer with neuroendocrine differentiation (TNBC-NED). J Pathol Clin Res 2023. [PMID: 37082801 DOI: 10.1002/cjp2.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 04/22/2023]
Abstract
Primary breast neuroendocrine (NE) neoplasms are uncommon, and definitions harbor controversy. We retrospectively collected 73 triple-negative breast cancers (TNBC) and evaluated NE biomarker expression along with p53 aberrant staining (which correlates with TP53 gene mutation) and Rb protein loss by immunohistochemistry. In the study cohort, we found 11 (15%) cases of TNBC with neuroendocrine differentiation (TNBC-NED) showing positivity for one or more NE markers (synaptophysin/chromogranin/insulinoma-associated protein 1 [INSM1]). We also identified one separate small cell neuroendocrine carcinoma. Histologic types for these 11 TNBC-NED cases were as follows: 8 invasive ductal carcinoma (IDC) not otherwise specified (NOS), 2 IDC with apocrine features, 1 IDC with solid papillary features. INSM1 had the highest positivity and was seen in all 11 carcinomas. Seven (64%) cases showed p53 aberrant staining, 6 (55%) had Rb protein loss, while 6 (55%) had p53/Rb co-aberrant staining/protein loss. TNBC-NED was associated with Rb protein loss (p < 0.001), as well as p53/Rb co-aberrant staining/protein loss (p < 0.001). In 61 cases negative for NE markers, 37 (61%) showed p53 aberrant staining, while 5 (8%) had Rb protein loss. We also analyzed genomic and transcriptomic data from The Cancer Genome Atlas (TCGA) PanCancer Atlas of 171 basal/TNBC patients. Transcriptomic analysis revealed mRNA expression of RB1 to be correlated negatively with SYN1 mRNA expression (p = 0.0400) and INSM1 mRNA expression (p = 0.0106) in this cohort. We would like to highlight the importance of these findings. TNBC-NED is currently diagnosed as TNBC, and although it overlaps morphologically with TNBC without NED, the unique p53/Rb signature highlights a genetic overlap with NE carcinomas of the breast.
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Affiliation(s)
- Sean M Hacking
- Laboratory Medicine Program, University Health Network, Toronto General Hospital, Toronto, Canada
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Evgeny Yakirevich
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Chen K, Xu J, Wang W, Jiang R, Zhang H, Wang X, Cao J, Fang M. Clinical outcomes and biomarkers of phyllodes tumors of the breast: A single-center retrospective study. Cancer Med 2023. [PMID: 37081723 DOI: 10.1002/cam4.5849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 04/22/2023] Open
Abstract
PURPOSE Phyllodes tumors (PTs) are rare neoplasms with a certain risk of recurrence and/or metastasis. In clinical practice, there is a lack of high-quality clinical studies and unified guidelines to guide the treatment. MATERIALS AND METHODS All malignant and recurrence/metastasis PTs were retrospectively collected, which were diagnosed from 2008 to 2022. RESULTS A total of 82 patients were enrolled, including 69 malignant and 13 borderline tumors. 96.3% (79/82) received surgical treatment. During a median follow-up of 55.5 months, 20 patients (20/82, 24.4%) had distant metastasis (DM), while 32 (32/82, 39.0%) had local recurrence (LR). Univariate analysis showed the survival of PTs was associated with surgical methods (p < 0.001), tumor size (p = 0.026), and biological behavior (p = 0.017), but not age at diagnosis. In relapsed borderline PTs, we did not find deaths due to disease progression. Patients with DM were all malignant PTs, with disease-progression occurring within 3 years in more than 80% of patients. Among salvage treatments, the combination of antiangiogenic drugs improved the prognosis to some extent, with a significant increase in mPFS (2.77 vs. 1.53 months), but no significant statistical results were obtained (p = 0.168). Lactate dehydrogenase (LDH) was an independent predictor of the prognosis for malignant PTs (p = 0.001, HR = 1.203, 95%CI, 1.082-1.336). CONCLUSION Borderline PTs rarely metastasize, and even if LR occurs, surgical resection can lead to long-term survival. In metastatic phyllodes tumors (MPT), systemic therapy is not effective, but antiangiogenic drugs may prolong survival. LDH is an independent prognostic factor for malignant PTs to identify high-risk tumors.
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Affiliation(s)
- Keyu Chen
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiaojiao Xu
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Wei Wang
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
- Wenzhou Medical University, Wenzhou, China
| | - Ruiyuan Jiang
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Huanping Zhang
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
- Wenzhou Medical University, Wenzhou, China
| | - Xiaojia Wang
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jun Cao
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Department of rare and head and neck oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Meiyu Fang
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Department of rare and head and neck oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
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Radu I, Scripcariu V, Panuța A, Rusu A, Afrăsânie VA, Cojocaru E, Aniței MG, Alexa-Stratulat T, Terinte C, Șerban CF, Gafton B. Breast Sarcomas-How Different Are They from Breast Carcinomas? Clinical, Pathological, Imaging and Treatment Insights. Diagnostics (Basel) 2023; 13:diagnostics13081370. [PMID: 37189471 DOI: 10.3390/diagnostics13081370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Breast sarcoma (BS) is a very rare and poorly studied condition. This has led to a lack of studies with a high level of evidence and to low efficacy of current clinical management protocols. Here we present our experience in treating this disease in the form of a retrospective case series study including discussion of clinical, imaging, and pathological features and treatment. We also compare the main clinical and biological features of six cases of BS (phyllodes tumors were excluded) with a cohort of 184 patients with unilateral breast carcinoma (BC) from a previous study performed at our institution. Patients with BS were diagnosed at a younger age, presented no evidence of lymph node invasion or distant metastases, had no multiple or bilateral lesions, and underwent a shorter length of hospital stay versus the breast carcinoma group. Where recommended, adjuvant chemotherapy consisted of an anthracycline-containing regimen, and adjuvant external radiotherapy was delivered in doses of 50 Gy. The comparison data obtained from our BS cases and the ones with BC revealed differences in diagnosis and treatment. A correct pathological diagnosis of breast sarcoma is essential for the right therapeutic approach. We still have more to learn about this entity, but our case series could add value to existing knowledge in a meta-analysis study.
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Affiliation(s)
- Iulian Radu
- First Surgical Oncology Unit, Department of Surgery, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Surgery, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Viorel Scripcariu
- First Surgical Oncology Unit, Department of Surgery, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Surgery, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andrian Panuța
- Department of Surgery, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Clinic of Plastic and Reconstructive Microsurgery, Emergency Clinical Hospital "Sf. Spiridon", 700111 Iasi, Romania
| | - Alexandra Rusu
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Vlad-Adrian Afrăsânie
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I-Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Maria Gabriela Aniței
- First Surgical Oncology Unit, Department of Surgery, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Surgery, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Teodora Alexa-Stratulat
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Terinte
- Department of Pathology, Regional Institute of Oncology, 700483 Iasi, Romania
| | | | - Bogdan Gafton
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
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Clusan L, Ferrière F, Flouriot G, Pakdel F. A Basic Review on Estrogen Receptor Signaling Pathways in Breast Cancer. Int J Mol Sci 2023; 24:ijms24076834. [PMID: 37047814 PMCID: PMC10095386 DOI: 10.3390/ijms24076834] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 04/08/2023] Open
Abstract
Breast cancer is the most common cancer and the deadliest among women worldwide. Estrogen signaling is closely associated with hormone-dependent breast cancer (estrogen and progesterone receptor positive), which accounts for two-thirds of tumors. Hormone therapy using antiestrogens is the gold standard, but resistance to these treatments invariably occurs through various biological mechanisms, such as changes in estrogen receptor activity, mutations in the ESR1 gene, aberrant activation of the PI3K pathway or cell cycle dysregulations. All these factors have led to the development of new therapies, such as selective estrogen receptor degraders (SERDs), or combination therapies with cyclin-dependent kinases (CDK) 4/6 or PI3K inhibitors. Therefore, understanding the estrogen pathway is essential for the treatment and new drug development of hormone-dependent cancers. This mini-review summarizes current literature on the signalization, mechanisms of action and clinical implications of estrogen receptors in breast cancer.
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Affiliation(s)
- Léa Clusan
- Université de Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France
| | - François Ferrière
- Université de Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France
| | - Gilles Flouriot
- Université de Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France
| | - Farzad Pakdel
- Université de Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France
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Leng PN, Wan Zain WZ, Mohammad Azmi MAF, Yahya MM, Azis KA, Mat Johar SFN, Wan Sulaiman WA, Balingi D, Tuan Sharif SE, Wan Abdul Rahman WF, Chiew Chea L, Haron J. Carcinosarcoma: A Rare and Aggressive Breast Tumor in a Young Lady. Cureus 2023; 15:e37003. [PMID: 37139022 PMCID: PMC10150779 DOI: 10.7759/cureus.37003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
Carcinosarcoma of the breast is a subtype of metaplastic breast carcinoma characterized by differentiation of the neoplastic epithelium toward mesenchymal-looking elements. It is a highly aggressive rare subtype of invasive breast neoplasm that exhibits a distinct histologic entity. Only a limited number of reports related to this type of disease have been reported. Here, we present a case of breast carcinosarcoma in a lady in her early 20s, which is relatively young among all cases published. It was challenging to achieve diagnosis preoperatively with histopathological evaluation of the ultrasound-guided tru-cut biopsy sample. With no evidence of distant metastasis clinically and radiologically, a surgical option was opted for. Left mastectomy and left chest wall reconstruction with deep inferior epigastric artery free flap were performed. Post-excision specimen was confirmed to be carcinosarcoma.
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128
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Tomé AI, Figueiredo J, Antunes SC, Trindade M, Travancinha D. Breast Phyllodes Tumor: A Tumor With Unpredictable Clinical Behavior. Cureus 2023; 15:e37537. [PMID: 37193421 PMCID: PMC10182856 DOI: 10.7759/cureus.37537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/18/2023] Open
Abstract
Phyllodes tumors are uncommon biphasic breast tumors with a wide range of clinical behaviors. The distinction between a phyllodes tumor and a fibroadenoma can be difficult. The diagnosis of phyllodes tumor should be suspected in all women who present with a rapidly growing breast lump. Based on the histological characteristics, the World Health Organization (WHO) classifies phyllodes tumors as benign, borderline, or malignant. The risk of recurrence and metastatic potential varies based on histological features. Wide excision or mastectomy is the standard of care ensuring histologically clear margins. Despite the grading criteria defined by the WHO, the management of phyllodes tumors continues to be a challenge. We report the case of a 48-year-old woman who presented to the emergency department with a large and ulcerated phyllodes tumor of the left breast. The tumor size did not allow conservative surgery. The final diagnosis of a borderline phyllodes tumor was made, and, in this case, the patient did not undergo adjuvant treatment.
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Affiliation(s)
- Ana Isabel Tomé
- Department of Obstetrics and Gynecology, Hospital Garcia de Orta, Almada, PRT
| | - Joana Figueiredo
- Department of Obstetrics and Gynecology, Hospital Garcia de Orta, Almada, PRT
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Baez-Navarro X, van Bockstal MR, Andrinopoulou ER, van Deurzen CHM. HER2-Low Breast Cancer: Incidence, Clinicopathologic Features, and Survival Outcomes From Real-World Data of a Large Nationwide Cohort. Mod Pathol 2023; 36:100087. [PMID: 36788086 DOI: 10.1016/j.modpat.2022.100087] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/10/2022] [Accepted: 12/26/2022] [Indexed: 01/11/2023]
Abstract
Patients with breast cancer (BC) with low levels of human epidermal growth factor receptor 2 (HER2) expression (HER2-low) could benefit from novel antibody-drug conjugates. However, there is conflicting information regarding the characteristics of HER2-low BC and its outcome. We assessed the clinicopathologic characteristics and outcomes of HER2-low BC using real-world data from the Dutch National Pathology Registry. This retrospective study incorporated all patients with primary invasive BC, without neoadjuvant therapy, reported in the Dutch National Pathology Registry synoptic reporting module between 2014 and 2022. HER2 status was categorized as HER2-0 (defined as an immunohistochemistry score of 0 according to the current American Society of Clinical Oncology/College of American Pathologists guidelines) or HER2-low (immunohistochemistry score 1+ or 2+ without amplification). Clinicopathologic characteristics and overall survival of HER2-low BC were compared with HER2-0, adjusted for estrogen receptor (ER) status. We included 65,035 patients with BC, resulting in 69,424 tumors. The proportion of HER2-low BC was 62% in the ER+ cohort and 38% in the ER- cohort. A substantial number of patients had a different HER2 category between the needle biopsy and the corresponding surgical resection (28%) or among multiple tumors (28%). After multivariable logistic analysis, HER2-low tumors were significantly associated with histologic subtype, a higher ER, and lower progesterone receptor expression in the ER+ cohort, whereas within the ER-cohort, HER2-low tumors were associated with a lower tumor grade. However, the absolute differences were limited, and there was no significant difference in overall survival between HER2-low and HER2-0 tumors within the ER+ or ER- cohort. The classification of HER2 expression (HER2-0 vs HER2-low) varies between biopsies and corresponding resection specimens and within multiple tumors in the same patient, which could affect clinical decision making in case only HER2-low cases are eligible for novel HER2-targeting agents. The limited follow-up time and the lack of substantial clinicopathologic differences between HER2-low and HER2-0-cases could explain the lack of differences in overall survival.
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Affiliation(s)
- Ximena Baez-Navarro
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | | | - Eleni-Rosalina Andrinopoulou
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
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130
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Mareti E, Vavoulidis E, Papanastasiou A, Maretis T, Tsampazis N, Margioula-Siarkou C, Chatzinikolaou F, Giasari S, Nasioutziki M, Daniilidis A, Zepiridis L, Dinas K. Evaluating the potential role of human papilloma virus infection in breast carcinogenesis via real-time polymerase chain reaction analyzes of breast fine needle aspiration samples from Greek patients. Diagn Cytopathol 2023. [PMID: 36939123 DOI: 10.1002/dc.25130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/07/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND Human papilloma virus (HPV), in addition to its known clinical contribution to cervical cancer is probably actively involved in the development of breast tumors in various populations worldwide. Predominant HPV types in breast cancer patients vary geographically. The present study further examines HPV incidence in Greece, based on molecular analysis of clinical cytological samples. METHODS Greek patient fine needle aspiration (FNA) biopsy samples were examined using RT-PCR and immunohistological staining. FNA biopsy samples were collected from 114 female patients, diagnosed between the years 2018 and 2021, 57 with C5 diagnosed breast cancer lesions and 57 diagnosed with benign diseases. RESULTS A total of three different HPV types were identified within the patient sample. HPV-39 was found only in the control group, in 1.8% of patients, while HPV-59 was present in both control and study groups in 1.8% and 3.5% respectively. HPV-16, on the other hand, was present only in the study group in 12.3% of cases. HPV type presence was statistically differentiated between histological groups. HPV-16 was exclusively in IDC, HPV-39 was present in one cyst diagnosed sample and HPV-59 was present in 3 samples that included fibroadenoma, IDC and LN diagnosis. CONCLUSION More international comparative studies are required to investigate population differences and HPV genotype distribution to offer definite answers to the effect that certain HPV types might have a role in breast cancer, as this study also supports, albeit in a cofactory role.
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Affiliation(s)
- Evangelia Mareti
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.,Laboratory of Gynecologic Oncology, 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Eleftherios Vavoulidis
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.,Laboratory of Gynecologic Oncology, 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Anastasios Papanastasiou
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Theodoros Maretis
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Nikolaos Tsampazis
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.,Laboratory of Gynecologic Oncology, 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Chrysoula Margioula-Siarkou
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.,Laboratory of Gynecologic Oncology, 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Fotios Chatzinikolaou
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Sofia Giasari
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Maria Nasioutziki
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Angelos Daniilidis
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.,Laboratory of Gynecologic Oncology, 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Leonidas Zepiridis
- 1st Department of Obstetrics & Gynecology, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Konstantinos Dinas
- 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.,Laboratory of Gynecologic Oncology, 2nd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
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131
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Hypoxia-induced autophagy in triple negative breast cancer: association with prognostic variables, patients' survival and response to neoadjuvant chemotherapy. Virchows Arch 2023; 482:823-837. [PMID: 36939902 PMCID: PMC10156790 DOI: 10.1007/s00428-023-03527-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/21/2023]
Abstract
Autophagy is a cellular response to diverse stresses within tumor microenvironment (TME) such as hypoxia. It enhances cell survival and triggers resistance to therapy. This study investigated the prognostic importance of HIF-1α and miR-210 in triple negative breast cancer (TNBC). Also, we studied the relation between beclin-1 and Bcl-2 and their prognostic relevance in triple negative breast cancer. Furthermore, the involvement of hypoxia-related markers, beclin-1 and Bcl-2 in mediating resistance to neoadjuvant chemotherapy (NACT) in TNBC was evaluated. Immunohistochemistry was performed to evaluate HIF-1α, beclin-1 and Bcl-2 expression whereas, miR-210 mRNA was detected by quantitative reverse transcription PCR (q-PCR) in 60 TNBC patients. High HIF-1α expression was related to larger tumors, grade III cases, positive lymphovascular invasion, advanced stage, high Ki-67 and poor overall survival (OS). High miR-210 and negative Bcl-2 expression were related to nodal metastasis, advanced stage and poor OS. High beclin-1 was associated with grade III, nodal metastasis, advanced stage and poor OS. Also, high beclin-1 and negative Bcl-2 were significantly associated with high HIF-1α and high miR-210. High HIF- 1α, miR-210 and beclin-1 as well as negative Bcl-2 were inversely related to pathologic complete response following NACT. High beclin-1 and lack of Bcl-2 are significantly related to hypoxic TME in TNBC. High HIF-1α, miR-210, and beclin-1 expression together with lack of Bcl-2 are significantly associated with poor prognosis as well as poor response to NACT. HIF-1α and miR-210 could accurately predict response to NACT in TNBC.
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132
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Ko SY. Malignant phyllodes tumor of the breast with heterologous osteosarcoma and chondrosarcomatous differentiation: A rare case report with imaging findings. Radiol Case Rep 2023; 18:1982-1988. [PMID: 36994218 PMCID: PMC10040453 DOI: 10.1016/j.radcr.2023.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/18/2023] [Indexed: 03/28/2023] Open
Abstract
Phyllodes tumors of the breast are rare fibroepithelial neoplasms accounting for 0.3%-1.5% of all female breast tumors [1,2]. Malignant transformations occur in 10%-20% of phyllodes tumors, often in the form of stroma. Heterologous osteosarcoma and chondrosarcomatous differentiation of phyllodes tumor are extremely rare, and little is known about their imaging findings. Here, we report a rare case of a 52-year-old woman with no history of previous surgery or radiation therapy, who presented with a rapidly growing right breast mass that was diagnosed as a malignant phyllodes tumor with heterologous osteosarcoma and chondrosarcomatous differentiation. The patient underwent modified radical mastectomy.
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133
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Zhang X, Cui H, Hu N, Han P, Fan W, Wang P, Zuo X, Zhao D, Huang H, Li S, Kong H, Peng F, Tian J, Zhang L. Correlation of androgen receptor with ultrasound, clinicopathological features and clinical outcomes in breast cancer. Insights Imaging 2023; 14:46. [PMID: 36929229 PMCID: PMC10020396 DOI: 10.1186/s13244-023-01387-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/04/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND This study aimed to explore whether there is an association between androgen receptor (AR) expression and ultrasound, clinicopathological features and prognosis of breast cancer. METHODS A total of 141 breast cancer patients were included in this retrospective study. AR expression was analyzed by immunohistochemistry. The images of B-mode, color Doppler and strain elastography from 104 patients were collected continuously, and the corresponding ultrasound characteristics were obtained. The differences in ultrasound and clinicopathological features in different AR status were analyzed. Progression-free survival (PFS) of patients was obtained through up to 90 months of follow-up; then, the effect of AR on PFS was analyzed. Subsequently, a nomogram was constructed to predict the AR status. The predictive accuracy was calculated using C-index. RESULTS The positive expression of AR (AR +) was associated with lower histological grade (p = 0.034) and lower Ki-67 level (p = 0.029). Triple-negative breast cancer (TNBC) had the lowest probability of AR + (p < 0.001). The AR + group mostly showed unsmooth margin (p < 0.001), posterior acoustic shadowing (p = 0.002) and higher elasticity score (p = 0.022) on ultrasound. The echo pattern of most tumors with AR + was heterogeneous (p = 0.024) in Luminal A subtype. AR + could be a sign of a better prognosis in overall breast cancer (p < 0.001), as well as in human epidermal growth factor receptor 2 (HER2) overexpression and Luminal B subtypes (p = 0.001 and 0.025). The nomogram showed relatively reliable performance with a C-index of 0.799. CONCLUSION Our research demonstrated that AR expression was closely related to ultrasound, clinicopathological features and prognosis of breast cancer.
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Affiliation(s)
- Xudong Zhang
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Hao Cui
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Nana Hu
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Peng Han
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Wei Fan
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Panting Wang
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Xiaoxuan Zuo
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Dantong Zhao
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - He Huang
- Department of Clinical Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Shuo Li
- Department of Clinical Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Hanqing Kong
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Fuhui Peng
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Jiawei Tian
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086
| | - Lei Zhang
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, 150086.
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134
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Wang B, Yang D, Zhang X, Gong X, Xu T, Han J, Ren Y, Zou S, Li L, Wang Y. The diagnostic value of contrast-enhanced ultrasonography in breast ductal abnormalities. Cancer Imaging 2023; 23:25. [PMID: 36899406 PMCID: PMC10007791 DOI: 10.1186/s40644-023-00539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/25/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Ductal lesions are an important, often overlooked, and poorly understood issue in breast imaging, which have a risk of underlying malignancy ranging from 5 to 23%. Ultrasonography (US), which has largely replaced galactography or ductography, has become an important imaging method to assess patients with ductal lesions. However, it is difficult to distinguish benign from malignant ductal abnormalities only by ultrasonography, most of which are recommended to be at least in subcategory 4A; these require biopsy according to the ACR BI-RADS®atlas 5th Edition-breast ultrasound. Contrast-enhanced ultrasound (CEUS) has been shown to be valuable for differentiating benign from malignant tumors, but its value is unclear in breast ductal lesions. Therefore, the purposes of this study were to explore the characteristics of malignant ductal abnormalities on US and CEUS imaging and the diagnostic value of CEUS in breast ductal abnormalities. METHODS Overall, 82 patients with 82 suspicious ductal lesions were recruited for this prospective study. They were divided into benign and malignant groups according to the pathological results. Morphologic features and quantitative parameters of US and CEUS were analyzed by comparison and multivariate logistic regression to determine the independent risk factors. The diagnostic performance was assessed by receiver operating characteristic (ROC) curve analysis. RESULTS Shape, margin, inner echo, size, microcalcification and blood flow classification on US, wash-in time, enhancement intensity, enhancement mode, enhancement scope, blood perfusion defects, peripheral high enhancement and boundary on CEUS were identified as features correlated with malignant ductal lesions. However, multivariate logistic regression showed that only microcalcification (OR = 8.96, P = 0.047) and enhancement scope (enlarged, OR = 27.42, P = 0.018) were independent risk factors for predicting malignant ductal lesions. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under the ROC curve of microcalcifications combined with an enlarged enhancement scope were 0.895, 0.886, 0.872, 0.907, 0.890, and 0.92, respectively. CONCLUSIONS Microcalcification and enlarged enhancement scope are independent factors for predicting malignant ductal lesions. The combined diagnosis can greatly improve the diagnostic performance, indicating that CEUS can be useful in the differentiation of benign and malignant lesions to formulate more appropriate management for ductal lesions.
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Affiliation(s)
- Bo Wang
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Di Yang
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xuan Zhang
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - XuanTong Gong
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Tong Xu
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jie Han
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - YinPeng Ren
- Department of Breast Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - ShuangMei Zou
- Department of Pathology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lin Li
- Department of Radiology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Yong Wang
- Department of Ultrasound, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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135
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Sars C, Sackey H, Frisell J, Dickman PW, Karlsson F, Kindts I, Marta GN, Freitas-Junior R, Tvedskov TF, Kassem L, Ali AS, Ihalainen H, Neron M, Kontos M, Kaidar-Person O, Meattini I, Francken AB, van Duijnhoven F, Moberg IO, Marinko T, Kollar A, Ahmed M, Remoundos D, Banks J, Jagsi R, Dossett LA, Lindqvist EK. Current clinical practice in the management of phyllodes tumors of the breast: an international cross-sectional study among surgeons and oncologists. Breast Cancer Res Treat 2023; 199:293-304. [PMID: 36879102 PMCID: PMC9988205 DOI: 10.1007/s10549-023-06896-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Phyllodes tumors of the breast are rare fibroepithelial lesions that are classified as benign, borderline or malignant. There is little consensus on best practice for the work-up, management, and follow-up of patients with phyllodes tumors of the breast, and evidence-based guidelines are lacking. METHODS We conducted a cross-sectional survey of surgeons and oncologists with the aim to describe current clinical practice in the management of phyllodes tumors. The survey was constructed in REDCap and distributed between July 2021 and February 2022 through international collaborators in sixteen countries across four continents. RESULTS A total of 419 responses were collected and analyzed. The majority of respondents were experienced and worked in a university hospital. Most agreed to recommend a tumor-free excision margin for benign tumors, increasing margins for borderline and malignant tumors. The multidisciplinary team meeting plays a major role in the treatment plan and follow-up. The vast majority did not consider axillary surgery. There were mixed opinions on adjuvant treatment, with a trend towards more liberal regiments in patients with locally advanced tumors. Most respondents preferred a five-year follow-up period for all phyllodes tumor types. CONCLUSIONS This study shows considerable variation in clinical practice managing phyllodes tumors. This suggests the potential for overtreatment of many patients and the need for education and further research targeting appropriate surgical margins, follow-up time and a multidisciplinary approach. There is a need to develop guidelines that recognize the heterogeneity of phyllodes tumors.
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Affiliation(s)
- Carl Sars
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Helena Sackey
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.,Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden
| | - Jan Frisell
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.,Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden
| | - Paul W Dickman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Karlsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.,Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden
| | | | | | - Ruffo Freitas-Junior
- CORA Advanced Center for Diagnosis of Breast Diseases, Hospital das Clínicas, Federal University of Goias, Goiânia, Brazil
| | | | - Loay Kassem
- Department of Clinical Oncology, Cairo University Hospitals, Cairo, Egypt
| | - Ahmed S Ali
- Department of Clinical Oncology, Cairo University Hospitals, Cairo, Egypt
| | - Hanna Ihalainen
- Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mathias Neron
- Institut du Cancer de Montpellier, Surgical Oncology Department, Université Montpellier, Montpellier, France
| | - Michalis Kontos
- 1st Department of Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Orit Kaidar-Person
- Breast Radiation Unit, Sheba Tel Hashomer, Ramat Gan, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.,Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | | | | | - Ingvild Ona Moberg
- Department of Breast and Endocrine Surgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Tanja Marinko
- Institute of Oncology, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Attila Kollar
- Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Mahbubl Ahmed
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, USA
| | - Lesly A Dossett
- Department of Surgery, University of Michigan, Ann Arbor, USA
| | - Ebba K Lindqvist
- Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden
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136
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Lee NY, Chang YW, Lee EJ, Jin YM. Tall cell carcinoma with reversed polarity of breast: Sonographic and magnetic resonance imaging findings. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:494-497. [PMID: 35904337 DOI: 10.1002/jcu.23280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Tall cell carcinoma with reversed polarity (TCCRP) of breast is a rare subtype of breast cancer, which show tall and columnar cells with nuclei of reversed polarity, resembles tall cell variant in papillary thyroid cancer. Only 78 cases in 20 published studies had been reported by 2021. TCCRP was recently included as a separate subgroup of rare tumors in the World Health Organization Blue Book Classification of breast tumors (5th edition). We describe a TCCRP case in a 64-year-old woman with detailed radiologic features including quantitative ultrasonography.
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Affiliation(s)
- Na Young Lee
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Yun-Woo Chang
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Eun Ji Lee
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Yoon Mi Jin
- Department of Pathology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
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137
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Liu Z, Wen J, Wang M, Ren Y, Yang Q, Qian L, Luo H, Feng S, He C, Liu X, Wu Y, Luo D. Breast Amide Proton Transfer Imaging at 3 T: Diagnostic Performance and Association With Pathologic Characteristics. J Magn Reson Imaging 2023; 57:824-833. [PMID: 35816177 DOI: 10.1002/jmri.28335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Amide proton transfer (APT) imaging has been increasingly applied in tumor characterization. However, its value in evaluating breast cancer remains undetermined. PURPOSE To assess the diagnostic performance of APT imaging in breast cancer and its association with prognostic histopathologic characteristics. STUDY TYPE Prospective. SUBJECTS Eighty-four patients with breast lesions. FIELD STRENGTH/SEQUENCE A 3.0 T/single-shot fast spin echo APT imaging. ASSESSMENT APTw signal in breast lesion was quantified. Lesion malignancy, T stage, grades, Ki-67 index, molecular biomarkers (estrogen receptor [ER] expression, progesterone receptor [PR] expression, human epidermal growth factor receptor [HER-2] expression), molecular subtypes (luminal A, luminal B, triple negative, and HER-2 enriched) were determined. STATISTICAL TESTS Student t-test, one-way analysis of variance, receiver operating characteristic analysis, and Pearson's correlation with P < 0.05 as statistical significance. RESULTS APTw signal was significantly higher in malignant lesions (1.55% ± 1.24%) than in benign lesions (0.54% ± 1.13%), and in grade III lesions than in grade II lesions (1.65% ± 0.84% vs. 0.96% ± 0.96%), and in T2- (1.57% ± 0.64%) and T3-stage lesions (1.54% ± 0.63%) than in T1-stage lesions (0.81% ± 0.64%) for invasive breast carcinoma of no special type. APTw signal significantly correlated with Ki-67 index (r = 0.364) but showed no significant difference in groups of ER (P = 0.069), PR (P = 0.069), HER-2 (P = 0.961), and among molecular subtypes (P = 0.073). DATA CONCLUSION APT imaging shows potential in differentiating breast lesion malignancy and associates with prognosis-related tumor grade, T stage, and proliferative activity. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhou Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jie Wen
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Meng Wang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Ya Ren
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qian Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Honghong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Sha Feng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Cuiju He
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yao S, Li W, Liu S, Cai Y, Zhang Q, Tang L, Yu S, Jing Y, Yin X, Cheng H. Aldehyde dehydrogenase 2 polymorphism is associated with chemotherapy-related cognitive impairment in patients with breast cancer who receive chemotherapy. Cancer Med 2023; 12:5209-5221. [PMID: 36200595 PMCID: PMC10028021 DOI: 10.1002/cam4.5319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/07/2022] [Accepted: 09/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chemotherapy-related cognitive impairment (CRCI) is a common but easily overlooked condition that markedly affects the quality of life (QOL) of patients with breast cancer. The rs671 is a common gene polymorphism of aldehyde dehydrogenase 2 (ALDH2) in Asia that is involved in aldehyde metabolism and may be closely related to CRCI. However, no study has yet summarised the association between ALDH2 and CRCI. METHODS This study enrolled one hundred and twenty-four patients diagnosed with breast cancer according to the pathology results, genotyped for ALDH2 single-nucleotide polymorphisms (SNP) to explore these. The mini-mental state exam (MMSE), verbal fluency test (VFT), and digit span test (DST) results were compared in these patients before and after chemotherapy (CT). RESULTS We found that patients with ALDH2 gene genotypes of rs671_GG, rs886205_GG, rs4648328_CC, and rs4767944_TT polymorphisms were more likely to suffer from cognitive impairment during chemotherapy. A trend toward statistical significance was observed for rs671_GG of DST (z = 2.769, p = 0.006), VFT (t = 4.624, P<0.001); rs886205_GG of DST (z = 3.663, P<0.001); rs4648328_CC of DST (z = 2.850, p = 0.004), VFT (t = 3.477, p = 0.001); and rs4767944_TT of DST (z = 2.967, p = 0.003), VFT (t = 2.776, p = 0.008). The cognitive indicators of these patients significantly decreased after chemotherapy (p < 0.05). The difference in ALDH2 rs671 was most obvious. CONCLUSION Our results showed what kinds of ALDH2 genotyped patients that are more likely to develop CRCI. In the future, it may be possible to infer the risk of CRCI by detecting the single-nucleotide locus of ALDH2 that is conducive to strengthening clinical interventions for these patients and improving their QOL. More importantly, this study has important implications for Asian women with breast cancer as ALDH2 rs671 is a common polymorphism in Asians.
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Affiliation(s)
- Senbang Yao
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Wen Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Shaochun Liu
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Yinlian Cai
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Qianqian Zhang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Lingxue Tang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Sheng Yu
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Yanyan Jing
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Xiangxiang Yin
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
| | - Huaidong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Cancer and Cognition Laboratory, Anhui Medical University, Hefei, Anhui, China
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Iny E, Prakash I. ASO Author Reflections: Surgical Management of Phyllodes Tumors of the Breast. Ann Surg Oncol 2023; 30:1710-1711. [PMID: 36463356 DOI: 10.1245/s10434-022-12922-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Ericka Iny
- McGill University Medical School, Montreal, QC, Canada
| | - Ipshita Prakash
- McGill University Medical School, Montreal, QC, Canada. .,Departments of Surgery and Oncology, McGill University, Montreal, QC, Canada. .,Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Canada.
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Moldoveanu D, Iny E, Theriault C, Florea A, Wong SM, Basik M, Boileau JF, Margolese R, Pelmus M, Meterissian S, Prakash I. Margin Status and Local Recurrence in Phyllodes Tumours of the Breast: A Canadian Series. Ann Surg Oncol 2023; 30:1700-1709. [PMID: 36456792 DOI: 10.1245/s10434-022-12894-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/12/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Phyllodes tumours of the breast are rare fibroepithelial neoplasms with a propensity for recurrence. While surgical excision remains the standard of care, the optimal margin width is an area of active investigation. Recent studies have questioned the necessity for wide, local excision. METHODS We conducted a retrospective, cohort study of patients with phyllodes tumours treated at our institution between 2003 and 2021. Demographic, histopathological, and recurrence data were captured; malignant phyllodes were excluded. Cox proportional hazard models were used to identify covariates associated with local recurrence. RESULTS Of 187 patients with phyllodes tumours, 82.9% (n = 155) were classified as benign while 17.1% (n = 32) were borderline. Initial surgical margins were positive in 26.2% (n = 49), < 2 mm in 50.8% (n = 95), and ≥ 2 mm in 23% (n = 43) patients. Among patients with positive margins, 61.2% (n = 30) underwent margin revision. At a median follow-up of 2.9 years, the recurrence rate was 3.7%. On univariate analysis, only a positive margin at the time of initial surgery and not margin width was significantly associated with a higher rate of disease recurrence (hazard ratio [HR] 9.52, 95% confidence interval [CI] 1.85-49.2), as was a size greater than 4 cm on preoperative imaging (HR 10.78, 95% CI 0.97-120.1). Revision of an initially positive margin was not significantly associated with decreased local recurrence (p = 1). CONCLUSIONS In this large cohort of benign and borderline phyllodes tumours, positive resection margins and not margin width at the initial surgery were associated with a increased recurrence. Individualization of decisions regarding margin reexcision is important.
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Affiliation(s)
- Dan Moldoveanu
- Department of Surgery, McGill University Medical School, Montreal, QC, Canada
| | - Ericka Iny
- McGill University Medical School, Montreal, QC, Canada
| | | | - Anca Florea
- Department of Pathology, Jewish General Hospital, Montreal, QC, Canada
| | - Stephanie M Wong
- Department of Surgery, McGill University Medical School, Montreal, QC, Canada.,Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada
| | - Mark Basik
- Department of Surgery, McGill University Medical School, Montreal, QC, Canada.,Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada.,Department of Oncology, McGill University, Montreal, QC, Canada
| | - Jean-François Boileau
- Department of Surgery, McGill University Medical School, Montreal, QC, Canada.,Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada.,Department of Oncology, McGill University, Montreal, QC, Canada
| | - Richard Margolese
- Department of Surgery, McGill University Medical School, Montreal, QC, Canada.,Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada
| | - Manuela Pelmus
- Department of Pathology, Jewish General Hospital, Montreal, QC, Canada
| | - Sarkis Meterissian
- Department of Surgery, McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - Ipshita Prakash
- Department of Surgery, McGill University Medical School, Montreal, QC, Canada. .,Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Canada. .,Department of Oncology, McGill University, Montreal, QC, Canada.
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Nakach FZ, Zerouaoui H, Idri A. Binary classification of multi-magnification histopathological breast cancer images using late fusion and transfer learning. DATA TECHNOLOGIES AND APPLICATIONS 2023. [DOI: 10.1108/dta-08-2022-0330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PurposeHistopathology biopsy imaging is currently the gold standard for the diagnosis of breast cancer in clinical practice. Pathologists examine the images at various magnifications to identify the type of tumor because if only one magnification is taken into account, the decision may not be accurate. This study explores the performance of transfer learning and late fusion to construct multi-scale ensembles that fuse different magnification-specific deep learning models for the binary classification of breast tumor slides.Design/methodology/approachThree pretrained deep learning techniques (DenseNet 201, MobileNet v2 and Inception v3) were used to classify breast tumor images over the four magnification factors of the Breast Cancer Histopathological Image Classification dataset (40×, 100×, 200× and 400×). To fuse the predictions of the models trained on different magnification factors, different aggregators were used, including weighted voting and seven meta-classifiers trained on slide predictions using class labels and the probabilities assigned to each class. The best cluster of the outperforming models was chosen using the Scott–Knott statistical test, and the top models were ranked using the Borda count voting system.FindingsThis study recommends the use of transfer learning and late fusion for histopathological breast cancer image classification by constructing multi-magnification ensembles because they perform better than models trained on each magnification separately.Originality/valueThe best multi-scale ensembles outperformed state-of-the-art integrated models and achieved an accuracy mean value of 98.82 per cent, precision of 98.46 per cent, recall of 100 per cent and F1-score of 99.20 per cent.
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Is the Level of Contrast Enhancement on Contrast-Enhanced Mammography (CEM) Associated with the Presence and Biological Aggressiveness of Breast Cancer? Diagnostics (Basel) 2023; 13:diagnostics13040754. [PMID: 36832242 PMCID: PMC9955826 DOI: 10.3390/diagnostics13040754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
There is limited information about whether the level of enhancement on contrast-enhanced mammography (CEM) can be used to predict malignancy. The purpose of this study was to correlate the level of enhancement with the presence of malignancy and breast cancer (BC) aggressiveness on CEM. This IRB-approved, cross-sectional, retrospective study included consecutive patients examined with CEM for unclear or suspicious findings on mammography or ultrasound. Excluded were examinations performed after biopsy or during neoadjuvant treatment for BC. Three breast radiologists who were blinded to patient data evaluated the images. The enhancement intensity was rated from 0 (no enhancement) to 3 (distinct enhancement). ROC analysis was performed. Sensitivity and negative likelihood ratio (LR-) were calculated after dichotomizing enhancement intensity as negative (0) versus positive (1-3). A total of 156 lesions (93 malignant, 63 benign) in 145 patients (mean age 59 ± 11.6 years) were included. The mean ROC curve was 0.827. Mean sensitivity was 95.4%. Mean LR- was 0.12%. Invasive cancer presented predominantly (61.8%) with distinct enhancement. A lack of enhancement was mainly observed for ductal carcinoma in situ. Stronger enhancement intensity was positively correlated with cancer aggressiveness, but the absence of enhancement should not be used to downgrade suspicious calcifications.
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Contrast-Enhanced Spectral Mammography in the Evaluation of Breast Microcalcifications: Controversies and Diagnostic Management. Healthcare (Basel) 2023; 11:healthcare11040511. [PMID: 36833045 PMCID: PMC9956946 DOI: 10.3390/healthcare11040511] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
The aim of this study was to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in predicting breast lesion malignancy due to microcalcifications compared to lesions that present with other radiological findings. Three hundred and twenty-one patients with 377 breast lesions that underwent CESM and histological assessment were included. All the lesions were scored using a 4-point qualitative scale according to the degree of contrast enhancement at the CESM examination. The histological results were considered the gold standard. In the first analysis, enhancement degree scores of 2 and 3 were considered predictive of malignity. The sensitivity (SE) and positive predictive value (PPV) were significative lower for patients with lesions with microcalcifications without other radiological findings (SE = 53.3% vs. 82.2%, p-value < 0.001 and PPV = 84.2% vs. 95.2%, p-value = 0.049, respectively). On the contrary, the specificity (SP) and negative predictive value (NPV) were significative higher among lesions with microcalcifications without other radiological findings (SP = 95.8% vs. 84.2%, p-value = 0.026 and NPV = 82.9% vs. 55.2%, p-value < 0.001, respectively). In a second analysis, degree scores of 1, 2, and 3 were considered predictive of malignity. The SE (80.0% vs. 96.8%, p-value < 0.001) and PPV (70.6% vs. 88.3%, p-value: 0.005) were significantly lower among lesions with microcalcifications without other radiological findings, while the SP (85.9% vs. 50.9%, p-value < 0.001) was higher. The enhancement of microcalcifications has low sensitivity in predicting malignancy. However, in certain controversial cases, the absence of CESM enhancement due to its high negative predictive value can help to reduce the number of biopsies for benign lesions.
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Gonçalves JPL, Bollwein C, Noske A, Jacob A, Jank P, Loibl S, Nekljudova V, Fasching PA, Karn T, Marmé F, Müller V, Schem C, Sinn BV, Stickeler E, van Mackelenbergh M, Schmitt WD, Denkert C, Weichert W, Schwamborn K. Characterization of Hormone Receptor and HER2 Status in Breast Cancer Using Mass Spectrometry Imaging. Int J Mol Sci 2023; 24:ijms24032860. [PMID: 36769215 PMCID: PMC9918176 DOI: 10.3390/ijms24032860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Immunohistochemical evaluation of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 status stratify the different subtypes of breast cancer and define the treatment course. Triple-negative breast cancer (TNBC), which does not register receptor overexpression, is often associated with worse patient prognosis. Mass spectrometry imaging transcribes the molecular content of tissue specimens without requiring additional tags or preliminary analysis of the samples, being therefore an excellent methodology for an unbiased determination of tissue constituents, in particular tumor markers. In this study, the proteomic content of 1191 human breast cancer samples was characterized by mass spectrometry imaging and the epithelial regions were employed to train and test machine-learning models to characterize the individual receptor status and to classify TNBC. The classification models presented yielded high accuracies for estrogen and progesterone receptors and over 95% accuracy for classification of TNBC. Analysis of the molecular features revealed that vimentin overexpression is associated with TNBC, supported by immunohistochemistry validation, revealing a new potential target for diagnosis and treatment.
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Affiliation(s)
- Juliana Pereira Lopes Gonçalves
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstraße 18, 81675 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Christine Bollwein
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstraße 18, 81675 Munich, Germany
| | - Aurelia Noske
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstraße 18, 81675 Munich, Germany
| | - Anne Jacob
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstraße 18, 81675 Munich, Germany
| | - Paul Jank
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM), 35043 Marburg, Germany
| | - Sibylle Loibl
- German Breast Group (GBG), 63263 Neu-Isenburg, Germany
| | | | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Thomas Karn
- Department of Gynecology and Obstetrics, Goethe-University Frankfurt, 60590 Frankfurt, Germany
| | - Frederik Marmé
- Department of Obstetrics and Gynecology, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Volkmar Müller
- Department of Gynecology, Universitätsklinikum Hamburg-Eppendorf, 20251 Hamburg, Germany
| | | | | | - Elmar Stickeler
- Department of Obstetrics and Gynecology, University Hospital Aachen, 52074 Aachen, Germany
| | - Marion van Mackelenbergh
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, 24105 Kiel, Germany
| | | | - Carsten Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM), 35043 Marburg, Germany
| | - Wilko Weichert
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstraße 18, 81675 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Kristina Schwamborn
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstraße 18, 81675 Munich, Germany
- Correspondence:
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Prediction of the Malignancy of a Breast Lesion Detected on Breast Ultrasound: Radiomics Applied to Clinical Practice. Cancers (Basel) 2023; 15:cancers15030964. [PMID: 36765921 PMCID: PMC9913654 DOI: 10.3390/cancers15030964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
The study aimed to evaluate the performance of radiomics features and one ultrasound CAD (computer-aided diagnosis) in the prediction of the malignancy of a breast lesion detected with ultrasound and to develop a nomogram incorporating radiomic score and available information on CAD performance, conventional Breast Imaging Reporting and Data System evaluation (BI-RADS), and clinical information. Data on 365 breast lesions referred for breast US with subsequent histologic analysis between January 2020 and March 2022 were retrospectively collected. Patients were randomly divided into a training group (n = 255) and a validation test group (n = 110). A radiomics score was generated from the US image. The CAD was performed in a subgroup of 209 cases. The radiomics score included seven radiomics features selected with the LASSO logistic regression model. The multivariable logistic model incorporating CAD performance, BI-RADS evaluation, clinical information, and radiomic score as covariates showed promising results in the prediction of the malignancy of breast lesions: Area under the receiver operating characteristic curve, [AUC]: 0.914; 95% Confidence Interval, [CI]: 0.876-0.951. A nomogram was developed based on these results for possible future applications in clinical practice.
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Alnimer A, Bhamidimarri PM, Talaat IM, Alkhayaal N, Eltayeb A, Ali N, Abusnana S, Hamoudi R, Bendardaf R. Association Between Expression of Vitamin D Receptor and Insulin-Like Growth Factor 1 Receptor Among Breast Cancer Patients. World J Oncol 2023; 14:67-74. [PMID: 36895995 PMCID: PMC9990736 DOI: 10.14740/wjon1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/30/2022] [Indexed: 03/01/2023] Open
Abstract
Background Vitamin D receptor (VDR) and insulin-like growth factor 1 receptor (IGF1R) are known to be involved in breast cancer (BC) progression. Our previous work reported a correlation of differential localization of IGF1R with hormone receptor status in BC. A recent report described VDR and IGF1R as potential indicators of BC prognosis, but their interplay was not discussed. The present study focused on understanding the association of VDR expression with IGF1R activation, different molecular markers, and subtypes of BC. Methods A retrospective study was designed to evaluate the VDR expression among 48 BC patients pathologically diagnosed as invasive BC and were surgically treated at Sharjah Breast Care Center, University Hospital Sharjah (UHS), United Arab Emirates (UAE). Formalin-fixed paraffin-embedded (FFPE) tumor blocks with appropriate clinicopathological data were subjected to immunohistochemistry (IHC), and VDR protein expression was interpreted based on the staining intensity (SI) and the percentage of the positively stained cells (PP). Results Nearly 44% of cases in the study were vitamin D deficient. A positive VDR expression with strong intensity (score > 4) was seen in 27 cases (56.3%). The expression pattern for VDR was equally distributed in cytoplasm and nucleus. For the IGF1R intensity, 24 cases (50%) of total cohort showed strong expression. A significant association was detected between IGF1R and VDR expression (P = 0.031). Conclusions The present study identified positive association between IGF1R and VDR expression where most of the cases with strong VDR expression displayed strong IGF1R expression. These findings may contribute to current understanding on the role of VDR in BC and its interaction with IGF1R.
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Affiliation(s)
- Ayaa Alnimer
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,These authors contributed equally to the study
| | - Poorna Manasa Bhamidimarri
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,These authors contributed equally to the study
| | - Iman M Talaat
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Noura Alkhayaal
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,University Hospital Sharjah, Sharjah, United Arab Emirates
| | - Abdalla Eltayeb
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nival Ali
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Salah Abusnana
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,University Hospital Sharjah, Sharjah, United Arab Emirates
| | - Rifat Hamoudi
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Riyad Bendardaf
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,University Hospital Sharjah, Sharjah, United Arab Emirates.,Department of Oncology, University Hospital Sharjah, Sharjah, United Arab Emirates
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Zhou W, Luo H, Zhao H, Peng Y. Unexpected breast cancer mimicking benign lesions on ultrasound-guided vacuum-assisted excision biopsy: A retrospective cross-sectional study over a 20-year period. Front Oncol 2023; 13:1108689. [PMID: 36816915 PMCID: PMC9929534 DOI: 10.3389/fonc.2023.1108689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
Objectives This study investigated the occurrence rate of unexpected breast cancer (UEBC) mimicking benign lesions [Breast Imaging Reporting and Data System (BI-RADS) category 3 or 4a] using ultrasound-guided vacuum-assisted excision biopsy (US-VAEB), and explored the factors responsible for late diagnosis of T2 stage UEBC. Materials and methods We collected clinicopathologic data and preoperative US imaging features within 3 months before US-VAEB of patients who were diagnosed with UEBC from January 2002 to September 2022. The UEBC were divided into T1 and T2 stageUEBC. The US imaging features as well as clinical and pathological information of T1 and T2 stage UEBC were compared to explore the factors responsible for late diagnosis of T2 stage UEBC. Results Breast cancer was diagnosed in 91 of 19 306 patients who underwent US-VAEB. We excluded eight patients with breast cancer assigned to BI-RADS 4b category by preoperative US, and two for whom US imaging records were unavailable. Finally, we enrolled 81 patients. The occurrence rate of UEBC after US-VAEB was 0.42%(81/19296). Of the 81 cases of UEBC, 22 were at T2 stage. The ratio of T2 stage UEBC was 27.2%. The differences in risk factor of breast cancer and routine breast US screening between T1 and T2 stage UEBC were significant[96.6% (57/59) vs 81.8% (18/22), 44.1% (26/59) vs 13.6% (3/22), respectively, P<0.05). Conclusion UEBC was rarely detected by US-VAEB. Most cases of T2 stage UEBC were diagnosed late because of the absence of routine US screening and risk factors for breast cancer. Stricter clinical management regulations for breast lesions and performing regular US screening may be helpful to reduce T2 stage UEBC.
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Kada Mohammed S, Billa O, Ladoire S, Jankowski C, Desmoulins I, Poillot ML, Coutant C, Beltjens F, Dabakuyo S, Arnould L. HER2-positive invasive lobular carcinoma: a rare breast cancer which may not necessarily require anti-HER2 therapy. A population-based study. Breast Cancer 2023; 30:343-353. [PMID: 36715845 DOI: 10.1007/s12282-022-01432-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/21/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND HER2-positive (HER2 +) invasive lobular breast cancer (ILC) is rare and poorly characterised. In particular, patient outcomes compared to those associated with HER2 + invasive ductal cancer (IDC) and HER2-negative (HER2 -) ILC, as well as the benefits of anti-HER2 therapy, are not well established. METHODS We analysed the data from the Côte d'Or Registry of Breast and Gynaecological Cancers (France) for all patients diagnosed with early-stage HER2 + ILC (62 cases), HER2 + IDC (833 cases) and HER2 - ILC (685 cases) between 1998 and 2015 to compare overall and disease-free survival (OS and DFS) between these groups in correlation with anti-HER2 therapy. RESULTS ILCs were associated with older age, larger tumours, lower histological grades, higher hormonal receptor positivity rates and multifocality, and more common endocrine therapy. OS and DFS between the three groups did not differ. We found that anti-HER2 therapy was associated with a survival benefit in patients with HER2 + IDC. In contrast, the survival of HER2 + ILC patients was not improved by anti-HER2 treatment, remaining close to that of HER2 - ILC patients. CONCLUSION HER2 + ILC seems not to be associated with better outcomes than HER2 + IDC but may not differ from HER2 - ILC in terms of survival.
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Affiliation(s)
- Samia Kada Mohammed
- Department of Gynaecology and Obstetrics, Jean Verdier Hospital, Assistance Publique Des Hôpitaux de Paris (APHP), Avenue du 14 Juillet, 93140, Bondy, France.
| | - Oumar Billa
- Department of Epidemiology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
- INSERM U1231, 21000, Dijon, France
- University of Burgundy-Franche Comté, 21000, Dijon, France
| | - Clementine Jankowski
- Department of Surgery, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Marie-Laure Poillot
- Department of Epidemiology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Charles Coutant
- University of Burgundy-Franche Comté, 21000, Dijon, France
- Department of Surgery, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Françoise Beltjens
- Unit of Pathology, Department of Tumour Biology and Pathology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Sandrine Dabakuyo
- Department of Epidemiology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
| | - Laurent Arnould
- INSERM U1231, 21000, Dijon, France
- Unit of Pathology, Department of Tumour Biology and Pathology, Georges-François Leclerc Centre, 1 Rue du Professeur Marion, 21000, Dijon, France
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Comparison of the clinical and pathological characteristics of ultrasound-guided biopsy for breast masses and non-mass lesions between 16-gauge spring-loaded core needle biopsy and 12-gauge spring-loaded vacuum-assisted biopsy. J Med Ultrason (2001) 2023; 50:205-212. [PMID: 36645627 DOI: 10.1007/s10396-022-01279-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/07/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE To retrospectively compare the clinical and pathological characteristics of breast masses and non-mass lesions that underwent ultrasound (US)-guided 16-gauge spring-loaded core needle biopsy (CNB) or 12-gauge spring-loaded vacuum-assisted biopsy (VAB). METHODS We retrospectively compared the results from US-guided diagnostic breast biopsy performed with a 16-gauge CNB (Magnum™) or a 12-gauge VAB (Celero®). The patients' backgrounds and pathological features for each device were examined. RESULTS In 453 patients with 500 lesions, 373 lesions underwent CNB and 127 underwent VAB. The positive biopsy rate (positive predictive value 3) was significantly higher for VAB (92/127; 72.4%) than for CNB (231/373; 61.9%) (P = 0.032). Non-mass lesions were biopsied more frequently with VAB (57/127; 47.4%) than with CNB (27/378; 7.14%) (P = 0.000). The upgrade rate from high-risk to malignant lesions was significantly higher for CNB (5/19; 26.3%) than for VAB (1/8; 12.5%) (P = 0.043). There were five (1.34%) specimen failures with CNB and one (0.78%) with VAB, 18 (4.82%) re-biopsies with CNB and three (2.36%) with VAB, and 11/21 (52.4%) upgrades from ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC) with CNB and 11/30 (36.7%) with VAB. Although these rates tended to be higher with CNB than with VAB, the difference was not significant. CONCLUSION Although VAB had a significantly higher rate of non-mass lesion biopsies, the upgrade rate from high-risk to malignant lesions was significantly lower for VAB than for CNB. US-guided 12-gauge spring-loaded VAB may be more appropriate for biopsy of non-mass lesions.
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Mamtani A, Grabenstetter A, Sevilimedu V, Morrow M, Gemignani ML. Do non-classic invasive lobular carcinomas derive a benefit from neoadjuvant chemotherapy? Breast Cancer Res Treat 2023; 197:417-423. [PMID: 36394689 PMCID: PMC10118744 DOI: 10.1007/s10549-022-06813-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Invasive lobular breast cancers (ILCs) respond poorly to neoadjuvant chemotherapy (NAC). The degree of benefit of NAC among non-classic ILC (NC-ILC) variants compared with classic ILCs (C-ILCs) is unknown. METHODS Consecutive patients with Stage I-III ILC treated from 2003 to 2019 with NAC and surgery were identified, and grouped as C-ILC or NC-ILC as per the original surgical pathology report, with pathologist (A.G.) review performed if original categorization was unclear. A subset of similarly treated invasive ductal cancers (IDCs) was identified for comparison. Clinicopathologic characteristics and pathologic complete response (pCR) rates were evaluated. RESULTS Of 145 patients with ILC, 101 (70%) were C-ILC and 44 (30%) were NC-ILC (IDC cohort: 1157 patients). ILC patients were older, more often cT3/T4 and cN2/N3, and less often high-grade compared to IDC patients. Those with NC-ILC were less often ER+/HER2- (55% versus 93%), and more often HER2 + (25% versus 7%) and TN (21% versus 0%, all p < 0.001). Breast pCR was more common among NC-ILC, but most frequent in IDC. Nodal pCR rates were also lowest among C-ILC patients, but similar among NC-ILC and IDC patients. On multivariable analysis, C-ILC (OR 0.09) and LVI (OR 0.51) were predictive of lack of breast pCR; non-ER+/HER2- subtypes and breast pCR were predictive of nodal pCR. When our analysis was repeated with patients stratified by receptor subtype, histology was not independently predictive of either breast or nodal pCR. CONCLUSION NC-ILC patients were significantly more likely to achieve breast and nodal pCR compared with C-ILC patients, but when stratified by subtype, histology was not independently predictive of breast or nodal pCR.
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Affiliation(s)
- Anita Mamtani
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66 Street, New York, NY, 10065, USA.
| | - Anne Grabenstetter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Varadan Sevilimedu
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66 Street, New York, NY, 10065, USA
| | - Mary L Gemignani
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66 Street, New York, NY, 10065, USA
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