1
|
Upadhyay AK, Prakash A. Clinicopathological Profile of Breast Cancer at a Tertiary Cancer Center in Jharkhand, India: A Descriptive Cohort Study. Cureus 2023; 15:e39990. [PMID: 37416049 PMCID: PMC10321568 DOI: 10.7759/cureus.39990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Breast cancer is the most common cancer in females worldwide including Indian urban areas. There is no concrete data on breast cancer epidemiology from the state of Jharkhand, India. Materials and methods The present study is a retrospectively conducted descriptive cohort study. A total of 759 patients were selected from the database from 2012 to 2022. The parameters taken for the study were age, sex, stage at the time of presentation, histological type, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth receptor 2 (HER2) neu status (HER2/neu), site of metastasis for stage 4 diseases, parity, and significant family history. Results The median age for patients was 49 years (range: 19-91 years), with a clustering of 74.83% of cases between 31 and 60 years of age. Most of the patients were in stage III, with 365 (48.08%) cases. Bone was the commonest site of metastasis and was found in 41.25% of total cases. The total number of hormone receptor-positive patients was 384 (56.2%), the number of HER2/neu positive patients was 210 (30.7%), and triple-negative breast cancer was found in 184 cases (26.93%). Conclusion The pattern found in our Jharkhand patients was very much similar to other Indian studies with slightly more clustering of younger cases. The cases in India are almost a decade younger than the Western population and the same was replicated in our study. This is one of the largest studies on breast cancer profile and epidemiology from the eastern part of India. Most of our patients presented late, leading to a higher number of locally advanced (stage III) and metastatic (stage IV) cases. More awareness is required at the population level, including strict implementation of a robust screening program by our government, for improving the overall outcome.
Collapse
|
2
|
Clinicopathological features of and neoadjuvant therapy for human epidermal growth factor receptor 2-positive classic invasive lobular carcinoma. Hum Pathol 2021; 117:51-59. [PMID: 34363799 DOI: 10.1016/j.humpath.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/20/2022]
Abstract
Human epidermal growth factor receptor 2 (HER2)-positive classic invasive lobular carcinoma (ILC) is a rare entity, and its specific pathological characteristics and clinical behavior are unclear. Therefore, we retrospectively investigated the clinicopathological features of HER2-positive classic ILC and described HER2-targeted neoadjuvant chemotherapy outcome. Fourteen HER2-positive classic ILC cases were identified, their clinicopathological data were collected, and their clinical management was investigated. In general, HER2 positivity is associated with higher grade carcinoma in ductal lesions; however, our 14 cases had typical morphologic features of classic ILC. We did not identify unique morphologic features in HER2-positive classic ILC with the clinicopathological parameters examined, including age, menopausal status, histological grade, and hormone receptor status. Four of six patients who received HER2-targeted neoadjuvant chemotherapy had a pathological complete or partial response. Based on our findings, clinicopathological features of classic ILC may not predict HER2 overexpression or amplification. HER2-targeted neoadjuvant chemotherapy was effective against some HER2-positive classic ILCs. Taken together, these results demonstrate that HER2 immunohistochemistry and fluorescence in situ hybridization should be considered for all ILC patients regardless of subtype.
Collapse
|
3
|
Zhang H, Moisini I, Ajabnoor RM, Turner BM, D’aguiar M, Cai X, Gao S, Yang Q, Wang X, Schiffhauer L, Hicks DG. Frequency, Clinicopathologic Characteristics, and Follow-up of HER2-Positive Nonpleomorphic Invasive Lobular Carcinoma of the Breast. Am J Clin Pathol 2020; 153:583-592. [PMID: 31786600 DOI: 10.1093/ajcp/aqz194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To investigate human epidermal growth factor receptor 2 (HER2)-positive nonpleomorphic invasive lobular carcinoma (ILC), which has rarely been addressed. METHODS Clinicopathologic characteristics and follow-up of HER2-positive nonpleomorphic ILCs were collected and compared to those of HER2-negative counterparts. RESULTS Twenty-one cases of HER2-positive nonpleomorphic ILCs were identified, 6.3% of the study population. Compared to HER2-negative nonpleomorphic ILC, patients with HER2 positivity were older (P < .05), likely to be hormonal receptor negative (P < .01), and had higher histologic grade and angiolymphatic invasion (P < .01). HER2 positivity in nonpleomorphic ILCs was associated with higher recurrence/metastasis with hazard ratio of 2.03 (P < .05). No patient who received neoadjuvant therapy achieved pathologic complete response, and HER2-targeted therapy tended to reduce recurrence/metastasis in patients with HER2-positive nonpleomorphic ILC. CONCLUSIONS Our results highlight the existence of HER2 positivity in nonpleomorphic ILCs and reinforce that HER2 is associated with worse prognosis in nonpleomorphic ILC.
Collapse
Affiliation(s)
- Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Ioana Moisini
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Rana M Ajabnoor
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Bradley M Turner
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Marcus D’aguiar
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Shan Gao
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - Qi Yang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Xi Wang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Linda Schiffhauer
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | - David G Hicks
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| |
Collapse
|
4
|
Wu T, Li J, Wang D, Leng X, Zhang L, Li Z, Jing H, Kang J, Tian J. Identification of a correlation between the sonographic appearance and molecular subtype of invasive breast cancer: A review of 311 cases. Clin Imaging 2019; 53:179-185. [DOI: 10.1016/j.clinimag.2018.10.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 10/13/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
|
5
|
Zhou H, Lu K, Zheng L, Guo L, Gao Y, Miao X, Chen Z, Wang X. Prognostic significance of mammary Paget's disease in Chinese women: a 10-year, population-based, matched cohort study. Onco Targets Ther 2018; 11:8319-8326. [PMID: 30538501 PMCID: PMC6260180 DOI: 10.2147/ott.s171710] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To explore the prognostic significance of mammary Paget’s disease (PD) in breast cancer (BC) patients and to investigate the association between clinical manifestation and outcome in invasive ductal carcinoma patients with PD (PD-IDC). Patients and methods Eighty-five patients diagnosed with mammary PD with underlying BC from 2006 to 2012 at Zhejiang Cancer Hospital were recruited. A matched group comprised 85 patients diagnosed with BC without PD. Patients were matched according to four variables: stage (0–IV), age at diagnosis (within 5 years), histologic subtype, and the year of surgery. The 74 patients diagnosed with PD-IDC were divided into three groups based on their clinical presentation. Results Compared with the matched group, the PD group had more HER2 positivity (P<0.01) and hormone receptor negativity (P<0.01), and a worse outcome (Kaplan–Meier analysis, P<0.001 for disease-free survival and P=0.002 for overall survival). Multivariate Cox regression analyses showed that PD was an independent prognostic predictor for BC patients with PD. In addition, the 22 PD-IDC patients who presented with skin lesions in the nipple/areola and a mass in the breast or axilla had a higher risk of disease relapse than patients who presented with a mass in the breast without skin lesions or patients who presented with skin changes without a palpable mass (adjusted hazards ratio, 0.24; 95% CI, 0.08–0.73; P=0.012 and adjusted hazard ratio, 0.30; 95% CI, 0.06–1.40; P=0.124, respectively). Conclusion PD is an independent prognostic indicator of outcome in BC patients with PD. Furthermore, the primary symptoms at presentation may be an available indicator of prognosis in PD-IDC.
Collapse
Affiliation(s)
- Huanhuan Zhou
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China, ;
| | - Kongbeng Lu
- Department of Medical Oncology, Shaoxing Second Hospital, Shaoxing, Zhejiang, People's Republic of China
| | - Lei Zheng
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China, ;
| | - Liwei Guo
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yun Gao
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China, ;
| | - Xianyuan Miao
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China, ;
| | - Zhanhong Chen
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China, ;
| | - Xiaojia Wang
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China, ;
| |
Collapse
|
6
|
Köseoğlu RD, Markoç F, Müslehiddinoğlu A, İleri AB, Deresoy FA, Etikan İ. HER-2/Neu and Hormone Receptor Analysis in Breast Carcinomas and Their Association with Clinicopathologic Parameters. Eur J Breast Health 2018; 15:43-50. [PMID: 30816354 DOI: 10.5152/ejbh.2018.4118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/15/2018] [Indexed: 11/22/2022]
Abstract
Objective Invasive breast carcinomas of no special type (IC-NST) are the heterogeneous tumours showing distinct prognostic features even in patients with similar clinicopathological characteristics. To date, many clinicopathological data have been analyzed to make a guess about prognosis and to determine treatment modality. In this study, HER-2/neu status was analyzed by using both immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) methods, and its correlations with hormone receptor status and clinicopathological parameters were investigated. Materials and Methods The study was included 112 female patients with diagnosis of IC-NST. FISH for HER-2/neu was applied in only primary tumour tissues, while IHC analyses for HER-2/neu, estrogen (ER) and progesterone receptors (PR) were applied on both primary and metastatic lymph node foci. The results were compared with appropriate statistical methods. Results Our rates of HER-2/neu overexpression and gene amplification in the overall study group were 22.3 and 25%, respectively. In the metastatic group, these rates were higher than those of the overall study group (34% and 40%, respectively). Gene amplification rate of the axilla positive group was 40%, while this rate in non-metastatic group was 6.7% (p=0.015). Overexpression and amplification results were compliant (χ2=77,591, p<0.001). The concordance rates in HER-2/neu negative and overexpression groups were 95.3% and 88%, respectively. Our false negativity rate was 4.7%. While 36% of score 3+ cases were ER positive, 67.1% of HER-2/neu negative cases showed ER positivity (p=0.01). The increase of gene amplification rate in ER negative cases over 50 years age was more than two times and statistically significant (p=0.014). Conclusion The concordance rates between the results of IHC and FISH in the HER-2 negative and the overexpression categories were compatible with the literature and lower than the literature, respectively. In the case of ER negativity, the patient's age over 50 years was associated with a higher rate of gene amplification.
Collapse
Affiliation(s)
- Reşit Doğan Köseoğlu
- Department of Pathology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Fatma Markoç
- Department of Pathology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | | | - Ayşe Burcu İleri
- Department of Pathology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Faik Alev Deresoy
- Department of Pathology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - İlker Etikan
- Department of Biostatistics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| |
Collapse
|
7
|
Guo Q, Dong Z, Zhang L, Ning C, Li Z, Wang D, Liu C, Zhao M, Tian J. Ultrasound Features of Breast Cancer for Predicting Axillary Lymph Node Metastasis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:1354-1353. [PMID: 29119589 DOI: 10.1002/jum.14469] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/19/2017] [Accepted: 08/22/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The purpose of this study was to assess the clinical value of ultrasound (US) features of breast lesions for predicting the risk of axillary lymph node metastasis in patients with breast cancer. METHODS In this retrospective study, 425 patients with breast cancer were recruited, and their preoperative US features and postoperative pathologic results were collected. The association of these US features of breast cancer with axillary lymph node metastasis was determined by univariate and multivariate analyses. RESULTS Among the 425 patients, 200 (47.1%) had axillary lymph node metastasis, and 225 (52.9%) did not. The parameters of tumor shape, color Doppler flow imaging grades, histologic grade, and E-cadherin level were significantly and independently associated with axillary lymph node metastasis (P < .05 for all). CONCLUSIONS Axillary lymph node metastasis was prone to happen in patients with US features of an irregular tumor shape and higher color Doppler flow imaging grades. Ultrasound imaging provides a promising tool for predicting axillary lymph node metastasis in patients with breast cancer.
Collapse
Affiliation(s)
- Qiang Guo
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Departments of Ultrasound Medicine, Jinshan Branch of Shanghai Sixth People's Hospital affiliated with Shanghai Jiaotong University, Shanghai, China
| | - Zhiwu Dong
- Departments of Laboratory Medicine, Jinshan Branch of Shanghai Sixth People's Hospital affiliated with Shanghai Jiaotong University, Shanghai, China
| | - Lei Zhang
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chunping Ning
- Department of Ultrasound, Affiliated Hospital of Qingdao University, Medical College, Qingdao, China
| | - Ziyao Li
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dongmo Wang
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chong Liu
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ming Zhao
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiawei Tian
- Department of Ultrasound Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
8
|
Guo Q, Zhang L, Di Z, Ning C, Dong Z, Li Z, Wang D, Liu C, Zhao M, Tian J. Assessing Risk Category of Breast Cancer by Ultrasound Imaging Characteristics. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:815-824. [PMID: 29331358 DOI: 10.1016/j.ultrasmedbio.2017.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/03/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
The purpose of our study was to assess the potential clinical value of ultrasound imaging in predicting risk category in patients with breast cancer. Three hundred thirty-six patients were enrolled and divided into a high-risk group (99, 29.5%) and mid- to low-risk group (237, 70.5%) according to the St. Gallen risk criteria. All data were retrospectively collected to analyze correlations between ultrasound features and risk category. The results revealed that the ultrasound features of irregular shape (p= 0.002), vertical growth orientation (p= 0.002), angular contour (p= 0.022) and high color Doppler flow imaging grade (p= 0.001) tended to be present in images of the high-risk group. Therefore, tumor ultrasound features should be recognized as an ideal option for determination of risk category in patients with breast cancer.
Collapse
Affiliation(s)
- Qiang Guo
- Department of Ultrasound Medicine, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China; Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Lei Zhang
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Zhixin Di
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Chunping Ning
- Department of Ultrasound, Hospital of Qingdao University, Medical College, Qingdao, China
| | - Zhiwu Dong
- Department of Laboratory Medicine, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ziyao Li
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Dongmo Wang
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Chong Liu
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Ming Zhao
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China
| | - Jiawei Tian
- Department of Ultrasound Medicine, Hospital of Harbin Medical University, Heilongjiang, China.
| |
Collapse
|
9
|
Abstract
There is a global mandate even in countries with low resources to improve the accuracy of testing biomarkers in breast cancer viz. oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2neu) given their critical impact in the management of patients. The steps taken include compulsory participation in an external quality assurance (EQA) programme, centralized testing, and regular performance audits for laboratories. This review addresses the status of ER/PR and HER2neu testing in India and possible reasons for the delay in development of guidelines and mandate for testing in the country. The chief cause of erroneous ER and PR testing in India continues to be easily correctable issues such as fixation and antigen retrieval, while for HER2neu testing, it is the use of low-cost non-validated antibodies and interpretative errors. These deficiencies can however, be rectified by (i) distributing the accountability and responsibility to surgeons and oncologist, (ii) certification of centres for testing in oncology, and (iii) initiation of a national EQA system (EQAS) programme that will help with economical solutions and identifying the centres of excellence and instill a system for reprimand of poorly performing laboratories.
Collapse
Affiliation(s)
- Tanuja Shet
- Department of Histopathology, Tata Memorial Centre, Mumbai, India
| |
Collapse
|
10
|
Labuhn M, Vuaroqueaux V, Fina F, Schaller A, Nanni-Metellus I, Küng W, Eppenberger-Castori S, Martin P, Eppenberger U. Simultaneous Quantitative Detection of Relevant Biomarkers in Breast Cancer by Quantitative Real-Time PCR. Int J Biol Markers 2018. [DOI: 10.1177/172460080602100105] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The assessment of ERα, PgR and HER2 status is routinely performed today to determine the endocrine responsiveness of breast cancer samples. Such determination is usually accomplished by means of immunohistochemistry and in case of HER2 amplification by means of fluorescent in situ hybridization (FISH). The analysis of these markers can be improved by simultaneous measurements using quantitative real-time PCR (Qrt-PCR). In this study we compared Qrt-PCR results for the assessment of mRNA levels of ERα, PgR, and the members of the human epidermal growth factor receptor family, HER1, HER2, HER3 and HER4. The results were obtained in two independent laboratories using two different methods, SYBR Green I and TaqMan probes, and different primers. By linear regression we demonstrated a good concordance for all six markers. The quantitative mRNA expression levels of ERα, PgR and HER2 also strongly correlated with the respective quantitative protein expression levels prospectively detected by EIA in both laboratories. In addition, HER2 mRNA expression levels correlated well with gene amplification detected by FISH in the same biopsies. Our results indicate that both Qrt-PCR methods were robust and sensitive tools for routine diagnostics and consistent with standard methodologies. The developed simultaneous assessment of several biomarkers is fast and labor effective and allows optimization of the clinical decision-making process in breast cancer tissue and/or core biopsies.
Collapse
Affiliation(s)
| | | | - F. Fina
- Laboratoire de Transfert d'Oncologie Biologique, Assistance - Publique Hôpitaux de Marseille - France
| | - A. Schaller
- Abteilung für Humangenetik, Medizinische Universitäts-Kinderklinik, Bern - Switzerland
| | - I. Nanni-Metellus
- Laboratoire de Transfert d'Oncologie Biologique, Assistance - Publique Hôpitaux de Marseille - France
| | - W. Küng
- Department of Research and Gynecology, University Clinics, Basel - Switzerland
| | | | - P.M. Martin
- Laboratoire de Transfert d'Oncologie Biologique, Assistance - Publique Hôpitaux de Marseille - France
| | - U. Eppenberger
- Stiftung Tumorbank Basel, STB, Riehen - Switzerland
- Department of Research and Gynecology, University Clinics, Basel - Switzerland
| |
Collapse
|
11
|
Guo Q, Chen K, Lin X, Su Y, Xu R, Dai Y, Qiu C, Song X, Mao S, Chen Q. A nomogram to predict HER2 status in breast cancer patients with HER2-borderline disease as determined via immunohistochemistry. Oncotarget 2017; 8:93492-93501. [PMID: 29212167 PMCID: PMC5706813 DOI: 10.18632/oncotarget.19313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/11/2017] [Indexed: 01/03/2023] Open
Abstract
This study aimed to develop a nomogram to predict fluorescence in situ hybridization (FISH) assay results for HER2-borderline breast cancer as determined via immunohistochemistry (IHC) among patients in China. We reviewed a database of breast cancer patients diagnosed between January 2007 and April 2013 at our institutions. We used logistic regression to develop a nomogram and we used receiver operating characteristic curve analysis and calibration plots to validate our nomogram. In total, 1138, 301 and 344 patients had IHC-determined HER2-negative, HER2-borderline and HER2-positive disease, respectively. Within the training cohort, univariate and multivariate analyses suggested that estrogen receptor (ER) status, progesterone receptor (PR) status and tumor grade were significantly associated with HER2 status (P<0.01). A nomogram was developed and the AUCs for the training and validation cohorts were 0.795 and 0.749, respectively. The calibration plots suggested that the model was well calibrated. This new nomogram can be used to predict HER2 status in HER2-borderline breast cancer patients and will be particularly helpful to resource-limited countries.
Collapse
Affiliation(s)
- Qianqian Guo
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China.,Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
| | - Xiaojie Lin
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yi Su
- Department of Intensive Care, Foshan Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Rui Xu
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yan Dai
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Chang Qiu
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xue Song
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Siying Mao
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Qianjun Chen
- Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| |
Collapse
|
12
|
Singh R, Bhatt MLB, Singh SP, Kumar V, Goel MM, Mishra DP, Kumar R. Evaluation of KiSS1 as a Prognostic Biomarker in North Indian Breast Cancer Cases. Asian Pac J Cancer Prev 2017; 17:1789-95. [PMID: 27221854 DOI: 10.7314/apjcp.2016.17.4.1789] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the commonest female cancer worldwide and its propensity to metastasize negatively impacts on therapeutic outcome. Several clinicopathological parameters with prognostic/predictive significance have been associated with metastatic suppressor expression levels. The role of metastatic suppressor gene (MSG) KiSS1 in breast cancer remains unclear. Our goal was to investigate the possible clinical significance of KiSS1 breast cancer. MATERIALS AND METHODS The study was conducted on 87 histologically proven cases of breast cancer and background normal tiisue. Quantitative reverse transcriptase polymerase chain reaction (qRT PCR) and immunohistochemistry (IHC) were used to investigate KiSS1 at gene and protein levels, respectively, for correlation with several patient characteristics including age, family history, hormonal receptor status, stage, tumor size, nodal involvement and metastatic manifestation and finally with median overall survival (OS). RESULTS Our study revealed (i) KiSS1 levels were generally elevated in breast cancer vs normal tissue (< 0.05). (ii) however, a statistically significant lower expression of KiSS1 was observed in metastatic vs non metastatic cases (P = 0.04). (iii) KiSS1 levels strongly correlated with T,N,M category, histological grade and advanced stage (<0.001) but not other studied parameters. (iv) Lastly, a significant correlation between expression of KiSS1 and median OS was found (P = 0.04). CONCLUSIONS Conclusively, less elevated KiSS1 expression is a negative prognostic factor for OS, advancing tumor stage, axillary lymph node status, metastatic propensity and advancing grade of the breast cancer patient. Patients with negative KiSS1 expression may require a more intensive therapeutic strategy.
Collapse
Affiliation(s)
- Richa Singh
- Department of Radiotherapy, King George's Medical University, India E-mail :
| | | | | | | | | | | | | |
Collapse
|
13
|
Elidrissi Errahhali M, Elidrissi Errahhali M, Ouarzane M, El Harroudi T, Afqir S, Bellaoui M. First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases. BMC WOMENS HEALTH 2017; 17:3. [PMID: 28068979 PMCID: PMC5223366 DOI: 10.1186/s12905-016-0361-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 12/29/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Breast cancer is the most frequent malignancy among women in Eastern Morocco. In this paper, we provide the first report on molecular breast cancer subtypes in this region. This is the largest population-based study on breast cancer among Moroccan women. METHODS We analyzed 2260 breast cancer cases diagnosed at the Hassan II Regional Oncology Center between October 2005 and December 2012. Clinico-pathological and therapeutic features were studied. Molecular subtypes were determined and their associations with the clinico-pathological characteristics of the tumors were examined. RESULTS The mean age at diagnosis was 48.7 years ±11.4. Invasive ductal carcinoma was the predominant histological type (77.1%), followed by lobular invasive carcinoma (15.3%). The mean size of breast tumors was 3.5 cm ± 1.96, and 84% of our patients are diagnosed with tumors of more than 2 cm. Histological grade II tumors were the most frequent (70.4%), followed by advanced histological grade (18%). Lymph node positive tumors were observed in 64.8% of cases and 29.3% of patients had distant metastasis. Most tumors were hormone receptor-positive (73%) and 28.6% were HER2 positive. 86.1% of patients with hormone receptor-positive breast cancer were given hormone therapy, while 68.9% of patients with HER2+ breast cancer received targeted therapy with Herceptin. Luminal A was the commonest molecular subtype, followed by Luminal B, Triple Negative and HER2. The highest prevalence of premenopausal patients was observed in Triple Negative subtype (72.2%), followed by HER2 (64.1%), Luminal B (62.2%), and Luminal A (55.1%). Luminal B subtype had a poorer prognosis than Luminal A. Compared with Triple Negative, HER2 subtype tend to spread more aggressively and is associated with poorer prognosis. CONCLUSIONS Unlike Western countries, breast cancer occurs at an earlier age and is diagnosed at a more advanced stage in Eastern Morocco. In this region, hormone receptor-positive tumors are predominant and so the majority of breast cancer patients should benefit from hormone therapy. HER2 subtype presents an aggressive tendency, suggesting the importance of anti-HER2 therapy. This study will contribute in developing appropriate screening and cancer management strategies in Eastern Morocco.
Collapse
Affiliation(s)
- Manal Elidrissi Errahhali
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco
| | - Mounia Elidrissi Errahhali
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco
| | - Meryem Ouarzane
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco
| | | | - Said Afqir
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.,Hassan II Regional Oncology Center, Oujda, Morocco
| | - Mohammed Bellaoui
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
| |
Collapse
|
14
|
Killelea BK, Chagpar AB, Horowitz NR, Lannin DR. Characteristics and treatment of human epidermal growth factor receptor 2 positive breast cancer: 43,485 cases from the National Cancer Database treated in 2010 and 2011. Am J Surg 2016; 213:426-432. [PMID: 27769548 DOI: 10.1016/j.amjsurg.2016.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 05/05/2016] [Accepted: 05/16/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although identification of human epidermal growth factor receptor 2 (Her2) positive breast cancer represents one of the greatest advances over the past 3 decades, it has not been studied extensively on a national level. METHODS The National Cancer Database is a joint project of the American Cancer Society and the American College of Surgeons and contains data on about 70% of the cancer cases in the United States. Data on Her2 have been collected since 2010 and was used for this study. RESULTS Of 298,937 cases of invasive breast cancer with known Her2 status diagnosed in 2010 and 2011, 43,485 (14.5%) were Her2 positive. Her2 positivity was greatest in Asian/Pacific Islanders and least in non-Hispanic Whites and was markedly more common in younger women. The incidence of Her2 positive tumors ranged from a low of 13.9% in the Mountain West region to a high of 16.0% in the West South Central region (P < .001). Compared with Her2 negative tumors, Her2 positive tumors were larger (2.6 vs 2.2 cm, P < .001), more likely to have positive nodes (39% vs 31% P < .001), have lymphovascular invasion (30% vs 20%, P < .001), and be high grade (56% vs 29%, P < .001). There were also differences by histology: invasive ductal 16.4%, invasive lobular 5.5%, tubular 2.3%, inflammatory 36%, and Paget's with invasion 59%. When adjusted for age, race, tumor size, and nodal status Her2 positive tumors were much more likely to receive chemotherapy (odds ratio = 5.5, confidence interval = 5.2 to 6.0) and somewhat less likely to undergo breast preservation (odds ratio = .78, confidence interval = .76 to .80). CONCLUSIONS Her2 positive tumors have distinct epidemiologic, clinical, and treatment characteristics.
Collapse
Affiliation(s)
- Brigid K Killelea
- Department of Surgery, Yale University School of Medicine, The Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street North Pavilion, First Floor, New Haven, CT 06510, USA.
| | - Anees B Chagpar
- Department of Surgery, Yale University School of Medicine, The Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street North Pavilion, First Floor, New Haven, CT 06510, USA
| | - Nina R Horowitz
- Department of Surgery, Yale University School of Medicine, The Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street North Pavilion, First Floor, New Haven, CT 06510, USA
| | - Donald R Lannin
- Department of Surgery, Yale University School of Medicine, The Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street North Pavilion, First Floor, New Haven, CT 06510, USA
| |
Collapse
|
15
|
Königsberg R, Pfeiler G, Hammerschmid N, Holub O, Glössmann K, Larcher-Senn J, Dittrich C. Breast Cancer Subtypes in Patients Aged 70 Years and Older. Cancer Invest 2016; 34:197-204. [DOI: 10.1080/07357907.2016.1182184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Robert Königsberg
- Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna)—LB Cluster Translational Oncology, 3rd Medical Department—Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria
- Applied Cancer Research—Institution for Translational Research Vienna (ACR-ITR VIEnna)/CEADDP, Vienna, Austria
| | - Georg Pfeiler
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Nicole Hammerschmid
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Oliver Holub
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Kerstin Glössmann
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Julian Larcher-Senn
- Assign Data Management and Biostatistics GmbH, Assign Group, Innsbruck, Austria
| | - Christian Dittrich
- Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna)—LB Cluster Translational Oncology, 3rd Medical Department—Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria
- Applied Cancer Research—Institution for Translational Research Vienna (ACR-ITR VIEnna)/CEADDP, Vienna, Austria
| |
Collapse
|
16
|
|
17
|
Prendeville S, Feeley L, Bennett MW, O'Connell F, Browne TJ. Reflex Repeat HER2 Testing of Grade 3 Breast Carcinoma at Excision Using Immunohistochemistry and In Situ Analysis: Frequency of HER2 Discordance and Utility of Core Needle Biopsy Parameters to Refine Case Selection. Am J Clin Pathol 2016; 145:75-80. [PMID: 26712873 DOI: 10.1093/ajcp/aqv018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The updated American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines (2013) for human epidermal growth factor receptor 2 (HER2) testing in breast cancer recommend repeat testing at excision of HER2-negative grade 3 breast tumors. This study aimed to identify the rate of HER2 discordance in this cohort of cases. METHODS All HER2-negative grade 3 tumors diagnosed at a single institution over a 15-month period had reflex repeat HER2 testing at excision : HER2 testing was performed in accordance with ASCO/CAP guidelines using immunohistochemistry (IHC) and dual in situ hybridization (ISH). RESULTS One hundred cases were identified over the study period. HER2 was amplified at excision in three cases. The discordant tumors showed equivocal IHC at excision with low-level amplification on dual ISH. All discordant cases showed equivocal IHC on core needle biopsy (CNB) specimens and/or tumor upgrade at excision. CONCLUSIONS Our series demonstrated a high concordance rate (97%) for HER2 at excision in grade 3 breast tumors with a negative core biopsy result. These findings suggest that reflex repeat HER2 testing of all these cases, which has significant cost and workload implications, may not be justified. Features that may indicate HER2 heterogeneity, such as equivocal IHC on CNB specimens or tumor upgrade at excision, may help refine selection of cases for repeat testing.
Collapse
Affiliation(s)
- Susan Prendeville
- From the Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Linda Feeley
- From the Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Michael W Bennett
- From the Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Fionnuala O'Connell
- From the Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Tara Jane Browne
- From the Department of Histopathology, Cork University Hospital, Cork, Ireland.
| |
Collapse
|
18
|
Khabaz MN. Immunohistochemistry subtypes (ER/PR/HER) of breast cancer: where do we stand in the West of Saudi Arabia? Asian Pac J Cancer Prev 2015; 15:8395-400. [PMID: 25339035 DOI: 10.7314/apjcp.2014.15.19.8395] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In Saudi Arabia, cancer of breast is ranked the most frequent neoplasm and second source of cancer death in the female population. Breast cancer (BC) fast diagnosis, prognosis and medication management necessitate, these days, immunohistochemistry (IHC) assessment of hormone receptors and HER2 expression profile. The present report defines the IHC profile of ER, PR and HER2 in Saudi female breast neoplasms of ductal and lobular types and associations ER, PR and HER2 expression patterns with various clinicopathological factors (age, type of tumor, size, laterality, histological grade, and involvement of axillaries lymph nodes). Ninety nine cases of breast tumors were recruited from the pathology department archive of King Abdulaziz University Hospital, Kingdom of Saudi Arabia. ER, PR and HER2 expression was assessed using IHC staining. Ductal carcinomas with a variety of histological grades constituted 88 (88.8%) of total cases. Seventy four (77.8%), 59 (62.1%), and 35 (36.8%) of ductal carcinomas showed positive staining for ER, PR and HER2, in that order. Remaining breast cancer cases were four (4%) lobular carcinomas and two (2%) mixed form of ductal and lobular types, which were ER+, PR+, and HER2-. Breast cancer expression pattern of ER, PR and HER2 in Saudi female is different from that of Tunisian and Jordanian female populations and closer to the expression pattern of Egyptian, Lebanese, Iraqi and western country females. Furthermore, the present study found two IHC patterns of breast cancer ER+/PR-/HER2+ (5%) and ER+/PR-/HER2- (11.1%), which had not been reported in other Arabic studies. Thus the rates of IHC expression patterns in breast cancer show some variation among Arabic female populations.
Collapse
Affiliation(s)
- Mohamad Nidal Khabaz
- Department of Pathology, Faculty of Medicine, Rabigh Branch, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia E-mail : ;
| |
Collapse
|
19
|
Ghosh S, Sarkar S, Simhareddy S, Kotne S, Rao PBA, Turlapati SPV. Clinico-morphological profile and receptor status in breast cancer patients in a South Indian institution. Asian Pac J Cancer Prev 2015; 15:7839-42. [PMID: 25292074 DOI: 10.7314/apjcp.2014.15.18.7839] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most common malignancy in women worldwide and the second most common cancer in females in India. Receptor status may be important for survival. OBJECTIVE To analyse and correlate the clinical and morphological parameters with receptor status in breast carcinoma patients in a tertiary care institution in Southern India. MATERIALS AND METHODS This retrospective study involved 320 patients of breast cancer diagnosed in an oncology hospital over a period of 31/2 years. Data was analysed using SPSS Version 21. RESULTS Some 60.6% patients with breast carcinomas belonged to the age group of 40 to 60 years. The most common histological type was infiltrating ductal carcinoma, not otherwise specified, accounting for 84.4% of patients. On immunohistochemistry, estrogen receptor (ER) and progesterone receptor (PR) were expressed in 56.3% and 53.1% of cases, respectively. CONCLUSIONS Breast cancers in India, a developing country, occur in younger women and tend to be more aggressive with lower rates of ER and PR expression and higher histological tumor grades. Both ER and PR status of the tumors had significant associations with the patient age, pathological TNM stage and histological tumor grade.
Collapse
Affiliation(s)
- Saptarshi Ghosh
- Departments of Radiation Oncology, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India E-mail :
| | | | | | | | | | | |
Collapse
|
20
|
Vettuparambil A, Rajan G, Chirukandath R, Culas TB. Epidemiology, Pathological Characteristics and Estrogen and Progesterone Receptor Status of Operated Cases of Female Breast Cancer: A Retrospective Review of 266 Cases from Kerala. Indian J Surg Oncol 2015; 6:352-5. [PMID: 27065660 DOI: 10.1007/s13193-015-0425-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022] Open
Abstract
Breast cancer is presently the most common cancer among women in Kerala, in Southern India. The objectives of this study were to analyze the epidemiology and pathological characteristics of female breast carcinoma in Kerala. 266 patients who were diagnosed with operable breast cancer between April 2009 and June 2010 were studied. Various pathological characteristics including stage, grade, axillary lymph nodal status, tumor size, and estrogen and progesterone receptor status were studied. Estrogen and progesterone receptor status were evaluated by immunohistochemistry. Chi-square test and frequency tables were used for statistical analysis. The mean age at presentation was 50 years. 48.9 % of the patients were premenopausal. 53.76 % had grade II tumors. Positive axillary lymph nodes were found in 70.3 % patients, and 68 % presented with stage II disease. 54.13 % were ER positive and 62 % were PR positive. The relatively young age at diagnosis, late presentation of the disease, and lower estrogen and progesterone receptor expression compared to patients from the West point toward the need for better breast cancer awareness and screening programmes in Kerala.
Collapse
Affiliation(s)
| | - Gautham Rajan
- Government Medical College, Thrissur, Kerala 680596 India
| | | | | |
Collapse
|
21
|
Zhang L, Li J, Xiao Y, Cui H, Du G, Wang Y, Li Z, Wu T, Li X, Tian J. Identifying ultrasound and clinical features of breast cancer molecular subtypes by ensemble decision. Sci Rep 2015; 5:11085. [PMID: 26046791 PMCID: PMC4457139 DOI: 10.1038/srep11085] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/14/2015] [Indexed: 11/30/2022] Open
Abstract
Breast cancer is molecularly heterogeneous and categorized into four molecular subtypes: Luminal-A, Luminal-B, HER2-amplified and Triple-negative. In this study, we aimed to apply an ensemble decision approach to identify the ultrasound and clinical features related to the molecular subtypes. We collected ultrasound and clinical features from 1,000 breast cancer patients and performed immunohistochemistry on these samples. We used the ensemble decision approach to select unique features and to construct decision models. The decision model for Luminal-A subtype was constructed based on the presence of an echogenic halo and post-acoustic shadowing or indifference. The decision model for Luminal-B subtype was constructed based on the absence of an echogenic halo and vascularity. The decision model for HER2-amplified subtype was constructed based on the presence of post-acoustic enhancement, calcification, vascularity and advanced age. The model for Triple-negative subtype followed two rules. One was based on irregular shape, lobulate margin contour, the absence of calcification and hypovascularity, whereas the other was based on oval shape, hypovascularity and micro-lobulate margin contour. The accuracies of the models were 83.8%, 77.4%, 87.9% and 92.7%, respectively. We identified specific features of each molecular subtype and expanded the scope of ultrasound for making diagnoses using these decision models.
Collapse
Affiliation(s)
- Lei Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jing Li
- Department of Ultrasonic medicine, The 1st Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Yun Xiao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hao Cui
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Guoqing Du
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Wang
- Department of general surgery, The Second Hospital of Hebei Medical Universtiy, Shijiazhuang, Hebei, China
| | - Ziyao Li
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Tong Wu
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xia Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiawei Tian
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| |
Collapse
|
22
|
The differences in ultrasound and clinicopathological features between basal-like and normal-like subtypes of triple negative breast cancer. PLoS One 2015; 10:e0114820. [PMID: 25734578 PMCID: PMC4348341 DOI: 10.1371/journal.pone.0114820] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/17/2014] [Indexed: 12/31/2022] Open
Abstract
Purpose The aim of this study was to identify the ultrasound features and clinicopathological characteristics of basal-like subtype of triple negative breast cancers (TNBCs). Materials and Methods This study was approved by the ethical board of the Second Affiliated Hospital of Harbin Medical University. The patients’ clinicopathological information was available. The ultrasound features of 62 tumors from 62 TNBC patients were interpreted. The immunohistochemical results of cytokertain5/6 (CK5/6) and Epidermal Growth Factor Receptor (EGFR) were used to classify the tumor into basal-like and normal-like groups. The association of the ultrasound features interpreted by experienced ultrasound doctors with the immunohistochemical classification was studied. Results Of the 62 TNBC cases, 42 (67.7%) exhibited the basal-like phenotype and 20 (32.3%) exhibited the normal-like phenotype based on the immunohistochemical CK5/6 and EGFR markers. Of all the tumors, 90.3% were invasive carcinomas. The basal-like tumors were significantly associated with a maximum diameter on ultrasound of more than 20 mm (36, 85.7%) (P = 0.0014). The normal-like tumors usually exhibited lateral shadows (15, 75%) (P = 0.0115) as well as microlobulated margins (12, 60%) (P = 0.0204) compared to the basal-like subtype. Other ultrasound features showed no significant differences between the two groups. Conclusions Although ultrasound cannot yet be used to differentiate between the basal-like subtype and normal-like subtype of TNBC, ultrasound can be used to provide some useful information to the clinicians.
Collapse
|
23
|
Bachmann C, Schmidt S, Staebler A, Fehm T, Fend F, Schittenhelm J, Wallwiener D, Grischke E. CNS metastases in breast cancer patients: prognostic implications of tumor subtype. Med Oncol 2014; 32:400. [PMID: 25433950 DOI: 10.1007/s12032-014-0400-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 11/21/2014] [Indexed: 11/25/2022]
Abstract
Development of brain metastases (BM) in breast cancer leads to limited survival. The therapeutical options are limited. There are less data about the risk factors and prognostic importance in BM. Objective is to investigate predictors of central nervous system metastases and outcome after diagnosis of BM according to tumor subtype. Based on medical records, 80 consecutive patients with primary non-metastatic operable breast cancer, treated at Department of Gynecology, University of Tübingen, and who developed BM during follow-up, were retrospectively analyzed. Clinicopathological parameters and their prognostic impact were evaluated. A node involvement (40 %), ER/PR negative (53.75 vs. 61.25 %), triple negative (28.75 %) and HER2+ status (40 %) were associated with BM. BM in breast cancer patients lead to a shortened survival. In cerebral metastatic breast cancer patients with HER2-negative and triple-negative, patients had significant shorter survival after detection of BM compared with HER2-positive and non-triple-negative patients (p = 0.001; p = 0.03). Risk of BM varies significantly by subtype. Understanding the biology of metastases can help categorize patients into prognostically useful categories and tailor treatment regimens for individual patients. Prospective clinical trials would be required for evaluating the potential role of screening for asymptomatic BM and of treatment of triple-negative patients.
Collapse
Affiliation(s)
- C Bachmann
- Department of Gynecology, University of Tübingen, Calwer Str. 7, 72070, Tübingen, Germany,
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Zhang L, Liu YJ, Jiang SQ, Cui H, Li ZY, Tian JW. Ultrasound Utility for Predicting Biological Behavior of Invasive Ductal Breast Cancers. Asian Pac J Cancer Prev 2014; 15:8057-62. [DOI: 10.7314/apjcp.2014.15.19.8057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
25
|
de Macêdo Andrade AC, Ferreira Júnior CA, Dantas Guimarães B, Pessoa Barros AW, Sarmento de Almeida G, Weller M. Molecular breast cancer subtypes and therapies in a public hospital of northeastern Brazil. BMC WOMENS HEALTH 2014; 14:110. [PMID: 25216732 PMCID: PMC4166019 DOI: 10.1186/1472-6874-14-110] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 09/10/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND The frequencies of molecular breast cancer subtypes vary among different human populations. The Northeastern region of Brazil has a mixed population of African, Indigenous and European ancestry. This retrospective study investigated breast cancer subtypes and applied therapies in a public hospital of Northeastern Brazil. METHODS Data of 633 patients with invasive breast cancer from 2005 to 2011 were obtained from medical records. Status of hormone receptor (HR), HER2 and Ki67 expression index of 269 out of 633 patients were used to define subtypes of Luminal A and B, HER2 and triple negative (TN) breast cancer. Expression index of Ki67 ≥ 14% was applied to distinguish Luminal A from Luminal B subtypes. RESULTS Overall, 185 (68.77%) and 132 (49.07%) patients showed positive hormone receptor (HR+) and positive HER2 (HER2+) tumors. The mean age ranged from 53.33 to 58.25 years for patients with tumors of Luminal B and Luminal A subtypes, respectively (p = 0.0182). In general, 67.39% of patients with TN tumors aged over 50 and 19.57% aged between 31 and 40 years (p = 0.0046). The rate of small tumors (T1: ≤ 2.0 cm) varied from 22.73% to 52.46% for TN and Luminal A subtypes (p = 0.0088). The rate of high graded (G3) tumors was increased for HER2 and TN subtypes (35.29% and 34.28%) compared to Luminal A and Luminal B subtypes (3.92% and 12.62%), respectively (p < 0.0001). The five-year survival rate ranged from 92.86% to 75.00%, for Luminal A, HER2 and TN subtypes, respectively (HR: 0.260 to 1.015; 95% CI: 0.043 to 3.594; p = 0.2589). Patients with HER2 positive (HER2+) breast tumors did not receive immunotherapy and chemotherapy application varied from 54.84% to 86.49% for Luminal A and HER2 subtypes, respectively (p = 0.0131). CONCLUSIONS The results of this study revealed a high percentage of HER2+ breast tumors and an increased rate of patients with TN tumors aged over 50 years. This emphasizes the need for establishing immunotherapy as an additional therapeutic option to improve clinical outcomes for patients with HER2+ tumors and to investigate the risk factors of TN breast cancer.
Collapse
Affiliation(s)
| | | | | | | | | | - Mathias Weller
- Programa de Pós-Graduação em Saúde Pública, Universidade Estadual da Paraíba (UEPB), Rua Juvêncio Arruda, S/N Campus Universitário (Bodocongó), CEP, 58,109 - 790 Campina Grande, Paraíba, Brazil.
| |
Collapse
|
26
|
Pérez G, Aranda C, Olivares IM, García JR. [Prevalence of hormonal receptors and human epidermal growth factor receptor 2 in Mexican female patients with breast cancer]. Med Clin (Barc) 2014; 143:231-2. [PMID: 24183125 DOI: 10.1016/j.medcli.2013.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/07/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Gabriel Pérez
- Departamento de Investigación, Hospital General Regional, Tlaneplanta, Estado de México, México
| | - Catalina Aranda
- Departamento de Investigación, Hospital General Regional, Tlaneplanta, Estado de México, México
| | - Ivonne María Olivares
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina-Instituto Politécnico Nacional, México D.F., México
| | - José Rubén García
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina-Instituto Politécnico Nacional, México D.F., México.
| |
Collapse
|
27
|
Bachmann C, Schmidt S, Staebler A, Schittenhelm J, Wallwiener D, Grischke EM. Risk factors and survival outcome in cerebral metastatic breast cancer. Med Oncol 2014; 31:862. [PMID: 24504842 DOI: 10.1007/s12032-014-0862-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/23/2014] [Indexed: 11/26/2022]
Abstract
The development of brain metastases (BM) of primary breast cancer patients leads to limited survival. HER2-positive and triple-negative status are risk factors for the development of BM. Estrogen receptor (ER)/progesterone receptor (PR)/HER2 are important prognostic markers and are essential for effective treatment decisions. We retrospectively analyzed the impact of known risk factors and the outcome after the development of BM. Eighty consecutive patients, treated between January 1, 2001, and June 30, 2012, on the basis of primary non-metastatic operable breast cancer and who developed BM, were enrolled. Clinical parameters (TNM; ER, PR, HER2) and their impact on the occurrence of BM and additionally their prognostic influence after the occurrence of BM were investigated. A small tumor size, ductal histology, grade 3, hormone receptor-negative, triple-negative and HER2+ tumors were associated with BM. Median time from breast cancer diagnosis to BM was 35 months (range 26.2-43.8). Grade 3 versus 2 has significantly negative prognostic impact with earlier development of BM (median 23 vs. 41 months; p=0.033). HER2-positive patients had significantly longer survival after the occurrence of BM than HER2-negative patients (p=0.009). The risk of BM varies significantly by subtype. In high-risk patients, the occurrence of BM must be considered, and possibly, general screening in these patients is warranted. The survival advantage of HER2-positive breast cancer patients compared with HER2-negative patients after the occurrence of BM is possibly explainable by systemic control of disease. Standard of care for patients with BM is whole-brain radiotherapy, with/without surgery, or stereotactic radiosurgery. Perhaps novel therapies may additionally improve survival in these patients.
Collapse
MESH Headings
- Adenocarcinoma, Mucinous/metabolism
- Adenocarcinoma, Mucinous/mortality
- Adenocarcinoma, Mucinous/secondary
- Adult
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/secondary
- Female
- Follow-Up Studies
- Humans
- Immunoenzyme Techniques
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Risk Factors
- Survival Rate
Collapse
Affiliation(s)
- C Bachmann
- Department of Gynecology, University Tübingen, Calwer Str. 7, 72070, Tübingen, Germany,
| | | | | | | | | | | |
Collapse
|
28
|
Krishnaswamy U, Balachandran P, Rajakumar I, Balachandar K, Mansoor M. Correlation of Her-2 neu over-expression with clinico pathological features of carcinoma breast. APOLLO MEDICINE 2013. [DOI: 10.1016/j.apme.2013.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
29
|
|
30
|
Boulos F, Farra CG, Saad Aldin EM, Masaad C, Hassoun Y, Fedda F, Doumiati H, Tawil AN, Nasser Z, Nahleh Z, Tfayli A. Changing frequency of equivocal HER-2/neu scores and factors predictive of negative HER 2/neu fluorescent in situ hybridisation in invasive carcinomas of the breast. J Clin Pathol 2013; 67:204-9. [PMID: 24108431 DOI: 10.1136/jclinpath-2013-201546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Analysis of human epidermal growth factor receptor 2 (HER-2) status has become standard of care in breast cancer patients due to its important prognostic and therapeutic implications. Immunohistochemistry (IHC) is the most commonly used primary method for detection of HER-2 overexpression. Controversy exists on the interpretation of samples that are equivocal for HER 2 status (IHC 2+). Recent guidelines state that samples equivocal for HER 2 status require validation with fluorescent in situ hybridisation (FISH). The use of FISH, however, despite higher accuracy comes at a higher cost that is not affordable to all patients. METHODS This study is a retrospective study conducted at the American University of Beirut Medical Center, including women diagnosed with breast cancer with equivocal IHC scores presenting between 2009 and 2011. We attempted to correlate clinicopathological characteristics of patients diagnosed with breast cancer that can influence conclusions made on HER 2 status when analysing IHC equivocal samples in an effort to decrease the need for FISH testing. 113 patients in our records were included; charts were reviewed for different patient clinical characteristics and samples were analysed for pathological characteristics. RESULTS Using logistic regression, progesterone receptor status and HER-2 staining of the normal glands around the tumour by IHC were the two statistically significant variables that showed association with FISH results. The strength of progesterone receptor status positivity and HER-2 staining of the normal glands around the tumour were proportional to the likelihood of a negative FISH. Also, the presence of strong and diffuse hormone receptor positivity in low-grade tumours was predictive of negative HER-2 status. CONCLUSIONS In countries where resources are strained, oncologists need to think of measures to minimise the increasing financial burden of cancer care. Our study serves to highlight a few clinicopathological characteristics that might eliminate the need for further testing through FISH.
Collapse
Affiliation(s)
- Fouad Boulos
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, , Beirut, Lebanon
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Bachmann C, Grischke EM, Staebler A, Schittenhelm J, Wallwiener D. Receptor change-clinicopathologic analysis of matched pairs of primary and cerebral metastatic breast cancer. J Cancer Res Clin Oncol 2013; 139:1909-16. [DOI: 10.1007/s00432-013-1511-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 08/30/2013] [Indexed: 10/26/2022]
|
32
|
Qiao EQ, Ji M, Wu J, Li J, Xu X, Ma R, Zhang X, He Y, Zha Q, Song X, Zhu L, Tang JH. Joint detection of multiple immunohistochemical indices and clinical significance in breast cancer. Mol Clin Oncol 2013; 1:703-710. [PMID: 24649232 PMCID: PMC3915321 DOI: 10.3892/mco.2013.111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 04/17/2013] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is one of the most common malignancies in women. This study was conducted to analyze the association between the expressions of eight immunohistochemical (IHC) indices and clinicopathological characteristics in breast cancers (BCs) and investigate the clinical significance. IHC Envision ldpe-g-nvp was used to detect the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), p53, type II topoisomerase (TOPO II) and Ki-67 in postoperative paraffin blocks of 286 cases of invasive BC and statistically analyzed their correlations with clinicopathological characteristics. The positive rates of ER, PR, HER2, VEGF, p53, EGFR, TOPO II and Ki-67 expression were 62.24, 41.96, 57.34, 53.85, 81.82, 46.85, 54.55 and 69.93%, respectively. ER expression was negatively correlated with age, tumor size and histological grade (P<0.05) and PR expression was negatively correlated with age and histological grade (P<0.05). Among the ER, PR and c-erbB-2 statuses, a significant correlation was observed between ER expression and PR status (P=0.0000), whereas the expression of ER and PR exhibited a negative correlation with HER2 status (P<0.05). We also demonstrated a significant correlation between EGFR expression and lymph node metastasis (P=0.0240), p53 expression and tumor size (P=0.0300), p53 and Ki-67 expression and histological grade (P<0.05) and the expressions of VEGF, EGFR, p53, TOPO II, Ki-67 and HER2 status (P<0.05). In addition, the Luminal B and HER2/neu subtypes exhibited a close correlation with age (P<0.01), while the HER2/neu and triple-negative subtypes were positively correlated with poor histological grade (P<0.05). In conclusion, there is a definite correlation between IHC indices and clinicopathological characteristics in BCs. Combined detection of these indices may be significant in the evaluation of biological behavior and prognosis of BC and thus in the diagnosis and comprehensive treatment of this disease.
Collapse
Affiliation(s)
- En-Qi Qiao
- Departments of General Surgery, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Minghua Ji
- Radiotherapy, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Jianzhong Wu
- Research Center for Clinical Oncology, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Jian Li
- Departments of General Surgery, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Xinyu Xu
- Department of Pathology, Jiangsu Cancer Hospital, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Rong Ma
- Research Center for Clinical Oncology, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | | | - Yuejun He
- Xuzhou Medical College, Xuzhou, Jiangsu 221000, P.R. China
| | - Quanbin Zha
- Xuzhou Medical College, Xuzhou, Jiangsu 221000, P.R. China
| | - Xue Song
- Departments of General Surgery, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Liwei Zhu
- Departments of General Surgery, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| | - Ji-Hai Tang
- Departments of General Surgery, Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009
| |
Collapse
|
33
|
Cancello G, Maisonneuve P, Rotmensz N, Viale G, Mastropasqua M, Pruneri G, Montagna E, Iorfida M, Mazza M, Balduzzi A, Veronesi P, Luini A, Intra M, Goldhirsch A, Colleoni M. Progesterone receptor loss identifies Luminal B breast cancer subgroups at higher risk of relapse. Ann Oncol 2013; 24:661-8. [DOI: 10.1093/annonc/mds430] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
|
34
|
Dodiya H, Patel A, Patel D, Kaushal A, Vijay DG. Study of hormone receptors and epidermal growth factor expression in invasive breast cancers in a cohort of Western India. Indian J Clin Biochem 2013; 28:403-9. [PMID: 24426244 DOI: 10.1007/s12291-012-0294-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 12/15/2012] [Indexed: 12/19/2022]
Abstract
The objective of study was to evaluate and correlate the pathological characteristics of breast cancer patients with estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2/neu) detected by immunohistochemistry and/or fluorescent in situ hybridization method. We have conducted 2 year study of 204 cases of breast cancer at HCG-Medisurge Hospitals, Ahmedabad from 2009 to 2011. Significant correlation was found in ER and PR expression whereas no correlation was found in hormonal receptors and Her2/neu expression. ER and PR positivity increased with advancing age in breast carcinoma patients while not affecting Her2/neu expression. The expression of hormone receptors were higher in infiltrating lobular carcinoma and infiltrating duct carcinoma subtypes of breast carcinoma as compared to other subtypes such medullary and in situ carcinoma. High-grade carcinoma patients were predominantly ER/PR negative and Her2/neu positive as compared to lower grade breast carcinoma whereas high-stage carcinoma patients were ER/PR positive and Her2/neu positive as compared to lower stage breast carcinoma.
Collapse
Affiliation(s)
- Hardik Dodiya
- Department of Clinical Research and Development, Aastha Oncology Associates, HCG-Medisurge Hospitals Private Limited, Ahmedabad, 380006 Gujarat India
| | - Amit Patel
- Department of Clinical Research and Development, Aastha Oncology Associates, HCG-Medisurge Hospitals Private Limited, Ahmedabad, 380006 Gujarat India
| | - Dipal Patel
- Department of Clinical Research and Development, Aastha Oncology Associates, HCG-Medisurge Hospitals Private Limited, Ahmedabad, 380006 Gujarat India
| | - Ashish Kaushal
- Department of Clinical Research and Development, Aastha Oncology Associates, HCG-Medisurge Hospitals Private Limited, Ahmedabad, 380006 Gujarat India
| | - D G Vijay
- Department of Clinical Research and Development, Aastha Oncology Associates, HCG-Medisurge Hospitals Private Limited, Ahmedabad, 380006 Gujarat India
| |
Collapse
|
35
|
Bachmann C, Grischke EM, Fehm T, Staebler A, Schittenhelm J, Wallwiener D. CNS metastases of breast cancer show discordant immunohistochemical phenotype compared to primary. J Cancer Res Clin Oncol 2012; 139:551-6. [DOI: 10.1007/s00432-012-1358-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 11/23/2012] [Indexed: 10/27/2022]
|
36
|
Prakhya S, Prakash G. Analysis of BRCA1 Gene Rearrangements in Breast Carcinomas by RT-PCR and ER, PR, HER2NEU Status by IHC and HPE Correlation. J Clin Diagn Res 2012; 6:1663-8. [PMID: 23373023 PMCID: PMC3552199 DOI: 10.7860/jcdr/2012/4587.2640] [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: 05/28/2012] [Accepted: 08/24/2012] [Indexed: 11/24/2022]
Abstract
AIM An attempt to analyze invasive ductal carcinomas of the breast, based on the histopathological sub classification and grading, the hormonal status on immunohistochemistry (IHC) and the BRCA1 gene expression. METHODS Fifty patients were selected from the Kancheepuram area on the basis of their admissions to the Surgical Out-Patients Wing of the Meenakshi Medical College and Hospital over a period of 3 years from 2008-2011. RESULTS Among the fifty patients who were selected in the case series, the most common age group was 41-60 years (23 patients). The grade 3 tumours were the commonest. An immunohistochemical evaluation of the hormone receptors revealed most of the tumours to be of the luminal subtype. BRCA1 gene mutation analysis showed that all the 50 cases of breast cancer elaborated an up-regulation of the selected base-pair fragment. CONCLUSION Among the various determinants of breast cancer development, this study proved that age, the histological tumour grade and the immunohistochemical analysis also formed the important factors that aided in the diagnosis of breast cancers and their classifications. Also, genetic studies could provide useful insights by helping in the determination of the presence or the absence of gene mutations, which could revolutionize the treatment. This would be possible by using gene therapy in the future.
Collapse
Affiliation(s)
- Srivatsa Prakhya
- Pathologist, Department of Pathology, Meenakhi Medical College, kanchipuram, India
| | - Geetha Prakash
- Head, Department of Pathology Meenakhi Medical College, kanchipuram, India
| |
Collapse
|
37
|
Pathmanathan N, Provan PJ, Mahajan H, Hall G, Byth K, Bilous AM, Balleine RL. Characteristics of HER2-positive breast cancer diagnosed following the introduction of universal HER2 testing. Breast 2012; 21:724-9. [PMID: 23099207 DOI: 10.1016/j.breast.2012.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 08/17/2012] [Accepted: 09/05/2012] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to determine the impact of universal HER2 testing on the clinico-pathologic profile of HER2+ breast cancer. Data were extracted from breast cancer pathology reports spanning two periods: before (2003/4, n = 379), and after (2008/9, n = 560) the introduction of universal testing. In 2003/4, 43.3% of breast cancers were tested for HER2 with 16% of tested cases HER2+. In 2008/9, 98.4% of cases were tested with 14.7% HER2+. In 2008/9, HER2+ status was associated with younger age, higher grade, increased tumour size, lymph node involvement, negative oestrogen and/or progesterone receptor status. HER2+ cases diagnosed in 2003/4 were not significantly different in respect of these features. The rate of HER2+ breast cancer amongst screen detected cases in 2008/9 was 8.3%. The phenotype of HER2+ breast cancer was stable following the introduction of universal testing. The overall rate of HER2+ breast cancer was influenced by screen detection.
Collapse
Affiliation(s)
- Nirmala Pathmanathan
- Department of Tissue Pathology and Diagnostic Oncology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia.
| | | | | | | | | | | | | |
Collapse
|
38
|
Obr A, Edwards DP. The biology of progesterone receptor in the normal mammary gland and in breast cancer. Mol Cell Endocrinol 2012; 357:4-17. [PMID: 22193050 PMCID: PMC3318965 DOI: 10.1016/j.mce.2011.10.030] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Revised: 09/23/2011] [Accepted: 10/26/2011] [Indexed: 11/21/2022]
Abstract
This paper reviews work on progesterone and the progesterone receptor (PR) in the mouse mammary gland that has been used extensively as an experimental model. Studies have led to the concept that progesterone controls proliferation and morphogenesis of the luminal epithelium in a tightly orchestrated manner at distinct stages of development by paracrine signaling pathways, including receptor activator of nuclear factor κB ligand (RANKL) as a major paracrine factor. Progesterone also drives expansion of stem cells by paracrine signals to generate progenitors required for alveologenesis. During mid-to-late pregnancy, progesterone has another role to suppress secretory activation until parturition mediated in part by crosstalk between PR and prolactin/Stat5 signaling to inhibit induction of milk protein gene expression, and by inhibiting tight junction closure. In models of hormone-dependent mouse mammary tumors, the progesterone/PR signaling axis enhances pre-neoplastic progression by a switch from a paracrine to an autocrine mode of proliferation and dysregulation of the RANKL signaling pathway. Limited experiments with normal human breast show that progesterone/PR signaling also stimulates epithelial cell proliferation by a paracrine mechanism; however, the signaling pathways and whether RANKL is a major mediator remains unknown. Work with human breast cancer cell lines, patient tumor samples and clinical studies indicates that progesterone is a risk factor for breast cancer and that alteration in progesterone/PR signaling pathways contributes to early stage human breast cancer progression. However, loss of PR expression in primary tumors is associated with a less differentiated more invasive phenotype and worse prognosis, suggesting that PR may limit later stages of tumor progression.
Collapse
Affiliation(s)
- Alison Obr
- Departments of Molecular & Cellular Biology and Pathology and Immunology, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Dean P. Edwards
- Departments of Molecular & Cellular Biology and Pathology and Immunology, Baylor College of Medicine, Houston, Texas, 77030, USA
| |
Collapse
|
39
|
Petrelli F, Barni S. Role of HER2-neu as a prognostic factor for survival and relapse in pT1a-bN0M0 breast cancer: a systematic review of the literature with a pooled-analysis. Med Oncol 2012; 29:2586-93. [PMID: 22415399 DOI: 10.1007/s12032-012-0201-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 02/23/2012] [Indexed: 01/03/2023]
Abstract
High levels of human epidermal growth receptor 2 (HER2) expression are associated with recurrence and death in breast cancer (BC) patients. We have performed a systematic review and meta-analysis in order to evaluate the prognosis for HER2+ pT1a-bN0M0 BC patients. A search of PubMed and Embase was performed. Studies were included if they reported hazard ratios (HRs) with a 95% confidence interval (CI) for multivariate analyses of relapse or survival in pT1a-bN0M0, HER2+ BC patients treated with surgery and chemotherapy and/or endocrine therapy, but not with trastuzumab. A total of 764 patients from seven studies were included in the meta-analysis. In the pooled analysis, HER2 had a detrimental effect on relapse-free (HR 4.68, 95% CI 3.05-7.18; p<0.00001) and distant relapse-free survival, with a HR of 5.6 (95% CI 2.65-11.85; p<0.00001). HER2+ status was also linked to increased risk of death (HR 3.4, 95% CI 0.86-13.41; p=0.08) and worst BC-specific survival (HR 2.61, 95% CI 1.51-4.51; p=0.0006), but these data were presented in few studies. HER2+ pT1a-bN0M0 BC is associated with a dismal prognosis. In these patients, HER2 has to be taken into account when deciding on adjuvant therapy, and trastuzumab should be considered.
Collapse
Affiliation(s)
- F Petrelli
- Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio-Caravaggio, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy.
| | | |
Collapse
|
40
|
Mostafa NAE, Eissa SS, Belal DM, Shoman SH. Assessment of Her-2/neu gene amplification status in breast carcinoma with equivocal 2+ Her-2/neu immunostaining. J Egypt Natl Canc Inst 2011; 23:41-6. [PMID: 22099935 DOI: 10.1016/j.jnci.2011.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 02/15/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Amplification of Her-2/neu gene occurs in 25-30% of breast carcinomas. FDA approved trastuzumab (Herceptin) is effective only in tumors having the gene amplification. Immunohistochemistry (IHC) for Her-2/neu protein is widely used but false positive and false negative results exist. Fluorescence in-situ hybridization (FISH) has both excellent sensitivity and specificity in detecting Her-2/neu amplification. Comparative studies have shown discordant results in proportion of cases with equivocal 2+ immunostain. This study is thus conducted to ascertain the frequency of Her-2/neu gene amplification by FISH in breast carcinoma specified as score 2+ by IHC and to correlate these findings with parameters of prognosis in breast cancer. METHODS From October 2008 till May 2010 all paraffin blocks from cases with invasive breast carcinoma which were scored as 2+ by IHC were eligible for the study, there were 50 cases. Immunohistochemical evaluation of Her-2/neu was performed using the HercepTest. All cases were immunohistochemically evaluated for ER and PR. FISH was performed using FDA approved Path-Vysion Her-2/neu/CEP 17 dual color probe. RESULTS Nine cases (18%) out of 50 cases scored as Her-2/neu 2+ by IHC showed true gene amplification with a median value of scoring ratio 4.28 ranging from 2.37 to 13.26. Another two cases showed low level of amplification but when corrected for Her-2/neu/CEP ratio they did not show true amplification as they were associated with polysomy 17. With the exception of tumor size, neither patient's age, histologic grade nor lymph node status were correlated with Her-2/neu gene amplification. Significant inverse correlation existed between Her-2/neu gene amplification and ER (P=0.01), PR status (P<0.001). CONCLUSION Even though FISH is a more complex and expensive procedure, it should be considered the method of choice for assessment of Her-2/neu gene status especially for equivocal cases by IHC that are not accompanied by true gene amplification in the majority of breast carcinoma cases.
Collapse
MESH Headings
- Adult
- Aged
- Breast Neoplasms/diagnosis
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/secondary
- Female
- Gene Amplification
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Lymphatic Metastasis
- Middle Aged
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
Collapse
Affiliation(s)
- Naglaa A E Mostafa
- Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
| | | | | | | |
Collapse
|
41
|
Yu J, Dabbs DJ, Shuai Y, Niemeier LA, Bhargava R. Classical-type invasive lobular carcinoma with HER2 overexpression: clinical, histologic, and hormone receptor characteristics. Am J Clin Pathol 2011; 136:88-97. [PMID: 21685036 DOI: 10.1309/ajcp7uriw0qettat] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The majority of invasive lobular carcinomas (ILCs) express estrogen receptor (ER) and progesterone receptor (PR) but lack ERBB2 (HER2) amplification. HER2 overexpression is traditionally considered to occur in the pleomorphic variant of ILCs. We describe 12 cases of classical-type ILCs with HER2 overexpression in a 3-year period. All tumors displayed the characteristic morphologic features of classical ILC with uniform cells and discohesive growth patterns. The lobular phenotype was confirmed by the absence of E-cadherin staining. Multiple variables regarding clinical, histologic, and hormone receptor characteristics of tumors were evaluated and compared with a set of HER2- classical ILCs. The study identified 2 main pathologic features associated with HER2 overexpression in classical type ILC: histiocytoid morphologic features and absence of PR expression. ER is still expressed in HER2+ classical ILCs, although the level of expression is significantly reduced compared with the HER2- cases. The implications of the findings are discussed.
Collapse
|
42
|
Danese MD, Lalla D, Brammer M, Doan Q, Knopf K. Estimating recurrences prevented from using trastuzumab in HER-2/neu-positive adjuvant breast cancer in the United States. Cancer 2010; 116:5575-83. [PMID: 20734398 DOI: 10.1002/cncr.25347] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 02/16/2010] [Accepted: 03/01/2010] [Indexed: 01/05/2023]
Abstract
BACKGROUND Breast cancer recurrence is associated with significant morbidity, mortality, and cost. Patients with early stage HER2+ tumors are at increased risk of recurrence. The use of trastuzumab for these patients has been shown to reduce recurrences and improve overall survival. METHODS A Monte Carlo simulation was conducted based on Surveillance, Epidemiology, and End Results incidence rates for 2005, United States Census data for 2005, and the results of key trials of the adjuvant use of trastuzumab. Patients included in this analysis had incident, HER2+, stage I to III breast cancer. The number of recurrences that could be prevented with trastuzumab, the cardiac adverse events that might occur, and the associated cost savings were estimated. RESULTS Approximately 31,200 women had HER2+ breast cancer in 2005, of whom 7298 would have had a recurrence over the subsequent 5 years despite standard of care adjuvant treatment. If trastuzumab were added to their regimen, 2791 women might have avoided recurrence, and 948 may have had an asymptomatic or symptomatic cardiac adverse event, for a ratio of expected recurrences to cardiac adverse events of 3.2 (95% confidence interval, 1.5-5.9). In economic terms, avoidance of future breast cancer recurrences was associated with lifetime reduction in future direct and indirect costs on the order of $240 million to $1.7 billion. CONCLUSIONS On the basis of the simulation results, targeting HER2+ tumors with trastuzumab in the adjuvant setting should prevent a significant number of women from recurrence events, with important outcomes for patients, physicians, payers, and society.
Collapse
Affiliation(s)
- Mark D Danese
- Outcomes Insights, Inc., Newbury Park, California, USA.
| | | | | | | | | |
Collapse
|
43
|
Pensa M, Swede H, Brockmeyer JA, Gregorio DI. Patterns of HER2 testing in the management of primary breast cancer. Cancer Epidemiol 2009; 33:113-7. [PMID: 19679057 DOI: 10.1016/j.canep.2009.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 06/19/2009] [Accepted: 06/29/2009] [Indexed: 12/25/2022]
Abstract
BACKGROUND Women with invasive breast cancer should be tested for human epidermal growth factor receptor-2 (HER2) status at the time of diagnosis. To date, no population-based patterns of use studies have examined demographic and clinicopathologic factors associated with decisions by clinicians to test patients. METHODS We reviewed summary pathology reports submitted to the Connecticut Tumor Registry for all Black/African American (B/AA) women (n=644) and a 7% random sample (n=720) of White women diagnosed in 2000-2003 with primary invasive breast carcinoma. Receipt of a HER2 test (yes vs. no) was examined in relation to patient race, age, socioeconomic status, year of diagnosis, estrogen receptor (ER) status, tumor grade, lymph node status, size and stage at diagnosis. RESULTS A greater proportion of tumors from B/AA patients were tested compared to those of White women (69.5% vs. 61.9%, p<0.05). Tumors of patients under the age of 60 were 1.50-times more likely than older women to have been tested, and B/AA women were 1.40-times more likely than White patients to be tested. HER2 testing was more likely to be observed when information also was reported about ER status (OR=15.9, p<0.001), tumor grade (OR=2.28, p<0.05), tumor size (OR=2.16, p<0.05), and lymph node status (OR=2.06, p<0.05). CONCLUSIONS Variation in which breast cancer patients received HER2 testing appears to reflect expectations about a woman's prognosis. Discrepancies in receipt of testing deserve further study as current guidelines call for all tumors to be assessed in order to adequately characterize prognosis and determine eligibility for HER2-targeted therapy.
Collapse
Affiliation(s)
- Mellisa Pensa
- Department of Community Medicine & Health Care, University of Connecticut School of Medicine, Farmington, CT 06030-6325, USA
| | | | | | | |
Collapse
|
44
|
Ross JS, Slodkowska EA, Symmans WF, Pusztai L, Ravdin PM, Hortobagyi GN. The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist 2009; 14:320-68. [PMID: 19346299 DOI: 10.1634/theoncologist.2008-0230] [Citation(s) in RCA: 816] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The human epidermal growth factor receptor (HER-2) oncogene encodes a transmembrane tyrosine kinase receptor that has evolved as a major classifier of invasive breast cancer and target of therapy for the disease. The validation of the general prognostic significance of HER-2 gene amplification and protein overexpression in the absence of anti-HER-2 targeted therapy is discussed in a study of 107 published studies involving 39,730 patients, which produced an overall HER-2-positive rate of 22.2% and a mean relative risk for overall survival (OS) of 2.74. The issue of HER-2 status in primary versus metastatic breast cancer is considered along with a section on the features of metastatic HER-2-positive disease. The major marketed slide-based HER-2 testing approaches, immunohistochemistry, fluorescence in situ hybridization, and chromogenic in situ hybridization, are presented and contrasted in detail against the background of the published American Society of Clinical Oncology-College of American Pathologists guidelines for HER-2 testing. Testing issues, such as the impact of chromosome 17 polysomy and local versus central HER-2 testing, are also discussed. Emerging novel HER-2 testing techniques, including mRNA-based testing by real-time polymerase chain reaction and DNA microarray methods, HER-2 receptor dimerization, phosphorylated HER-2 receptors, and HER-2 status in circulating tumor cells, are also considered. A series of biomarkers potentially associated with resistance to trastuzumab is discussed with emphasis on the phosphatase and tensin homologue deleted on chromosome ten/Akt and insulin-like growth factor receptor pathways. The efficacy results for the more recently approved small molecule HER-1/HER-2 kinase inhibitor lapatinib are also presented along with a more limited review of markers of resistance for this agent. Additional topics in this section include combinations of both anti-HER-2 targeted therapies together as well as with novel agents including bevacizumab, everolimus, and tenespimycin. A series of novel HER-2-targeting agents is also presented, including pertuzumab, ertumaxomab, HER-2 vaccines, and recently discovered tyrosine kinase inhibitors. Biomarkers predictive of HER-2 targeted therapy toxicity are included, and the review concludes with a consideration of HER-2 status in the prediction of response to non-HER-2 targeted treatments including hormonal therapy, anthracyclines, and taxanes.
Collapse
Affiliation(s)
- Jeffrey S Ross
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY 12208, USA.
| | | | | | | | | | | |
Collapse
|
45
|
Kim SH, Seo BK, Lee J, Kim SJ, Cho KR, Lee KY, Je BK, Kim HY, Kim YS, Lee JH. Correlation of ultrasound findings with histology, tumor grade, and biological markers in breast cancer. Acta Oncol 2008; 47:1531-8. [PMID: 18607848 DOI: 10.1080/02841860801971413] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE Ultrasound has been used successfully to differentiate benign and malignant breast lesions. The aim of this study was to investigate the correlation between ultrasound and prognostic indicators in breast cancer such as histological type, tumor grade, and biological markers. MATERIALS AND METHODS Ultrasound findings (shape, margin, orientation, boundary, echo pattern, posterior acoustic feature, and presence of calcifications) of 458 breast cancers were analyzed and correlated with the tumor type, tumor grade, and biological markers by univariate and multivariate logistic regression analyses. The biological markers were estrogen receptor, progesterone receptor, and HER-2/neu. RESULTS Invasive cancers displayed more frequently an irregular shape, a not parallel orientation, and a hypoechoic or complex echo pattern than carcinoma in situ cases (p < 0.05). Poorly differentiated invasive cancers had more frequently not circumscribed margins, an abrupt boundary, and a hypoechoic or complex echo pattern than moderately/well differentiated cancers (p < 0.05). Estrogen or progesterone receptor negative cancers more often displayed a hypoechoic or complex echo pattern and HER-2/neu positive cancers had more calcifications (p < 0.05). CONCLUSION Ultrasound pattern is correlated with tumor type, tumor grade, and biological markers in breast cancers and it may be useful for prediction of prognosis.
Collapse
|
46
|
Ayadi L, Khabir A, Amouri H, Karray S, Dammak A, Guermazi M, Boudawara T. Correlation of HER-2 over-expression with clinico-pathological parameters in Tunisian breast carcinoma. World J Surg Oncol 2008; 6:112. [PMID: 18945339 PMCID: PMC2577672 DOI: 10.1186/1477-7819-6-112] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Accepted: 10/22/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast carcinoma is a disease with a tremendous heterogeneity in its clinical behavior. Newer prognostic factors and predictors of response to therapy are needed. The aim of this study was to evaluate the expression of HER-2, estrogen receptor (ER) and progesterone receptors (PR) in breast carcinoma and to compare it with other prognostic parameters such as histological type and grade, tumor size, patients' age, and lymph node metastases. PATIENTS AND METHODS This is a retrospective study conducted in the department of pathology at Sfax University Hospital. Confirmed 155 Cases of breast carcinoma were reviewed in the period between January 2000 and December 2004. We used immunohistochemistry to evaluate the expression of HER-2, ER, and PR receptor and Chi-square and Fisher exact test to correlate immunohistochemical findings with prognostic parameters for breast carcinoma such as patients' age, tumor size, histological type, histological grade and lymph node status. RESULTS The mean age of patients was 51.5 years, ranging from 22 to 89 years. 80 (51.6%) of the patients were below 50 years. The percentage of expression of HER-2, ER and PR was 26, 59.4, and 52.3%, respectively. HER-2 was over-expressed (3+) in 18.1% of the cases, was inversely related to ER expression (p = 0.00) and to PR expression (p = 0.048). This over-expression was also associated with a high tumor grade with marginal significance (p = 0.072). A negative correlation was noted between ER and PR expression and SBR grade (p = 0.000) and ER and age (p = 0.002). CONCLUSION HER-2 over-expression was observed in 18.1% of Tunisian breast carcinoma affecting female patients. This group presents apparently an aggressive form of breast carcinoma with high histological grade and negative ER.
Collapse
Affiliation(s)
- Lobna Ayadi
- Department of Pathology, Habib Bourguiba University Hospital, Sfax, Tunisia.
| | | | | | | | | | | | | |
Collapse
|
47
|
Mersin H, Yildirim E, Berberoglu U, Gülben K. The prognostic importance of triple negative breast carcinoma. Breast 2008; 17:341-6. [PMID: 18450442 DOI: 10.1016/j.breast.2007.11.031] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Revised: 11/10/2007] [Accepted: 11/22/2007] [Indexed: 02/07/2023] Open
Abstract
There is a current debate on whether triple negative breast carcinomas (estrogen receptor--ER-negative, progesterone receptor--PR-negative and HER2-negative) have a poor prognosis. Our aim in this retrospective study was to determine whether triple negative feature is a prognostic factor for disease-free survival (DFS) in 322 breast carcinoma patients, of whom 80 (24.8%) had triple negative tumor histology. In the multivariate analysis, tumor subgroup (triple vs non-triple, p<0.0001; hazard ratio [HR], 4.2; 95% confidence interval [95%CI], 2.2-8.2) was a significant factor related to relapse, in addition to number of metastatic nodes (>4 vs <or=4, p=0.04; HR, 1.6; 95%CI, 1.2-2.4), lymphatic vascular invasion (yes vs no, p=0.002; HR, 2.0; 95%CI, 1.3-3.1) and HER2 (positive vs negative, p<0.0001; HR, 5.9; 95%CI, 3.0-10.0). This result indicated that patients with triple negative histology had a poor disease-free survival and this histology was an independent significant prognostic factor for DFS.
Collapse
Affiliation(s)
- Hakan Mersin
- Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | | | | | | |
Collapse
|
48
|
Implications of applied research for prognosis and therapy of breast cancer. Crit Rev Oncol Hematol 2008; 65:223-34. [PMID: 18243013 DOI: 10.1016/j.critrevonc.2007.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Revised: 10/19/2007] [Accepted: 11/30/2007] [Indexed: 11/23/2022] Open
Abstract
Breast cancer is the one of leading causes of cancer-related deaths in women within economically developed regions of the world. The heterogeneity of the natural history of breast cancer complicates patient management in that there is tremendous variability in response to treatment and for survival. More recently, several biomarkers (hormone receptor status and HER2 expression) have been added to the risk evaluation and therapeutic assessments. Evolving knowledge of molecular biology and newer techniques, such as genomics and proteomics, offer the potential to better define the biologic nature of the disease process, both for risk and therapy. This review discusses classical as well as new prognostic and predictive techniques. These are leading to a paradigm shift from empirical treatment to an individually tailored approach, which may soon become a realistic option for patients, based on specific molecular profiles.
Collapse
|
49
|
Axillary lymph node status of operable breast cancers by combined steroid receptor and HER-2 status: triple positive tumours are more likely lymph node positive. Breast Cancer Res Treat 2008; 113:181-7. [DOI: 10.1007/s10549-008-9914-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Accepted: 01/22/2008] [Indexed: 01/24/2023]
|
50
|
HER2 in well differentiated breast cancer: is testing necessary? Breast Cancer Res Treat 2008; 112:551-6. [DOI: 10.1007/s10549-008-9893-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 01/02/2008] [Indexed: 12/11/2022]
|