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Kuang Y, Luo R, Chen A, Zhang Z, Wang K, Lu J, Luo Y, Liu X, Zhu Y. Vacancy-engineered Mn-doped iron oxide nano-crystals for enhanced sonodynamic therapy through self-supplied oxygen. Colloids Surf B Biointerfaces 2024; 244:114172. [PMID: 39191114 DOI: 10.1016/j.colsurfb.2024.114172] [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: 07/20/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 08/29/2024]
Abstract
Sonodynamic therapy (SDT) is a minimally invasive therapeutic approach, that uses ultrasound activating sonosensitizers to generate reactive oxygen species (ROS) for inducing the tumor cell death. However, the SDT is always limited by the dissatisfactory performance of sonosensitizers and hypoxic tumor microenvironment (TME). Nano iron oxide is a narrow bandgap semiconductor material with good biocompatibility. The doping of manganese into iron oxide (Mn-doped iron oxide nano-crystals named Mn-Fe2O3 NCs) not only reduced the band gap of iron oxide and altered the valence band position of iron oxide, but also introduced more oxygen vacancies and inhibited the complexation of electrons (e-) and holes (h+), significantly enhancing the ability to generate ROS. The Mn-Fe2O3 NCs improved the hypoxic TME by self-generating oxygen and consuming endogenous glutathione (GSH), which amplified oxidative stress and further enhanced the SDT. The therapeutic results showed that the prepared Mn-Fe2O3 NCs could efficiently inhibit the triple-negative breast cancer (TNBC) cells by SDT (80.49 % inhibition ratio in vivo). Overall, we propose a simple method to design inorganic sonosensitizers for enhancing efficient sonodynamic therapy.
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Affiliation(s)
- Yunqi Kuang
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Ruixin Luo
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Aihong Chen
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Ziwen Zhang
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Kaiyang Wang
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Jie Lu
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Yu Luo
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Xijian Liu
- School of Chemistry and Chemical Engineering, Shanghai Frontiers Science Research Center for Druggability of Cardiovascular noncoding RNA, Shanghai Engineering Technology Research Center for Pharmaceutical Intelligent Equipment, Institute for Frontier Medical Technology, Shanghai University of Engineering Science, Shanghai 201620, China.
| | - Yicheng Zhu
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, China.
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2
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Fu M, Gao Q, Xiao M, Li RF, Sun XY, Li SL, Peng X, Ge XY. Extracellular Vesicles Containing circMYBL1 Induce CD44 in Adenoid Cystic Carcinoma Cells and Pulmonary Endothelial Cells to Promote Lung Metastasis. Cancer Res 2024; 84:2484-2500. [PMID: 38657100 DOI: 10.1158/0008-5472.can-23-3508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/13/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant epithelial neoplasm that arises in secretory glands and commonly metastasizes to the lungs. MYBL1 is frequently overexpressed in ACC and has been suggested to be a driver of the disease. In this study, we identified a circular RNA (circRNA) derived from MYBL1 pre-mRNA that was accompanied by the overexpression of MYBL1 in ACC. Overexpression of circMYBL1 was correlated with increased lung metastasis and poor overall survival in patients with ACC. Ectopic circMYBL1 overexpression promoted malignant phenotypes and lung metastasis of ACC cells. Mechanistically, circMYBL1 formed a circRNA-protein complex with CCAAT enhancer-binding protein β (CEBPB), which inhibited ubiquitin-mediated degradation and promoted nuclear translocation of CEBPB. In the nucleus, circMYBL1 increased the binding of CEBPB to the CD44 promoter region and enhanced its transcription. In addition, circMYBL1 was enriched in small extracellular vesicles (sEV) isolated from the plasma of patients with ACC. Treatment with sEVs containing circMYBL1 in sEVs enhanced prometastatic phenotypes of ACC cells, elevated the expression of CD44 in human pulmonary microvascular endothelial cells (HPMEC), and enhanced the adhesion between HPMECs and ACC cells. Moreover, circMYBL1 encapsulated in sEVs increased the arrest of circulating ACC cells in the lung and enhanced lung metastatic burden. These data suggest that circMYBL1 is a tumor-promoting circRNA that could serve as a potential biomarker and therapeutic target for ACC. Significance: circMYBL1 stabilizes CEBPB and upregulates CD44 to promote adhesion between cancer cells and endothelial cells and enables lung metastasis of adenoid cystic carcinoma, suggesting that inhibition of this axis could improve patient outcomes.
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MESH Headings
- Humans
- Lung Neoplasms/secondary
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Lung Neoplasms/genetics
- Hyaluronan Receptors/metabolism
- Hyaluronan Receptors/genetics
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/secondary
- Mice
- Animals
- Extracellular Vesicles/metabolism
- Endothelial Cells/metabolism
- Endothelial Cells/pathology
- RNA, Circular/genetics
- RNA, Circular/metabolism
- CCAAT-Enhancer-Binding Protein-beta/metabolism
- CCAAT-Enhancer-Binding Protein-beta/genetics
- Cell Line, Tumor
- Female
- Mice, Nude
- Male
- Gene Expression Regulation, Neoplastic
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins/genetics
- Mice, Inbred BALB C
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Affiliation(s)
- Min Fu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, PR China
- National Center for Stomatology, Beijing, PR China
- National Clinical Research Center for Oral Diseases, Beijing, PR China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Qian Gao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Mian Xiao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Rui-Feng Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xin-Yi Sun
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Sheng-Lin Li
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xi-Yuan Ge
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, PR China
- National Center for Stomatology, Beijing, PR China
- National Clinical Research Center for Oral Diseases, Beijing, PR China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
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3
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Yan Q, Deng Y, Zhang Q. A comprehensive overview of metaplastic breast cancer: Features and treatments. Cancer Sci 2024; 115:2506-2514. [PMID: 38735837 PMCID: PMC11309924 DOI: 10.1111/cas.16208] [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: 01/18/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/14/2024] Open
Abstract
Metaplastic breast cancer is a rare, aggressive, and chemotherapy-resistant subtype of breast cancers, accounting for less than 1% of invasive breast cancers, characterized by adenocarcinoma with spindle cells, squamous epithelium, and/or mesenchymal tissue differentiation. The majority of metaplastic breast cancers exhibit the characteristics of triple-negative breast cancer and have unfavorable prognoses with a lower survival rate. This subtype often displays gene alterations in the PI3K/AKT pathway, Wnt/β-catenin pathway, and cell cycle dysregulation and demonstrates epithelial-mesenchymal transition, immune response changes, TP53 mutation, EGFR amplification, and so on. Currently, the optimal treatment of metaplastic breast cancer remains uncertain. This article provides a comprehensive review on the clinical features, molecular characteristics, invasion and metastasis patterns, and prognosis of metaplastic breast cancer, as well as recent advancements in treatment strategies.
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Affiliation(s)
- Qiaoke Yan
- Department of Medical OncologyHarbin Medical University Cancer HospitalHarbin CityHeilongjiang ProvinceChina
| | - Yuwei Deng
- Department of Medical OncologyHarbin Medical University Cancer HospitalHarbin CityHeilongjiang ProvinceChina
| | - Qingyuan Zhang
- Department of Medical OncologyHarbin Medical University Cancer HospitalHarbin CityHeilongjiang ProvinceChina
- Department of Medical OncologyHeilongjiang Cancer Prevention and Treatment InstituteHarbin CityHeilongjiang ProvinceChina
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4
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Meng M, Xie LJ, Qiu X. A case of adenoid cystic carcinoma of the breast. Asian J Surg 2024; 47:2415-2416. [PMID: 38242787 DOI: 10.1016/j.asjsur.2024.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Affiliation(s)
- Meng Meng
- Department of General Surgery, Shandong Linglong Yingcheng Hospital, Zhaoyuan, Yantai, China
| | - Li Juan Xie
- Department of General Surgery, Shandong Linglong Yingcheng Hospital, Zhaoyuan, Yantai, China
| | - Xuan Qiu
- Department of Faculty Surgery, St. Petersburg State University, Saint Petersburg, Russia, 199106.
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5
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Yao M, Luo S, Li L, Wang Y, Zhu W, Liu Y, Liang C. Sonographic and clinicopathologic features of metaplastic breast carcinoma and infiltrating ductal carcinoma: a comparative single-center cohort study. Quant Imaging Med Surg 2024; 14:909-919. [PMID: 38223107 PMCID: PMC10784059 DOI: 10.21037/qims-23-1096] [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: 08/02/2023] [Accepted: 11/14/2023] [Indexed: 01/16/2024]
Abstract
Background The rarity of metaplastic breast carcinoma (MBC) has resulted in limited sonographic data. Given the inferior prognosis of MBC compared to invasive ductal carcinoma (IDC), accurate preoperative differentiation between the two is imperative for effective treatment planning and prognostic prediction. The objective of this study was to assess the diagnostic accuracy of MBC and differentiate it from IDC by analyzing sonographic and clinicopathologic features. Methods In this retrospective cohort study, 197 women comprising 200 IDC lesions were enrolled between January 2012 and December 2021 and 20 women comprising 20 pure MBC lesions were enrolled between January 2019 and December 2019. A comparison was made between the sonographic and clinicopathologic characteristics of MBC and IDC. Results The results indicated that patients with MBC had a higher proportion of tumor grade 3 (95.0% vs. 32.5%; P<0.001), high Ki-67 expression (100.0% vs. 75.0%; P<0.001), and the triple-negative subtype (90.0% vs. 13.0%; P<0.001) as compared to those with IDC. On ultrasound (US) findings, MBC lesions tended to have a larger size (≥5 cm: 45.0% vs. 1.5%; P<0.001), regular shape (45.0% vs. 1.5%, P<0.001), circumscribed margin (40.0% vs. 0.5%, P<0.001), a complex cystic and solid echo pattern (50.0% vs. 3.5%; P<0.001), and posterior acoustic enhancement (95.0% vs. 14.5%; P<0.001). Additionally, MBC was more likely to be misinterpreted as a benign lesion by sonographers than was IDC (30.0% vs. 4.5%; P<0.001). Multilayer perceptron analysis revealed posterior acoustic enhancement, circumscribed margins, and size as distinguishing factors between these two tumor types. The estimated rates of local recurrence, distant metastasis, and 5-year overall survival in 19 cases with MBC were found to be 10.5%, 31.6%, and 65.0%, respectively. Conclusions MBC typically presents as a large breast mass with more benign US features in older women, findings which may facilitate its accurate diagnosis and differentiation from other breast masses.
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Affiliation(s)
- Mengxia Yao
- Department of Ultrasound, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Siwei Luo
- Department of Ultrasound, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Lian Li
- Department of Ultrasound, Nanfang Hospital, Southern Medical University/The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yin Wang
- Department of Ultrasound, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Wu Zhu
- Department of Ultrasound, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yu Liu
- Department of Ultrasound, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Changhong Liang
- Department of Radiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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6
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Thomas A, Douglas E, Reis-Filho JS, Gurcan MN, Wen HY. Metaplastic Breast Cancer: Current Understanding and Future Directions. Clin Breast Cancer 2023; 23:775-783. [PMID: 37179225 PMCID: PMC10584986 DOI: 10.1016/j.clbc.2023.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/16/2023] [Indexed: 05/15/2023]
Abstract
Metaplastic breast cancers (MBC) encompass a group of highly heterogeneous tumors which share the ability to differentiate into squamous, mesenchymal or neuroectodermal components. While often termed rare breast tumors, given the relatively high prevalence of breast cancer, they are seen with some frequency. Depending upon the definition applied, MBC represents 0.2% to 1% of breast cancers diagnosed in the United States. Less is known about the epidemiology of MBC globally, though a growing number of reports are providing information on this. These tumors are often more advanced at presentation relative to breast cancer broadly. While more indolent subtypes exist, the majority of MBC subtypes are associated with inferior survival. MBC is most commonly of triple-negative phenotype. In less common hormone receptor positive MBCs, hormone receptor status appears not to be prognostic. In contrast, relatively rare HER2-positive MBCs are associated with superior outcomes. Multiple potentially targetable molecular features are overrepresented in MBC including DNA repair deficiency signatures and PIK3/AKT/mTOR and WNT pathways alterations. Data on the prevalence of targets for novel antibody-drug conjugates is also emerging. While chemotherapy appears to be less active in MBC than in other breast cancer subtypes, efficacy is seen in some MBCs. Disease-specific trials, as well as reports of exceptional responses, may provide clues for novel approaches to this often hard-to-treat breast cancer. Strategies which harness newer research tools, such as large data and artificial intelligence hold the promise of overcoming historic barriers to the study of uncommon tumors and could markedly advance disease-specific understanding in MBC.
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Affiliation(s)
- Alexandra Thomas
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
| | - Emily Douglas
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jorge S Reis-Filho
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Metin N Gurcan
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Hannah Y Wen
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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7
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Corso G, Criscitiello C, Nicosia L, Pesapane F, Vicini E, Magnoni F, Sibilio A, Zanzottera C, De Scalzi AM, Mannucci S, Marabelli M, Calvello M, Feroce I, Zagami P, Porta FM, Toesca A, Tarantino P, Nicolò E, Mazzarol G, La Vecchia C, Bonanni B, Leonardi MC, Veronesi P, Fusco N. Metaplastic breast cancer: an all-round multidisciplinary consensus. Eur J Cancer Prev 2023; 32:348-363. [PMID: 37021548 DOI: 10.1097/cej.0000000000000794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Metaplastic breast cancer (MpBC) is a rare and aggressive histologic subtype of breast cancer (BC) characterized by the presence of at least two cellular types, commonly epithelial and mesenchymal components. Despite growing evidence that MpBC is a unique entity, it has long been treated as a variant of nonspecial type (NST) BC. MpBC typically shows the phenotype of triple-negative breast cancer (TNBC), but compared to NST-TNBC, it is a relatively chemorefractory tumor associated with worse outcomes. Therefore, there is an urgent need to develop management guidelines specifically for MpBC to improve the prognosis of patients with early MpBC. This expert consensus aims to guide diagnosis and standardize clinical management of early MpBC among treating physicians. We provide guidance on the challenging radiological and pathological diagnosis of MpBC. Evidence on the involvement of genetic predisposition in the development of MpBC is also explored. We emphasize the importance of a multidisciplinary approach for the treatment of patients with early MpBC. The optimal surgery and radiotherapy approach is presented, as well as the opportunity offered by novel therapeutic approaches to increase treatment response in this chemoresistant subtype. Appropriate management of patients with MpBC is critical to reduce the high risk of local and distant recurrence that characterizes this disease.
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Affiliation(s)
- Giovanni Corso
- Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS
- Department of Oncology and Hemato-Oncology, University of Milan
- European Cancer Prevention Organization (ECP)
| | - Carmen Criscitiello
- Department of Oncology and Hemato-Oncology, University of Milan
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology (IEO), IRCCS
| | - Luca Nicosia
- Breast Imaging Division, Radiology Department, European Institute of Oncology (IEO), IRCCS, Milan
| | - Filippo Pesapane
- Breast Imaging Division, Radiology Department, European Institute of Oncology (IEO), IRCCS, Milan
| | - Elisa Vicini
- Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS
| | - Francesca Magnoni
- Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS
| | - Andrea Sibilio
- Division of Breast Surgery Forlì (Ravenna), AUSL Romagna, Ravenna
| | - Cristina Zanzottera
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), IRCCS, Milan
| | | | - Sara Mannucci
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), IRCCS, Milan
| | - Monica Marabelli
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), IRCCS, Milan
| | - Mariarosaria Calvello
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), IRCCS, Milan
- Division of Hematology, Clinica Moncucco, Lugano, Switzerland
| | - Irene Feroce
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), IRCCS, Milan
| | - Paola Zagami
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology (IEO), IRCCS
- Department of Biomedical, Surgical and Dental Sciences
| | | | - Antonio Toesca
- Candiolo Cancer Institute, FPO - IRCCS, Candiolo (TO), Italy
| | - Paolo Tarantino
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology (IEO), IRCCS
- Division of Breast Oncology, Dana-Farber Cancer Institute, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Eleonora Nicolò
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology (IEO), IRCCS
| | - Giovanni Mazzarol
- Division of Pathology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, and
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), IRCCS, Milan
| | | | - Paolo Veronesi
- Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS
- Department of Oncology and Hemato-Oncology, University of Milan
| | - Nicola Fusco
- Department of Oncology and Hemato-Oncology, University of Milan
- Harvard Medical School, Boston, MA, USA
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8
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Thomas A, Reis-Filho JS, Geyer CE, Wen HY. Rare subtypes of triple negative breast cancer: Current understanding and future directions. NPJ Breast Cancer 2023; 9:55. [PMID: 37353557 DOI: 10.1038/s41523-023-00554-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/19/2023] [Indexed: 06/25/2023] Open
Abstract
Rare subtypes of triple-negative breast cancers (TNBC) are a heterogenous group of tumors, comprising 5-10% of all TNBCs. Despite accounting for an absolute number of cases in aggregate approaching that of other less common, but well studied solid tumors, rare subtypes of triple-negative disease remain understudied. Low prevalence, diagnostic challenges and overlapping diagnoses have hindered consistent categorization of these breast cancers. Here we review epidemiology, histology and clinical and molecular characteristics of metaplastic, triple-negative lobular, apocrine, adenoid cystic, secretory and high-grade neuroendocrine TNBCs. Medullary pattern invasive ductal carcinoma no special type, which until recently was a considered a distinct subtype, is also discussed. With this background, we review how applying biological principals often applied to study TNBC no special type could improve our understanding of rare TNBCs. These could include the utilization of targeted molecular approaches or disease agnostic tools such as tumor mutational burden or germline mutation-directed treatments. Burgeoning data also suggest that pathologic response to neoadjuvant therapy and circulating tumor DNA have value in understanding rare subtypes of TNBC. Finally, we discuss a framework for advancing disease-specific knowledge in this space. While the conduct of randomized trials in rare TNBC subtypes has been challenging, re-envisioning trial design and technologic tools may offer new opportunities. These include embedding rare TNBC subtypes in umbrella studies of rare tumors, retrospective review of contemporary trials, prospective identification of patients with rare TNBC subtypes entering on clinical trials and querying big data for outcomes of patients with rare breast tumors.
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Affiliation(s)
- Alexandra Thomas
- Department of Internal Medicine, Atrium Health Wake Forest Baptist Cancer Center, Winston-Salem, NC, USA.
| | - Jorge S Reis-Filho
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charles E Geyer
- Department of Medicine, University of Pittsburgh UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Hannah Y Wen
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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9
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Cai SL, Liu JJ, Liu YX, Yu SH, Liu X, Lin XQ, Chen HD, Fang X, Ma T, Li YQ, Li Y, Li CY, Zhang S, Chen XG, Guo XJ, Zhang J. Characteristics of recurrence, predictors for relapse and prognosis of rapid relapse triple-negative breast cancer. Front Oncol 2023; 13:1119611. [PMID: 36874102 PMCID: PMC9978400 DOI: 10.3389/fonc.2023.1119611] [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: 12/09/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
Background Triple-negative breast cancer (TNBC) patients who recur at different times are associated with distinct biological characteristics and prognoses. Research on rapid-relapse TNBC (RR-TNBC) is sparse. In this study, we aimed to describe the characteristics of recurrence, predictors for relapse, and prognosis in rrTNBC patients. Methods Clinicopathological data of 1584 TNBC patients from 2014 to 2016 were retrospectively reviewed. The characteristics of recurrence were compared between patients with RR-TNBC and slow relapse TNBC(SR-TNBC). All TNBC patients were randomly divided into a training set and a validation set to find predictors for rapid relapse. The multivariate logistic regression model was used to analyze the data of the training set. C-index and brier score analysis for predicting rapid relapse in the validation set was used to evaluate the discrimination and accuracy of the multivariate logistic model. Prognostic measurements were analyzed in all TNBC patients. Results Compared with SR-TNBC patients, RR-TNBC patients tended to have a higher T staging, N staging, TNM staging, and low expression of stromal tumor-infiltrating lymphocytes (sTILs). The recurring characteristics were prone to appear as distant metastasis at the first relapse. The first metastatic site was apt to visceral metastasis and less likely to have chest wall or regional lymph node metastasis. Six predictors (postmenopausal status, metaplastic breast cancer,≥pT3 staging,≥pN1 staging, sTIL intermediate/high expression, and Her2 [1+]) were used to construct the predictive model of rapid relapse in TNBC patients. The C-index and brier score in the validation set was 0.861 and 0.095, respectively. This suggested that the predictive model had high discrimination and accuracy. The prognostic data for all TNBC patients showed that RR-TNBC patients had the worst prognosis, followed by SR-TNBC patients. Conclusion RR-TNBC patients were associated with unique biological characteristics and worse outcomes compared to non-RR-TNBC patients.
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Affiliation(s)
- Shuang-Long Cai
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Jing-Jing Liu
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Ying-Xue Liu
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Shao-Hong Yu
- College of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Xu Liu
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Xiu-Quan Lin
- Department for Chronic and Noncommunicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Hong-Dan Chen
- First Department of Cadre Clinic, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Xuan Fang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Tao Ma
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Ya-Qing Li
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Department of Oncological Surgery, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Ying Li
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Chun-Yan Li
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Sheng Zhang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Xiao-Geng Chen
- Department of Oncological Surgery, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Xiao-Jing Guo
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Department of Breast Pathology and Lab, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jin Zhang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
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10
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Foschini MP, Nishimura R, Fabbri VP, Varga Z, Kaya H, Cserni G. Breast lesions with myoepithelial phenotype. Histopathology 2023; 82:53-69. [PMID: 36482278 DOI: 10.1111/his.14826] [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: 06/29/2022] [Revised: 09/15/2022] [Accepted: 10/07/2022] [Indexed: 12/13/2022]
Abstract
Myoepithelial cells (MECs) constitute a continuous layer of cells surrounding the breast glands, localised between the epithelial cells (ECs) and the basal membrane. MECs play important roles in normal mammary gland as they produce basal membrane and stimulate secretion. During neoplastic transformation, MECs act as a barrier preventing stromal invasion. MECs themselves can undergo a great variety of changes, ranging from hyperplastic to metaplastic, to neoplastic, and giving rise to a wide spectrum of morphological pictures sometimes difficult to interpret on routine diagnoses. Several benign and malignant breast tumours can present features of MECs differentiation. As these latter tumours are quite infrequent, the purpose of the present study is to offer a review of the morphological spectrum of MECs lesions, with correlations to prognosis.
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Affiliation(s)
- Maria P Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Section of Anatomic Pathology, Bellaria Hospital, Bologna, Italy
| | - Rieko Nishimura
- Department of Pathology, Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Viscardo Paolo Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Department of Pathological Anatomy, Modena University Hospital, Modena, Italy
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Handan Kaya
- Marmara University Pendik Training Hospital Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gábor Cserni
- Department of Pathology, Albert Szent-Györgyi Medical Centre, University of Szeged, Szeged, Hungary.,Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
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11
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Vijapura C, Rosen L, Wahab R. Adenoid Cystic Carcinoma of the Breast: Radiologic-Pathologic Correlation. JOURNAL OF BREAST IMAGING 2022; 4:625-631. [PMID: 38416992 DOI: 10.1093/jbi/wbac045] [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: 01/18/2022] [Indexed: 03/01/2024]
Abstract
Adenoid cystic carcinoma (ACC) is an uncommon malignancy occurring most frequently in the salivary glands. Breast ACC is rare. Pain is common at the site of ACC; otherwise, presentation is similar to other primary breast cancers. Adenoid cystic carcinomas classically lack calcifications; the imaging manifestations of ACC are otherwise highly variable, likely related to multiple pathologic growth patterns. While ACC in other regions of the body tends to be more aggressive, ACC involving the breast typically has less aggressive biologic characteristics. Classic-type breast ACC has a lower tendency to recur locally with radiation, metastasize to regional lymph nodes, and spread to other parts of the body. Perineural spread of disease can be seen but is not common. The rarer solid basaloid-type has a higher tendency for local or distant spread and recurrence. Although ACC is usually triple receptor-negative (estrogen receptor, progesterone receptor, human epidermal growth factor-2 receptor), the indolent nature of this tumor dictates its management. With classic-type ACC, the inclusion of axillary surgery has no consensus and the use of chemotherapy or hormonal therapy is rare. Axillary nodal surgery and chemotherapy are often included in management of the more aggressive solid basaloid-type. An understanding of the breast imaging, histopathology, and clinical course is key for appropriate treatment and follow-up of ACC.
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Affiliation(s)
- Charmi Vijapura
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| | - Lauren Rosen
- University of Cincinnati Medical Center, Department of Pathology, Cincinnati, OH, USA
| | - Rifat Wahab
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
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12
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Adenoid Cystic Carcinoma of the Breast May Be Exempt from Adjuvant Chemotherapy. J Clin Med 2022; 11:jcm11154477. [PMID: 35956093 PMCID: PMC9369505 DOI: 10.3390/jcm11154477] [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: 06/14/2022] [Revised: 07/17/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
Consistent standards regarding whether postoperative adjuvant chemotherapy is required in the treatment of adenoid cystic carcinoma of the breast (ACCB) are currently lacking. Using clinical data from the Surveillance, Epidemiology, and End Results (SEER) database (1988−2015), and the National Cancer Center of China (2004−2020), we retrospectively analyzed patients with ACCB who received radical treatment. A total of 661 patients were eligible. The median age at diagnosis was 61 years; 99.5% of patients were initially diagnosed with stage I and II breast cancer, and 76.7% had triple-negative breast cancer. Only 12.4% of patients received adjuvant chemotherapy. Multivariate analysis showed that patients with lymph node metastasis and non-radiotherapy had worse overall survival (OS) (p < 0.05). Patients with lymph node metastasis, stage IIB and III, histological grade ≥ 2, and non-radiotherapy had worse breast cancer-specific survival (BCSS) (p < 0.05). Adjuvant chemotherapy did not improve the OS or BCSS. Patients treated with adjuvant chemotherapy also had no better survival outcomes after propensity score matching. External data verification confirmed that chemotherapy did not improve disease-free survival or OS. Adjuvant chemotherapy cannot improve the clinical outcomes of ACCB, even in subgroups with a high risk of recurrence and metastasis.
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13
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Yang L, Wang C, Liu M, Wang S. Evaluation of Adjuvant Treatments for Adenoid Cystic Carcinoma of the Breast: A Population-Based, Propensity Score Matched Cohort Study from the SEER Database. Diagnostics (Basel) 2022; 12:diagnostics12071760. [PMID: 35885663 PMCID: PMC9324850 DOI: 10.3390/diagnostics12071760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is an extremely rare type of breast cancer. The role of adjuvant treatments for ACC remains controversial. Patients with a histology-confirmed diagnosis of ACC of the breast were identified based on the SEER (Surveillance, Epidemiology and End Results) database. Propensity score matching (PSM) was performed to balance the baseline characteristics. The Kaplan–Meier method and Cox regression models were performed to determine the impact of the adjuvant chemotherapy (CT) and radiotherapy (RT) associated with breast cancer-specific survival (BCSS) and overall survival (OS). A total of 1036 patients with ACC of the breast were included. After a median follow-up of 11.3 years, the 10-year OS and BCSS rate was 76.2% and 92.6%, respectively. After PSM, adjuvant CT converted into neither OS (Log-rank p = 1.000) nor BCSS (Log-rank p = 0.900) benefits in patients with ACC of the breast. Adjuvant RT also did not improve OS (Log-rank p = 0.060) and BCSS (Log-rank p = 0.400). According to the univariate stratified analysis, adjuvant RT was favorable for OS in patients who underwent breast-conserving surgery (HR 0.66, 95% CI 0.45, 0.99, p = 0.042). From the multivariate analysis, histology grade and nodal status were independent prognostic factors for both OS and BCSS. In conclusion, ACC of the breast presented a favorable prognosis. Adjuvant treatment, especially adjuvant CT, might not be essential for patients with this disease.
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Affiliation(s)
| | | | - Miao Liu
- Correspondence: (M.L.); (S.W.); Tel.: +86-1088324010 (M.L.); +86-1088324011 (S.W.)
| | - Shu Wang
- Correspondence: (M.L.); (S.W.); Tel.: +86-1088324010 (M.L.); +86-1088324011 (S.W.)
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14
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蔡 文, 庄 严, 陈 建, 王 宏. [Effect of postmastectomy radiotherapy on survival outcomes of patients with metaplastic breast cancer]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1733-1740. [PMID: 34916202 PMCID: PMC8685700 DOI: 10.12122/j.issn.1673-4254.2021.11.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To evaluate the effect of postmastectomy radiotherapy (PMRT) on the overall survival (OS) and breast cancer-specific survival (BCSS) of patients with metaplastic breast cancer (MpBC) in comparison with those of patients with invasive ductal breast carcinoma (IDC). METHODS We selected the patients with pathologically confirmed MpBC and IDC who either received PMRT or not from the archived cases (from January, 1998 to December, 2016) in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. In total, 31 982 patients were selected, including 308 patients with MpBC and PMRT, 629 with MpBC and PMRT, and 31 045 with IDC and PMRT. All the included patients were above 18 years of age without distant metastases or a second primary cancer and underwent radical surgery. Baseline characteristics of the patients were compared among the 3 subgroups, and multivariate Cox regression and Kaplan-Meier analyses were performed for analyzing the prognostic factors of MpBC, OS, and BCSS. RESULTS The majority (81.2%) of patients with MpBC were older than 50 years, had pathological grade III (68%), and were negative for ER (75.9%) and PR (79.8%) and in stage T2-3 (71.3%) and N0-1 (85.6%). Multivariate Cox regression analysis showed that age, T stage, N stage, PMRT, and chemotherapy were significantly associated with the prognosis of patients with MpBC (P < 0.05), while pathological grade, ER status, or PR status did not significantly affect the prognosis (P>0.05). Kaplan-Meier analysis showed that the patients with MpBC and PMRT had better OS (HR=1.394, 95% CI: 1.125-1.727; P < 0.05) and BCSS (HR=1.390, 95% CI: 1.074-1.800; P < 0.05) than those with MpBC who did not receive PMRT; but after PMRT, the patients with MpBC had worse OS (HR=1.626, 95%CI: 1.386-1.908; P < 0.001) and BCSS (HR=1.710, 95% CI: 1.418-2.062; P < 0.001) as compared with those with IDC. CONCLUSION MpBC has unique clinicopathological features. In patients with MpBC, age, T stage, N stage, radiotherapy and chemotherapy are all the prognostic factors affecting the survival outcomes, and PMRT can improve the OS and BCSS of the patients.
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Affiliation(s)
- 文娟 蔡
- 南方医科大学南方医院放疗科,广东 广州 510515Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 严 庄
- 南方医科大学公共卫生学院生物统计学系,广东省热带广东省热带病研究重点实验室,广东 广州 510515Department of Biostatistics, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangzhou 510515, China
| | - 建辉 陈
- 南方医科大学南方医院放疗科,广东 广州 510515Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 宏梅 王
- 南方医科大学南方医院放疗科,广东 广州 510515Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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15
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Cserni G, Quinn CM, Foschini MP, Bianchi S, Callagy G, Chmielik E, Decker T, Fend F, Kovács A, van Diest PJ, Ellis IO, Rakha E, Tot T. Triple-Negative Breast Cancer Histological Subtypes with a Favourable Prognosis. Cancers (Basel) 2021; 13:5694. [PMID: 34830849 PMCID: PMC8616217 DOI: 10.3390/cancers13225694] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022] Open
Abstract
Triple-negative breast cancers (TNBC), as a group of tumours, have a worse prognosis than stage-matched non-TNBC and lack the benefits of routinely available targeted therapy. However, TNBC is a heterogeneous group of neoplasms, which includes some special type carcinomas with a relatively indolent course. This review on behalf of the European Working Group for Breast Screening Pathology reviews the literature on the special histological types of BC that are reported to have a triple negative phenotype and indolent behaviour. These include adenoid cystic carcinoma of classical type, low-grade adenosquamous carcinoma, fibromatosis-like metaplastic carcinoma, low-grade mucoepidermoid carcinoma, secretory carcinoma, acinic cell carcinoma, and tall cell carcinoma with reversed polarity. The pathological and known molecular features as well as clinical data including treatment and prognosis of these special TNBC subtypes are summarised and it is concluded that many patients with these rare TNBC pure subtypes are unlikely to benefit from systemic chemotherapy. A consensus statement of the working group relating to the multidisciplinary approach and treatment of these rare tumour types concludes the review.
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Affiliation(s)
- Gábor Cserni
- Department of Pathology, University of Szeged, 6725 Szeged, Hungary
- Department of Pathology, Bács-Kiskun County Teaching Hospital, 6000 Kecskemét, Hungary
| | - Cecily M. Quinn
- Department of Histopathology, BreastCheck, Irish National Breast Screening Programme & St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Maria Pia Foschini
- Unit of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, Bellaria Hospital, University of Bologna, 40139 Bologna, Italy;
| | - Simonetta Bianchi
- Department of Health Sciences, Division of Pathological Anatomy, University of Florence, 50134 Florence, Italy;
| | - Grace Callagy
- Discipline of Pathology, School of Medicine, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Thomas Decker
- Department of Surgical Pathology, Dietrich Bonhoeffer Medical Centre, 17036 Neubrandenburg, Germany;
- Reference Centre for Mammography Münster, University Hospital Münster, 48149 Münster, Germany
- Reference Center for Mammography, 10623 Berlin, Germany
| | - Falko Fend
- Department of Pathology, University of Tübingen, 72076 Tübingen, Germany;
| | - Anikó Kovács
- Department of Clinical Pathology, Sahlgrenska University Hospital, 41 345 Gothenburg, Sweden;
| | - Paul J. van Diest
- Department of Pathology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Ian O. Ellis
- Department of Histopathology, University of Nottingham and The Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham NG5 1PB, UK; (I.O.E.); (E.R.)
| | - Emad Rakha
- Department of Histopathology, University of Nottingham and The Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham NG5 1PB, UK; (I.O.E.); (E.R.)
| | - Tibor Tot
- Pathology & Cytology Dalarna, Falun County Hospital, 791 82 Falun, Sweden;
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16
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Saridakis A, Berger ER, Harigopal M, Park T, Horowitz N, Le Blanc J, Zanieski G, Chagpar A, Greenup R, Golshan M, Lannin DR. Apocrine Breast Cancer: Unique Features of a Predominantly Triple-Negative Breast Cancer. Ann Surg Oncol 2021; 28:5610-5616. [DOI: 10.1245/s10434-021-10518-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/01/2021] [Indexed: 12/14/2022]
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