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Fernandes U, Guidi G, Martins D, Vieira B, Leal C, Marques C, Freitas F, Dupont M, Ribeiro J, Gomes C, Marques R, Avelar P, Esteves AS, Pinto-de-Sousa J. Breast cancer in young women: a rising threat: A 5-year follow-up comparative study. Porto Biomed J 2023; 8:e213. [PMID: 37362019 PMCID: PMC10289488 DOI: 10.1097/j.pbj.0000000000000213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Breast cancer in young women is usually considered as breast cancer occurring in women younger than 40 years and is the most frequent cancer-related cause of death in these patients. In the past few years, there seems to be an increasing trend in the prevalence of breast cancer in young women, which, associated with poorer prognosis, more aggressive histologic features, and more frequent recurrence rates, makes it a rising threat to young women. This study aimed to evaluate the biological behavior of breast cancer in young women in our institution. Material and methods A retrospective, unicentric, cohort study was conducted between 2012 and 2016. All consecutive patients with breast cancer were enrolled in the study. Cases were divided into two groups: case group, those younger than 40 years, and control group, those 40 years or older. The exclusion criterion was nonoperative treatment. Several clinical and pathologic parameters were evaluated, as well as were overall survival time and disease-free survival time. Results The incidence of breast cancer in young women presented a rising tendency over the study period. Significant differences were observed in the comparison of the groups according to body mass index, age at menarche, age at birth of the first child, and proliferation rate. There were no differences in overall survival and disease-free survival rates between the groups. Conclusions Young women had a more symptomatic presentation, a greater tumor proliferation rate, but similar outcomes compared with older patients. Greater multicentric studies are needed to confirm or refute these results.
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Affiliation(s)
- Urânia Fernandes
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Gonçalo Guidi
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Daniela Martins
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Bruno Vieira
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Clara Leal
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Carolina Marques
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Francisca Freitas
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Margarida Dupont
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Juliana Ribeiro
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Carina Gomes
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Rita Marques
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Paulo Avelar
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Ana Sofia Esteves
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - João Pinto-de-Sousa
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
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Dufour O, Houvenaeghel G, Classe JM, Cohen M, Faure C, Mazouni C, Chauvet MP, Jouve E, Darai E, Azuar AS, Gimbergues P, Gonçalves A, de Nonneville A. Early breast cancer in women aged 35 years or younger: A large national multicenter French population-based case control-matched analysis. Breast 2023; 68:163-172. [PMID: 36774756 PMCID: PMC9945754 DOI: 10.1016/j.breast.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND There is a scarcity of data exploring early breast cancer (eBC) in very young patients. We assessed shared and intrinsic prognostic factors in a large cohort of patients aged ≤35, compared to a control group aged 36 to 50. METHODS Patients ≤50 were retrospectively identified from a multicentric cohort of 23,134 eBC patients who underwent primary surgery between 1990 and 2014. Multivariate Cox analyses for DFS and OS were built. To assess the independent impact of age, 1 to 3 case-control analysis was performed by matching ≤35 and 36-50 years patients. RESULTS Of 6481 patients, 556 were aged ≤35, and 5925 from 36 to 50. Age ≤35 was associated with larger tumors, higher grade, ER-negativity, macroscopic lymph node involvement (pN + macro), lymphovascular invasion (LVI), mastectomy, and chemotherapy (CT) use. In multivariate analysis, age ≤35 was associated with worse DFS [HR 1.56, 95% CI 1.32-1.84; p < 0.001], and OS [HR 1.29, 95% CI 1.03-1.60; p = 0.025], as were high grade, large tumor, LVI, pN + macro, ER-negativity, period of diagnostic, and absence of ET or CT (for DFS). Adverse prognostic impact of age ≤35 was maintained in the case control-matched analysis for DFS [HR 1.56, 95%CI 1.28-1.91, p < 0.001], and OS [HR 1.33, 95%CI 1.02-1.73, p = 0.032]. When only considering patients ≤35, ER, tumor size, nodal status, and LVI were independently associated with survival in this subgroup. CONCLUSIONS Age ≤35 is associated with less favorable presentation and more aggressive treatment strategies. Our results support the poor prognosis value of young age, which independently persisted when adjusting for other prognostic factors and treatments.
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Affiliation(s)
- Ondine Dufour
- Institut Paoli-Calmettes, CRCM, Département d'Oncologie Médicale, CNRS, Aix-Marseille Université, Marseille, France
| | - Gilles Houvenaeghel
- Institut Paoli-Calmettes, CRCM, Département de Chirurgie Oncologique, CNRS, Aix-Marseille Université, Marseille, France
| | - Jean-Marc Classe
- Institut René Gauducheau, Site Hospitalier Nord, St Herblain, France
| | - Monique Cohen
- Institut Paoli-Calmettes, CRCM, Département de Chirurgie Oncologique, CNRS, Aix-Marseille Université, Marseille, France
| | | | - Chafika Mazouni
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, France
| | | | - Eva Jouve
- Centre Claudius Regaud, 20-24 Rue du Pont St Pierre, Toulouse, France
| | - Emile Darai
- Hôpital Tenon, 4 Rue de la Chine, Paris, France
| | | | | | - Anthony Gonçalves
- Institut Paoli-Calmettes, CRCM, Département d'Oncologie Médicale, CNRS, Aix-Marseille Université, Marseille, France
| | - Alexandre de Nonneville
- Institut Paoli-Calmettes, CRCM, Département d'Oncologie Médicale, CNRS, Aix-Marseille Université, Marseille, France.
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Sudhir R, Sannapareddy K, Potlapalli A, Penmetsa V. Clinico-radio-pathological Features and Biological Behavior of Breast Cancer in Young Indian Women: A Prospective Study. Indian J Radiol Imaging 2021; 31:323-332. [PMID: 34556915 PMCID: PMC8448222 DOI: 10.1055/s-0041-1734342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aims The aim of the study is to evaluate the characteristic imaging features of breast cancer on mammogram, ultrasound, and magnetic resonance imaging (MRI) in women less than 40 years of age and to assess the degree of correlation between clinico-radio-pathological features and biological behavior. Methods and Materials A prospective observational study on consecutive women under 40 years of age evaluated with ultrasound of breast, digital mammogram, or contrast-enhanced breast MRI, diagnosed with breast cancer on histopathology and molecular analysis done at our center between January and December 2019 were included. Patient demographics, clinical presentation, family history, BRCA mutation status, imaging, pathological findings, and molecular status were determined. Results Out of 2,470 women diagnosed with breast cancer, 354 (14.3%) were less than 40 years of age who were included in this study. Mammography showed positive findings in 85%, ultrasonography in 94.3%, and MRI in 96.4% of women. Majority of the women (69.6%) presented in the late stage (Stage III and IV) with high-grade carcinoma in 39.5% and triple-negative breast cancer (TNBC) in 45.7%. Tumors with human epidermal growth factor-2neu expression were associated with the presence of microcalcifications ( p -value = 0.006), and TNBC with circumscribed margins or BI-RADS 3/4a category on imaging ( p -value = 0.007) and high-grade invasive carcinoma compared with others ( p -value <0.0001). Conclusion The incidence of breast cancer in Indian women less than 40 years of age is relatively high as compared with the West. The detection of breast cancer in young women remains challenging due to dense breast tissue, lower incidence rate, and lack of regular breast screening. While ultrasound is the recommended imaging method for evaluation of breast under the age of 40 years, we found a better characterization of lesions and higher cancer detection rates when they were also evaluated with mammography and MRI.
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Affiliation(s)
- Rashmi Sudhir
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Kamala Sannapareddy
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Alekya Potlapalli
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
| | - Vidhatri Penmetsa
- Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
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Bahl M, Pinnamaneni N, Mercaldo S, McCarthy AM, Lehman CD. Digital 2D versus Tomosynthesis Screening Mammography among Women Aged 65 and Older in the United States. Radiology 2019; 291:582-590. [PMID: 30938625 DOI: 10.1148/radiol.2019181637] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Although breast cancer incidence and mortality rates increase with advancing age, there are limited data on the benefits and risks of screening mammography in older women and on the performance of two-dimensional digital mammography (DM) and digital breast tomosynthesis (DBT) in older women. Purpose To compare performance metrics of DM and DBT among women aged 65 years and older. Materials and Methods For this retrospective study, consecutive screening mammograms in patients aged 65 years and older from March 2008 to February 2011 (DM group) and from January 2013 to December 2015 (DBT group) were reviewed. Cancer detection rate, abnormal interpretation rate, positive predictive values, sensitivity, and specificity were calculated. Multivariable logistic regression models were fit to compare performance metrics in the DM versus DBT groups. Results The DM group had 15 019 women (mean age ± standard deviation, 72.7 years ± 6.3), and the DBT group had 20 646 women (mean age, 72.1 years ± 5.9). After adjusting for multiple variables, there was no difference in cancer detection rate between the DM and DBT groups (6.9 vs 8.2 per 1000 examinations; adjusted odds ratio [AOR], 1.13; P = .23). Compared with the DM group, the DBT group had a lower abnormal interpretation rate (5.7% vs 5.8%; AOR, 0.88; P < .001), higher positive predictive value 1 (14.5% vs 11.9%; AOR, 1.26; P = .03), and higher specificity (95.1% vs 94.8%; AOR, 1.18; P < .001). The DBT group had a higher proportion of invasive cancers relative to in situ cancers (81.1% vs 74.4%; P = .06) and fewer node-positive cancers (10.2% vs 16.6%; P = .054) than did the DM group. Conclusion In women aged 65 years and older, integration of digital breast tomosynthesis led to improved performance metrics, with a lower abnormal interpretation rate, higher positive predictive value 1, and higher specificity. © RSNA, 2019 See also the editorial by Philpotts and Durand in this issue.
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Affiliation(s)
- Manisha Bahl
- From the Department of Radiology (M.B., N.P., C.D.L.), Institute for Technology Assessment (S.M.), and Department of Medicine (A.M.M.), Massachusetts General Hospital, 55 Fruit St, WAC 240, Boston, MA 02114
| | - Niveditha Pinnamaneni
- From the Department of Radiology (M.B., N.P., C.D.L.), Institute for Technology Assessment (S.M.), and Department of Medicine (A.M.M.), Massachusetts General Hospital, 55 Fruit St, WAC 240, Boston, MA 02114
| | - Sarah Mercaldo
- From the Department of Radiology (M.B., N.P., C.D.L.), Institute for Technology Assessment (S.M.), and Department of Medicine (A.M.M.), Massachusetts General Hospital, 55 Fruit St, WAC 240, Boston, MA 02114
| | - Anne Marie McCarthy
- From the Department of Radiology (M.B., N.P., C.D.L.), Institute for Technology Assessment (S.M.), and Department of Medicine (A.M.M.), Massachusetts General Hospital, 55 Fruit St, WAC 240, Boston, MA 02114
| | - Constance D Lehman
- From the Department of Radiology (M.B., N.P., C.D.L.), Institute for Technology Assessment (S.M.), and Department of Medicine (A.M.M.), Massachusetts General Hospital, 55 Fruit St, WAC 240, Boston, MA 02114
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Cormedi MCV, Lopes EFDT, Maistro S, Roela RA, Folgueira MAAK. Clinical stage and histological type of the most common carcinomas diagnosed in young adults in a reference cancer hospital. Clinics (Sao Paulo) 2018; 73:e656s. [PMID: 30281704 PMCID: PMC6131219 DOI: 10.6061/clinics/2018/e656s] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/12/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Cancer in young adults represents a great challenge, both biologically and socially, and understanding the unique characteristics of neoplasms in this age group is important to improving care. We aimed to evaluate the most common carcinomas and their characteristics, such as histological type and clinical stage, in young adults in the largest cancer hospital in Latin America. METHODS The hospital registry was consulted for the period between 2008 and 2014. Young adults were defined as individuals aged 18 to 39 years, and older adults were defined as individuals aged 40 years and older. Differences between age groups were assessed through chi-square tests. RESULTS Of the 39,389 patients included, 3,821 (9.7%) were young adults. Among the young adults, the most frequent cancer types were the following: breast, lymph node, colorectal, thyroid, testicle, hematopoietic and reticuloendothelial, uterine cervix, brain, soft tissue and stomach; these sites accounted for 74.5% of the observed tumors. Breast, colorectal and stomach cancers were more frequently diagnosed at advanced stages in young adults than in older adults (p<0.001). The most common histological types were infiltrating ductal carcinoma (86.12%) for breast cancer, adenocarcinomas not otherwise specified (45.35%) for colorectal cancer, squamous cell carcinoma not otherwise specified (65.26%) for uterine cervix cancer, signet ring cell adenocarcinomas (49.32%) for stomach cancer and adenocarcinomas not otherwise specified (50.79%) for lung cancer. CONCLUSION Young adults are diagnosed with cancer at more advanced stages, indicating that health professionals should be aware of cancer incidence in this age group. It is necessary to develop a better understanding of cancer in young adults and to implement dedicated health care strategies for these patients.
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Affiliation(s)
- Marina Candido Visontai Cormedi
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Edia Filomena Di Tullio Lopes
- Registro Hospitalar de Câncer, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Simone Maistro
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rosimeire Aparecida Roela
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Maria Aparecida Azevedo Koike Folgueira
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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Greally M, Kielty J, Watson GA, Das G, Malouf C, McSorley L, Coleman N, Quinn C, McDermott EW, Gullo G, Crown J, Prichard RS, Kelly CM, Walshe JM. Where youth matters-clinicopathologic characteristics and emerging trends in treatment and outcomes in young Irish women with breast cancer. Ir J Med Sci 2018; 188:59-67. [PMID: 29766409 DOI: 10.1007/s11845-018-1832-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/02/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Young women with breast cancer (YWBC) represent 7-12% of breast cancer diagnoses and ostensibly have more biologically aggressive subtypes with higher relapse and mortality rates. We studied the clinical and pathological characteristics in YWBC and examined how outcomes and treatment have evolved. METHODS YWBC were identified from pathology databases at two tertiary centers. Patients were divided into two cohorts: those diagnosed from 2000 to 2005 (C1) and from 2006 to 2015 (C2). Data were retrieved from clinical, radiology, and histology databases. Statistical analysis was performed using R® (V3.2.0). RESULTS We identified 345 patients. Median age was 36 years (23-39 years). Mastectomy was performed in 232 patients (67.2%) and axillary lymph node clearance (ALNC) in 207 patients (60% [C1 82.7 vs. C2: 49.4%, p < 0.001]). One hundred-seventy patients (49%) were ER + HER2-, 88 (25.5%) were HER2+, and 58 (16.8%) were triple negative. Eighty patients (23.2%) received neoadjuvant therapy. Pathological complete response rates were statistically similar between C1 and C2 [C1 1 (0.9%) vs C2 16 (6.8%) p = 0.1]. Distant relapse occurred in 59 (19%) patients. There was a higher relapse rate (RR) in C1 [27 (32.1%) vs. 32 (15.7%), p < 0.002). HER2+ and ER+ HER2- patients in C1 had higher RRs than C2. Median overall survival in patients with metastatic disease was 29 months (range 2-119 months). CONCLUSION Locally advanced disease was more prevalent in YWBC. Mastectomy and ALNC rates were high and most received multimodal treatment. The extent of axillary surgery declined over time. Outcomes were unchanged in triple negative patients. These remain a priority for research.
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Affiliation(s)
- Megan Greally
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland. .,Gastrointestinal Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Jennifer Kielty
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Geoffrey A Watson
- Department of Medical Oncology, Mater Misercordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Geoffrey Das
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Christina Malouf
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Lynda McSorley
- Department of Medical Oncology, Mater Misercordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Niamh Coleman
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Cecily Quinn
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Enda W McDermott
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Giuseppe Gullo
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - John Crown
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Ruth S Prichard
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Catherine M Kelly
- Department of Medical Oncology, Mater Misercordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Janice M Walshe
- Department of Medical Oncology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
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Harrell JC, Shroka TM, Jacobsen BM. Estrogen induces c-Kit and an aggressive phenotype in a model of invasive lobular breast cancer. Oncogenesis 2017; 6:396. [PMID: 29176653 PMCID: PMC5868054 DOI: 10.1038/s41389-017-0002-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/09/2017] [Accepted: 08/28/2017] [Indexed: 11/09/2022] Open
Abstract
Among the molecular subtypes of breast cancer are luminal (A or B) estrogen receptor positive (ER+), HER2+, and triple negative (basal-like). In addition to the molecular subtypes, there are 18 histologic breast cancer subtypes classified on appearance, including invasive lobular breast carcinoma (ILC), which are 8-15% of all breast cancers and are largely ER+ tumors. We used a new model of ER+ ILC, called BCK4. To determine the estrogen regulated genes in our ILC model, we examined BCK4 xenograft tumors from mice supplemented with or without estrogen using gene expression arrays. Approximately 3000 genes were regulated by estrogen in vivo. Hierarchical cluster analyses of the BCK4 derived tumors compared with ER+ and ER- breast cancer cell lines show the estrogen treated BCK4 tumors group with ER- breast cancers most likely due to a high proliferation score, while tumors from cellulose supplemented mice were more related to ER+ breast tumor cells. To elucidate genes regulated in vitro by estrogen in BCK4 cells, we performed expression profiling using Illumina arrays of the BCK4 cell line, treated with or without estrogen in vitro. A set of ~200 overlapping genes were regulated by estrogen in the BCK4 cell line and xenograft tumors, and pathway analysis revealed that the c-Kit pathway might be a target to reduce estrogen-induced proliferation. Subsequent studies found that inhibition of c-Kit activity using imatinib mesylate (Gleevec®) blocked estrogen mediated stimulation of BCK4 tumors and BCK4 cells in vitro as effectively as the anti-estrogen fulvestrant (Faslodex®). Decreased expression of c-Kit using shRNA also decreased baseline and estrogen induced proliferation in vitro and in vivo. These studies are the first to indicate that c-Kit inhibition is an effective approach to target c-Kit+ ILC.
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Affiliation(s)
- J Chuck Harrell
- Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas M Shroka
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Britta M Jacobsen
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, 80045, USA.
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, 80045, USA.
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Coelho RG, Calaça IC, Celestrini DM, Correia-Carneiro AHP, Costa MM, Zancan P, Sola-Penna M. Hexokinase and phosphofructokinase activity and intracellular distribution correlate with aggressiveness and invasiveness of human breast carcinoma. Oncotarget 2016; 6:29375-87. [PMID: 26320188 PMCID: PMC4745733 DOI: 10.18632/oncotarget.4910] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/27/2015] [Indexed: 01/01/2023] Open
Abstract
Glycolytic enzymes, such as hexokinase and phosphofructokinase, have been reported to be upregulated in many cancer types. Here, we evaluated these two enzymes in 54 breast cancer samples collected from volunteers subjected to mastectomy, and the results were correlated with the prognosis markers commonly used. We found that both enzymes positively correlate with the major markers for invasiveness and aggressiveness. For invasiveness, the enzymes activities increase in parallel to the tumor size. Moreover, we found augmented activities for both enzymes when the samples were extirpated from patients presenting lymph node involvement or occurrence of metastasis. For aggressiveness, we stained the samples for the estrogen and progesterone receptors, HER-2, p53 and Ki-67. The enzyme activities positively correlated with all markers but Ki-67. Finally, we conclude that these enzymes are good markers for breast cancer prognosis.
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Affiliation(s)
- Raquel G Coelho
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.,Instituto de Bioquímica Médica Leopoldo De Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.,Present address: Laboratório de Fisiologia Endócrina Doris Rosenthal (LFE), Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Isadora C Calaça
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Deborah M Celestrini
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Mauricio M Costa
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Patricia Zancan
- Laboratório de Oncobiologia Molecular (LabOMol), Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Mauro Sola-Penna
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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10
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Breast cancer in young women: Pathologic features and molecular phenotype. Breast 2016; 29:109-16. [PMID: 27479041 DOI: 10.1016/j.breast.2016.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Controversy exists about the prognosis of breast cancer in young women. Our objective was to describe clinicopathological and prognostic features to improve adjuvant treatment indications. METHODS We conducted a retrospective multi centre study including fifteen French hospitals. Disease-free survival's data, clinical and pathological criteria were collected. RESULTS 5815 patients were included, 15.6% of them where between 35 and 40 years old and 8.7% below 35. In 94% of the cases, a palpable masse was found in patients ≤35 years old. Triple negative and HER2 tumors were predominantly found in patients ≤35 (22.2% and 22.1%, p < 0.01). A young age ≤40 years (p < 0.001; hazard ratio [HR]: 2.05; 95% confidence limit [CL]: 1.60-2.63) or ≤35 years (p < 0.001; [HR]: 3.86; 95% [CL]: 2.69-5.53) impacted on the indication of chemotherapy. Age ≤35 (p < 0.001; [HR]: 2.01; 95% [CL]: 1.36-2.95) was a significantly negative factor on disease-free survival. Chemotherapy (p < 0.006; [HR]: 0.6; 95% [CL]: 0.40-0.86) and positive hormone receptor status (p < 0.001; [HR]: 0.6; 95% [CL]: 0.54-0.79) appeared to be protector factors. Patients under 36, had a significantly higher rate of local recurrence and distant metastasis compared to patients >35-40 (21.5 vs. 15.4% and 21.8 vs. 12.6%, p < 0.01). CONCLUSION Young women present a different distribution of molecular phenotypes with more luminal B and triple negative tumors with a higher grade and more lymph node involvement. A young age, must be taken as a pejorative prognostic factor and must play a part in indication of adjuvant therapy.
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Bastos EP, Brentani H, Pereira CAB, Polpo A, Lima L, Puga RD, Pasini FS, Osorio CABT, Roela RA, Achatz MI, Trapé AP, Gonzalez-Angulo AM, Brentani MM. A Set of miRNAs, Their Gene and Protein Targets and Stromal Genes Distinguish Early from Late Onset ER Positive Breast Cancer. PLoS One 2016; 11:e0154325. [PMID: 27152840 PMCID: PMC4859528 DOI: 10.1371/journal.pone.0154325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/12/2016] [Indexed: 01/16/2023] Open
Abstract
UNLABELLED Breast cancer (BC) in young adult patients (YA) has a more aggressive biological behavior and is associated with a worse prognosis than BC arising in middle aged patients (MA). We proposed that differentially expressed miRNAs could regulate genes and proteins underlying aggressive phenotypes of breast tumors in YA patients when compared to those arising in MA patients. OBJECTIVE Using integrated expression analyses of miRs, their mRNA and protein targets and stromal gene expression, we aimed to identify differentially expressed profiles between tumors from YA-BC and MA-BC. METHODOLOGY AND RESULTS Samples of ER+ invasive ductal breast carcinomas, divided into two groups: YA-BC (35 years or less) or MA-BC (50-65 years) were evaluated. Screening for BRCA1/2 status according to the BOADICEA program indicated low risk of patients being carriers of these mutations. Aggressive characteristics were more evident in YA-BC versus MA-BC. Performing qPCR, we identified eight miRs differentially expressed (miR-9, 18b, 33b, 106a, 106b, 210, 518a-3p and miR-372) between YA-BC and MA-BC tumors with high confidence statement, which were associated with aggressive clinicopathological characteristics. The expression profiles by microarray identified 602 predicted target genes associated to proliferation, cell cycle and development biological functions. Performing RPPA, 24 target proteins differed between both groups and 21 were interconnected within a network protein-protein interactions associated with proliferation, development and metabolism pathways over represented in YA-BC. Combination of eight mRNA targets or the combination of eight target proteins defined indicators able to classify individual samples into YA-BC or MA-BC groups. Fibroblast-enriched stroma expression profile analysis resulted in 308 stromal genes differentially expressed between YA-BC and MA-BC. CONCLUSION We defined a set of differentially expressed miRNAs, their mRNAs and protein targets and stromal genes that distinguish early onset from late onset ER positive breast cancers which may be involved with tumor aggressiveness of YA-BC.
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Affiliation(s)
- E. P. Bastos
- Oncology and Radiology Department, Laboratory of Medical Investigation 24 (LIM 24), University of Sao Paulo, Medical School, São Paulo, Brazil
| | - H. Brentani
- Laboratory of Medical Investigation 23 (LIM 23), Institute and Department of Psychiatry, University of Sao Paulo, Medical School, São Paulo, Brazil
| | - C. A. B. Pereira
- Mathematics and Statistic Institute, University of Sao Paulo, São Paulo, Brazil
| | - A. Polpo
- Department of Statistics, Federal University of Sao Carlos, São Paulo, Brazil
| | - L. Lima
- Laboratory of Medical Investigation 23 (LIM 23), Institute and Department of Psychiatry, University of Sao Paulo, Medical School, São Paulo, Brazil
| | | | - F. S. Pasini
- Oncology and Radiology Department, Laboratory of Medical Investigation 24 (LIM 24), University of Sao Paulo, Medical School, São Paulo, Brazil
| | - C. A. B. T. Osorio
- Department of Pathology of A.C. Camargo Cancer Center, São Paulo, Brazil
| | - R. A. Roela
- Oncology and Radiology Department, Laboratory of Medical Investigation 24 (LIM 24), University of Sao Paulo, Medical School, São Paulo, Brazil
| | - M. I. Achatz
- Department of Oncogenetics of A.C. Camargo Cancer Center, São Paulo, Brazil
| | - A. P. Trapé
- Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - A. M. Gonzalez-Angulo
- Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - M. M. Brentani
- Oncology and Radiology Department, Laboratory of Medical Investigation 24 (LIM 24), University of Sao Paulo, Medical School, São Paulo, Brazil
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Zhao Y, Dong X, Li R, Song J, Zhang D. Correlation Between Clinical-Pathologic Factors and Long-Term Follow-Up in Young Breast Cancer Patients. Transl Oncol 2015; 8:265-72. [PMID: 26310372 PMCID: PMC4562982 DOI: 10.1016/j.tranon.2015.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 05/07/2015] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE: Diagnosis of breast cancer in young patients (≤ 35) correlates with a worse prognosis compared to their older counterparts (> 35). The aim of this study is to evaluate the relevance of clinical-pathologic factors and prognosis in young (≤ 35) breast cancer patients. METHODS: One hundred thirty-two patients of operable breast cancer who were younger than 35 are analyzed in this study. They were treated in our hospital between January 2006 and December 2012. Patients are classified into four molecular subtypes based on the immunohistochemical profiles of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67. Clinical and pathologic factors have been combined to define a specific classification of three risk levels to evaluate the prognosis of these young women. RESULTS: Patients whose ages are less than 30 have poorer prognosis than patients whose ages are between 31 and 35. The status of lymph nodes post-surgery seems to be the only factor related to patient age in young patients. The patients in level of ER + or PR + and HER2 −/+ status have the worst prognosis in hormone receptor–positive breast cancer. Group 3 in risk factor grouping has the poorer prognosis than the other two groups. CONCLUSIONS: Patient age and axillary lymph nodes post-surgery are the independent and significant predictors of distant disease-free survival, local recurrence-free survival, and overall survival. The absence of PR relates to poor prognosis. The risk factor grouping provides a useful index to evaluate the risk of young breast cancer to identify subgroups of patients with a better prognosis.
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Affiliation(s)
- Yue Zhao
- Department of Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaoqiu Dong
- Department of Ultrasonography, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rongguo Li
- Department of Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jian Song
- Department of Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dongwei Zhang
- Department of Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Breast cancer in very young women: Clinicopathological study of 149 patients ≤25 years old. Breast 2015; 24:461-7. [DOI: 10.1016/j.breast.2015.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 02/09/2015] [Accepted: 04/08/2015] [Indexed: 11/21/2022] Open
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Wei JT, Huang WH, Du CW, Qiu SQ, Wei XL, Liu J, Zhang GJ. Clinicopathological features and prognostic factors of young breast cancers in Eastern Guangdong of China. Sci Rep 2014; 4:5360. [PMID: 24942640 PMCID: PMC5381536 DOI: 10.1038/srep05360] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 06/02/2014] [Indexed: 02/05/2023] Open
Abstract
Breast cancer in young women is typically with higher proportion of adverse pathological features. Breast cancer with BRCA1 mutation is often early-onset, and is usually associated with triple negative phenotpe. In this study, we aim to analyze the clinicopathological characteristics and prognosis in young breast cancer patients (≤35 years old) comparing to non-young patients (>35 years old). A total of 1913 cases of primary breast carcinoma with stage I-III were enrolled, with 283 cases diagnosed as young patients. No significant difference was observed in tumor size, TNM staging, lymph node metastasis, ER, HER-2 or histological grade between young and non-young patients. Multivariate analysis demonstrated that age was an independent prognostic factor for overall survival (OS). In 70 samples of young patients available, BRCA1 was immunohistochemically positive 85.7% in cytoplasm and 41.4% in nuclear. BRCA1 nuclear expression is not significantly associated with clinicopathological characteristics in young breast cancer patients.
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Affiliation(s)
- Jin-Tao Wei
- The Breast Center, Cancer Hospital of Shantou University Medical College, Shantou 515041, China
- These authors contributed equally to this work
- Current address: Breast Tumor Center, Chancheng District Central Hospital of Foshan City, Foshan 528031, China
| | - Wen-He Huang
- The Breast Center, Cancer Hospital of Shantou University Medical College, Shantou 515041, China
- These authors contributed equally to this work
| | - Cai-Wen Du
- Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515041, China
| | - Si-Qi Qiu
- The Breast Center, Cancer Hospital of Shantou University Medical College, Shantou 515041, China
| | - Xiao-Long Wei
- Cancer Research Center, Shantou University Medical College, Shantou 515041, China
| | - Jing Liu
- Cancer Research Center, Shantou University Medical College, Shantou 515041, China
| | - Guo-Jun Zhang
- The Breast Center, Cancer Hospital of Shantou University Medical College, Shantou 515041, China
- Cancer Research Center, Shantou University Medical College, Shantou 515041, China
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Carraro DM, Koike Folgueira MAA, Garcia Lisboa BC, Ribeiro Olivieri EH, Vitorino Krepischi AC, de Carvalho AF, de Carvalho Mota LD, Puga RD, do Socorro Maciel M, Michelli RAD, de Lyra EC, Grosso SHG, Soares FA, Achatz MIADSW, Brentani H, Moreira-Filho CA, Brentani MM. Comprehensive analysis of BRCA1, BRCA2 and TP53 germline mutation and tumor characterization: a portrait of early-onset breast cancer in Brazil. PLoS One 2013; 8:e57581. [PMID: 23469205 PMCID: PMC3586086 DOI: 10.1371/journal.pone.0057581] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 01/22/2013] [Indexed: 11/25/2022] Open
Abstract
Germline mutations in BRCA1, BRCA2 and TP53 genes have been identified as one of the most important disease-causing issues in young breast cancer patients worldwide. The specific defective biological processes that trigger germline mutation-associated and -negative tumors remain unclear. To delineate an initial portrait of Brazilian early-onset breast cancer, we performed an investigation combining both germline and tumor analysis. Germline screening of the BRCA1, BRCA2, CHEK2 (c.1100delC) and TP53 genes was performed in 54 unrelated patients <35 y; their tumors were investigated with respect to transcriptional and genomic profiles as well as hormonal receptors and HER2 expression/amplification. Germline mutations were detected in 12 out of 54 patients (22%) [7 in BRCA1 (13%), 4 in BRCA2 (7%) and one in TP53 (2%) gene]. A cancer familial history was present in 31.4% of the unrelated patients, from them 43.7% were carriers for germline mutation (37.5% in BRCA1 and in 6.2% in the BRCA2 genes). Fifty percent of the unrelated patients with hormone receptor-negative tumors carried BRCA1 mutations, percentage increasing to 83% in cases with familial history of cancer. Over-representation of DNA damage-, cellular and cell cycle-related processes was detected in the up-regulated genes of BRCA1/2-associated tumors, whereas cell and embryo development-related processes were over-represented in the up-regulated genes of BRCA1/2-negative tumors, suggesting distinct mechanisms driving the tumorigenesis. An initial portrait of the early-onset breast cancer patients in Brazil was generated pointing out that hormone receptor-negative tumors and positive familial history are two major risk factors for detection of a BRCA1 germline mutation. Additionally, the data revealed molecular factors that potentially trigger the tumor development in young patients.
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Affiliation(s)
- Dirce Maria Carraro
- Laboratory of Genomics and Molecular Biology, A.C. Camargo Hospital, São Paulo, Brazil.
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Collins LC, Marotti JD, Gelber S, Cole K, Ruddy K, Kereakoglow S, Brachtel EF, Schapira L, Come SE, Winer EP, Partridge AH. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Res Treat 2011; 131:1061-6. [PMID: 22080245 DOI: 10.1007/s10549-011-1872-9] [Citation(s) in RCA: 182] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 11/02/2011] [Indexed: 10/15/2022]
Abstract
Prior studies have suggested a higher prevalence of high grade, ER-negative, HER2-positive, and basal-like carcinomas in young women with breast cancer. However, the precise distribution of poor prognostic features in this population remains unclear. We examined the pathologic features and distribution of molecular phenotype in relation to patient age in a large group of young women (≤40 years) with invasive breast cancer. Medical records were reviewed for clinical characteristics, tumor stage, and receptor status. Pathologic features, including those features associated with basal-like carcinomas, were examined by central review. Using tumor grade and biomarker expression, cancers were categorized as luminal A (ER+ and/or PR+ and HER2-, histologic grade 1 or 2); luminal B (ER+ and/or PR+ and HER2+, or ER and/or PR+, HER2- and grade 3); HER2 (ER and PR- and HER2+); and triple negative (ER-, PR-, and HER2-). Among 399 women of ≤40 years, 33% had luminal A tumors, 35% luminal B, 11% HER2 (ER-negative), and 21% triple negative. Compared to published results for all breast cancers, a greater proportion of young women had luminal B tumors, and a lesser proportion had luminal A. There were no significant differences in molecular phenotype, tumor stage or grade among the different age groups of young women. However, this population of young women presented with a different distribution of molecular phenotypes compared to the general population of women with breast cancer. These findings may have implications with regard to the etiology and prognosis of breast cancer in young women.
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Affiliation(s)
- L C Collins
- Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA.
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ANDERSON D, YATES P, MCCARTHY A, LANG C, HARGRAVES M, MCCARTHY N, PORTER-STEELE J. Younger and older women's concerns about menopause after breast cancer. Eur J Cancer Care (Engl) 2011; 20:785-94. [DOI: 10.1111/j.1365-2354.2011.01282.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Carvalho FM, Bacchi LM, Santos PPC, Bacchi CE. Triple-negative breast carcinomas are a heterogeneous entity that differs between young and old patients. Clinics (Sao Paulo) 2010; 65:1033-6. [PMID: 21120307 PMCID: PMC2972605 DOI: 10.1590/s1807-59322010001000019] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 09/20/2010] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare the frequency and immunohistochemical profiles of triple-negative breast carcinomas in younger and older women. METHODS AND RESULTS We selected patients diagnosed with triple-negative breast carcinomas. The groups examined were women who were 35 years old or younger between 1997 and 2007 (n = 74) and, for comparison, women who were 60 years old or older (n = 19, consecutive cases). All formalin-fixed and paraffin-embedded tumor samples were reviewed and immunohistochemically stained for ER, PR, HER2, Ki-67 antigen, epidermal growth factor receptor, cytokeratin 5/6, p53, vimentin, CD117, and p63 using tissue microarrays blocks. Triple-negative breast carcinomas corresponded to 34.6% (74/213) of the carcinomas from the younger patients and 16.2% (19/117) of the carcinomas from the older patients (p = 0.002). No significant differences in the frequency of the basal phenotype were observed in the two patient groups based on CK5/6 and/or epidermal growth factor receptor expression (74.3% vs. 68.4%). However, triple-negative breast carcinomas in the older patients presented a higher frequency of CK5/6 expression compared to those of younger patients (42.1% vs. 9.6%; p = 0.005), whereas triple-negative breast carcinomas of younger patients had a higher expression level of epidermal growth factor receptor (71.6% vs. 47.3%). CONCLUSIONS These results show that there were significant molecular differences between the triple-negative basal-like breast carcinomas that were diagnosed in younger women and those that were diagnosed in older women. These findings may provide a basis for describing the more aggressive phenotype of the triple-negative breast carcinomas observed in younger women.
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Affiliation(s)
- Filomena M Carvalho
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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