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Current Perspectives on Lobular Neoplasia of the Breast. CURRENT RADIOLOGY REPORTS 2022. [DOI: 10.1007/s40134-022-00408-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Costantini M, Montella RA, Fadda MP, Tondolo V, Franceschini G, Bove S, Garganese G, Rinaldi PM. Diagnostic Challenge of Invasive Lobular Carcinoma of the Breast: What Is the News? Breast Magnetic Resonance Imaging and Emerging Role of Contrast-Enhanced Spectral Mammography. J Pers Med 2022; 12:jpm12060867. [PMID: 35743654 PMCID: PMC9224821 DOI: 10.3390/jpm12060867] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Invasive lobular carcinoma is the second most common histologic form of breast cancer, representing 5% to 15% of all invasive breast cancers. Due to an insidious proliferative pattern, invasive lobular carcinoma remains clinically and radiologically elusive in many cases. Breast magnetic resonance imaging (MR) is considered the most accurate imaging modality in detecting and staging invasive lobular carcinoma and it is strongly recommended in pre-operative planning for all ILC. Contrast-enhanced spectral mammography (CESM) is a new diagnostic method that enables the accurate detection of malignant breast lesions similar to that of breast MR. CESM is also a promising breast imaging method for planning surgeries. In this study, we compare the ability of contrast-enhanced spectral mammography (CESM) with breast MR in the preoperative assessment of the extent of invasive lobular carcinoma. All patients with proven invasive lobular carcinoma treated in our breast cancer center underwent preoperative breast MRI and CESM. Images were reviewed by two dedicated breast radiologists and results were compared to the reference standard histopathology. CESM was similar and in some cases more accurate than breast MR in assessing the extent of disease in invasive lobular cancers. Further evaluation in larger prospective randomized trials is needed to validate our preliminary results.
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Affiliation(s)
- Melania Costantini
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Area Diagnostica per Immagini, 00168 Rome, Italy
| | - Rino Aldo Montella
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
- Correspondence: ; Tel.: +39-078-9189-9901
| | - Maria Paola Fadda
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
| | - Vincenzo Tondolo
- General Surgery Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy;
| | - Gianluca Franceschini
- Multidisciplinary Breast Center, Dipartimento Scienze Della Salute Della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
- Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Sonia Bove
- Gynecology and Breast Care Center, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (S.B.); (G.G.)
| | - Giorgia Garganese
- Gynecology and Breast Care Center, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (S.B.); (G.G.)
- Dipartimento Scienze Della Vita e Sanità Pubblica, Sezione Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Pierluigi Maria Rinaldi
- Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy; (M.C.); (M.P.F.); (P.M.R.)
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You KY, Bi ZF, Ma YJ, Mao YL, Zou WL, Liu YM, Yao HR. The Selection of Treatment Modality for Breast Ductal Carcinoma In Situ: Experience From a Single Institution. Cancer Control 2021; 28:1073274821997426. [PMID: 33626920 PMCID: PMC8482722 DOI: 10.1177/1073274821997426] [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: 12/03/2022] Open
Abstract
Purpose: Although breast conservation surgery(BCS) followed by adjuvant radiotherapy is now the mainstream treatment method for breast ductal carcinoma in situ(DCIS), mastectomy is still performed in some patients who refuse to undergo radiation. However, the most effective treatment method for these patients is still unknown. In the current study, we aimed to compare the survival rates between mastectomy and BCS plus adjuvant radiotherapy in patients with DCIS. Materials and Methods: We performed a retrospective study of 333 patients with DCIS from May 2004 to December 2016. There were 209 patents who were treated with BCS and adjuvant radiotherapy, while the remaining of 124 patients underwent mastectomy. The disease-free survival (DFS) and local recurrence-free survival(LRFS) rates were compared between the 2 treatment groups. Cox proportional hazards regression was performed to explore factors associated with DFS and LRFS. Results: The 10-year local recurrence(LR) rates in the mastectomy and BCS plus adjuvant radiotherapy groups were 2.6% and 7.5%, respectively. There was no difference in the LR rate between the 2 groups. Furthermore the DFS rate was also similar between the mastectomy and BCS plus adjuvant radiotherapy groups. Based on the multivariable analysis, age and tumor grade were significantly correlated with the LRFS and DFS rates. In the subgroup analysis based on the factors of age and tumor grade, patients with a tumor grade of III who underwent mastectomy had better LRFS and DFS rates compared to those who received BCS plus radiotherapy. Conclusion: In patients with DCIS, the long-term efficacy was similar between mastectomy and BCS followed by adjuvant radiotherapy. However, in the subgroup of patients with grade III tumors, mastectomy seems to offer a better LRFS and DFS than BCS plus radiotherapy.
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Affiliation(s)
- Kai-Yun You
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,RNA Biomedical Institute, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Radiation Oncology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhuo-Fei Bi
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,RNA Biomedical Institute, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Radiation Oncology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yu-Jia Ma
- Department of Radiation Oncology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yong-Lin Mao
- Department of Radiation Oncology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wei-Liang Zou
- Department of Radiation Oncology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yi-Min Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Radiation Oncology, 56713Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - He-Rui Yao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,RNA Biomedical Institute, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Oncology, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Breast Tumor Center, 56713Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Wilson N, Ironside A, Diana A, Oikonomidou O. Lobular Breast Cancer: A Review. Front Oncol 2021; 10:591399. [PMID: 33520704 PMCID: PMC7844138 DOI: 10.3389/fonc.2020.591399] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/30/2020] [Indexed: 12/22/2022] Open
Abstract
Invasive lobular carcinoma accounts for 5%–15% of all invasive breast cancers, with a marked increase in incidence rates over the past two decades. Distinctive biological hallmarks of invasive lobular carcinoma include the loss of cell adhesion molecule E-cadherin leading to cells with a discohesive morphology, proliferating into single-file strands and estrogen receptor positivity. These key molecular features can make diagnosis difficult, as invasive lobular carcinoma is challenging to detect both physically and with current standard imaging. Treatment of invasive lobular carcinoma strongly favors endocrine therapy due to low chemosensitivity and lower rates of pathological response as a result. This review will summarize the distinct biological and molecular features of invasive lobular carcinoma, focusing on the diagnostic challenges faced and the subsequent surgical and medical management strategies. Prospective therapeutic options will also be explored, highlighting how furthering our understanding of the unique biology of lobular breast carcinoma is essential in guiding and informing the treatment of patients in the future.
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Affiliation(s)
- Natalie Wilson
- Cancer Research UK, Edinburgh Centre, MRC Institute Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Alastair Ironside
- Edinburgh Cancer Centre, Western General Hospital, Department of Pathology, NHS Lothian, Edinburgh, United Kingdom
| | - Anna Diana
- Division of Medical Oncology, Department of Precision Medicine, School of Medicine, "Luigi Vanvitelli" University of Campania, Naples, Italy
| | - Olga Oikonomidou
- Cancer Research UK, Edinburgh Centre, MRC Institute Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Richard JLC, Eichhorn PJA. Deciphering the roles of lncRNAs in breast development and disease. Oncotarget 2018; 9:20179-20212. [PMID: 29732012 PMCID: PMC5929455 DOI: 10.18632/oncotarget.24591] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/21/2018] [Indexed: 02/06/2023] Open
Abstract
Breast cancer is the second leading cause of cancer related deaths in women. It is therefore important to understand the mechanisms underlying breast cancer development as well as raises the need for enhanced, non-invasive strategies for novel prognostic and diagnostic methods. The emergence of long non-coding RNAs (lncRNAs) as potential key players in neoplastic disease has received considerable attention over the past few years. This relatively new class of molecular regulators has been shown from ongoing research to act as critical players for key biological processes. Deregulated expression levels of lncRNAs have been observed in a number of cancers including breast cancer. Furthermore, lncRNAs have been linked to breast cancer initiation, progression, metastases and to limit sensitivity to certain targeted therapeutics. In this review we provide an update on the lncRNAs associated with breast cancer and mammary gland development and illustrate the versatility of such lncRNAs in gene control, differentiation and development both in normal physiological conditions and in diseased states. We also highlight the therapeutic and diagnostic potential of lncRNAs in cancer.
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Affiliation(s)
- John Lalith Charles Richard
- Cancer Science Institute of Singapore, National University of Singapore, 117599, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
- Current Address: Genome Institute of Singapore, Agency for Science Technology and Research, 138672, Singapore
| | - Pieter Johan Adam Eichhorn
- Cancer Science Institute of Singapore, National University of Singapore, 117599, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
- School of Pharmacy, Curtin University, Perth, 6845, Australia
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Mullooly M, Khodr ZG, Dallal CM, Nyante SJ, Sherman ME, Falk R, Liao LM, Love J, Brinton LA, Gierach GL. Epidemiologic Risk Factors for In Situ and Invasive Breast Cancers Among Postmenopausal Women in the National Institutes of Health-AARP Diet and Health Study. Am J Epidemiol 2017. [PMID: 28637226 DOI: 10.1093/aje/kwx206] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Comparing risk factor associations between invasive breast cancers and possible precursors may further our understanding of factors related to initiation versus progression. Accordingly, among 190,325 postmenopausal participants in the National Institutes of Health-AARP Diet and Health Study (1995-2011), we compared the association between risk factors and incident ductal carcinoma in situ (DCIS; n = 1,453) with that of risk factors and invasive ductal carcinomas (n = 7,525); in addition, we compared the association between risk factors and lobular carcinoma in situ (LCIS; n = 186) with that of risk factors and invasive lobular carcinomas (n = 1,191). Hazard ratios and 95% confidence intervals were estimated from multivariable Cox proportional hazards regression models. We used case-only multivariable logistic regression to test for heterogeneity in associations. Younger age at menopause was associated with a higher risk of DCIS but lower risks of LCIS and invasive ductal carcinomas (P for heterogeneity < 0.01). Prior breast biopsy was more strongly associated with the risk of LCIS than the risk of DCIS (P for heterogeneity = 0.04). Increased risks associated with use of menopausal hormone therapy were stronger for LCIS than DCIS (P for heterogeneity = 0.03) and invasive lobular carcinomas (P for heterogeneity < 0.01). Associations were similar for race, age at menarche, age at first birth, family history, alcohol consumption, and smoking status, which suggests that most risk factor associations are similar for in situ and invasive cancers and may influence early stages of tumorigenesis. The differential associations observed for various factors may provide important clues for understanding the etiology of certain breast cancers.
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Affiliation(s)
- Maeve Mullooly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Zeina G Khodr
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, College Park, Maryland
| | - Sarah J Nyante
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mark E Sherman
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Roni Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Jeffrey Love
- Strategic Issues Research, AARP Research Center, Washington, DC
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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Cutuli B, De Lafontan B, Kirova Y, Auvray H, Tallet A, Avigdor S, Brunaud C, Delva C. Lobular carcinoma in situ (LCIS) of the breast: is long-term outcome similar to ductal carcinoma in situ (DCIS)? Analysis of 200 cases. Radiat Oncol 2015; 10:110. [PMID: 25944033 PMCID: PMC4428244 DOI: 10.1186/s13014-015-0379-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 03/16/2015] [Indexed: 01/01/2023] Open
Abstract
Background Lobular carcinomas in situ (LCIS) represent 1-2% of all breast cancers. Both significance and treatment remain widely debated, as well as the possible similarities with DCIS. Materials and methods Two hundred patients with pure LCIS were retrospectively analyzed in seven centres from 1990 to 2008. Median age was 52 years; 176 patients underwent breast-conserving surgery (BCS) and 24 mastectomy. Seventeen patients received whole breast irradiation (WBRT) after BCS and 20 hormonal treatment (15 by tamoxifen). Results With a 144-month median follow-up (FU), there were no local recurrences (LR) among 24 patients treated by mastectomy. With the same FU, 3 late LR out of 17 (17%) occurred in patients treated by BCS and WBRT (with no LR at 10 years). Among 159 patients treated by BCS alone, 20 developed LR (13%), but with only a 72-month FU (17.5% at 10 years). No specific LR risk factors were identified. Three patients developed metastases, two after invasive LR; 22 patients (11%) developed contralateral BC (59% invasive) and another five had second cancer. Conclusions LCIS is not always an indolent disease. The long-term outcome is quite similar to most ductal carcinomas in situ (DCIS). The main problems are the accuracy of pathological definition and a clear identification of more aggressive subtypes, in order to avoid further invasive LR. BCS + WBRT should be discussed in some selected cases, and the long-term results seem comparable to DCIS.
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Affiliation(s)
| | | | | | | | | | | | - Claire Brunaud
- Institut de Cancerologie de Lorraine, Vandoeuvre-les-Nancy, France.
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Sherman ME, Mies C, Gierach GL. Opportunities for molecular epidemiological research on ductal carcinoma in-situ and breast carcinogenesis: interdisciplinary approaches. Breast Dis 2015; 34:105-16. [PMID: 24225267 DOI: 10.3233/bd-130359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most invasive breast cancers arise from ductal carcinoma in-situ (DCIS), a non-obligate precursor of invasive breast cancer. Given that the natural history of individual DCIS lesions is unpredictable, many women with DCIS receive extensive treatments, which may include surgery, radiation and endocrine therapy, even though many of these lesions may have limited potential to progress to invasion and metastasize. In contrast to valid concerns about overtreatment, the fact that invasive breast cancers outnumber DCIS lesions by more than three-to-one, suggests that many cancer precursors (particularly DCIS, but LCIS also) progress to invasion prior to detection. Thus, DCIS poses a dual problem of overdiagnosis among some women and failure of early detection among others. These concerns are heightened by the multifold increase in rates of DCIS in conjunction with widespread use of mammographic screening and access to outpatient radiologically-guided biopsies. Accordingly, methods are needed to both specifically detect and identify DCIS lesions with potential to progress to invasive cancer and to discover techniques to triage and conservatively manage indolent cases of DCIS.
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Affiliation(s)
- Mark E Sherman
- National Cancer Institute, Division of Cancer Prevention, Bethesda, MD, USA
| | - Carolyn Mies
- University of Pennsylvania, Philadelphia, PA, USA
| | - Gretchen L Gierach
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
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Rendi MH. When is excision necessary for atypical lobular hyperplasia and lobular carcinoma in situ? BREAST CANCER MANAGEMENT 2014. [DOI: 10.2217/bmt.13.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY This management perspective briefly covers the histology and molecular features of lobular in situ neoplasia and provides an in-depth discussion of the need for surgical excision if lobular in situ neoplasia is diagnosed on core-needle biopsy. The management of lobular in situ neoplasia found on core-needle biopsy has been an area of recent study with varying results. Emerging data suggest that low-risk patients with a limited extent of isolated classic lobular in situ neoplasia found on core-needle biopsy may not require subsequent surgical excision. However, high-risk patients, those with extensive lobular in situ neoplasia, or other high-risk lesions noted on core-needle biopsy likely benefit from surgical excision. Most authors recommend surgical excision when pleomorphic lobular carcinoma in situ is found on core-needle biopsy due to its higher association with invasive carcinoma. However, the natural history of this more recently described variant of lobular carcinoma in situ is not fully defined, and the clinical management of pleomorphic lobular carcinoma in situ on excisional biopsy is yet to be determined.
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Affiliation(s)
- Mara H Rendi
- Department of Anatomic Pathology, University of Washington Medical Center, 1959 NE Pacific, Seattle, WA 98195, USA
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10
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High Risk Lesions. Breast Cancer 2014. [DOI: 10.1007/978-1-4614-8063-1_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Ross JS, Wang K, Sheehan CE, Boguniewicz AB, Otto G, Downing SR, Sun J, He J, Curran JA, Ali S, Yelensky R, Lipson D, Palmer G, Miller VA, Stephens PJ. Relapsed classic E-cadherin (CDH1)-mutated invasive lobular breast cancer shows a high frequency of HER2 (ERBB2) gene mutations. Clin Cancer Res 2013; 19:2668-76. [PMID: 23575477 DOI: 10.1158/1078-0432.ccr-13-0295] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE We queried whether comprehensive genomic profiling using a next-generation sequencing-based assay could identify novel and unanticipated targets of therapy for patients with relapsed invasive lobular carcinoma (ILC). EXPERIMENTAL DESIGN DNA sequencing (Illumina HiSeq 2000) was conducted for 3,320 exons of 182 cancer-related genes and 37 introns of 14 genes frequently rearranged in cancer on indexed, adaptor-ligated, hybridization-captured libraries using DNA isolated from formalin-fixed paraffin-embedded sections from 22 histologically verified ILC. RESULTS A total of 75 genomic alterations were identified with an average of 3.4 alterations per tumor (range, 1-6), of which 35 were actionable for an average of 1.59 actionable alterations per patient (range, 0-3). Nineteen of 22 (86%) of the ILC samples harbored at least one actionable alteration. Six (27%) cases featured alterations in ERRB2 including 4 (18%) with ERBB2 mutation, 1 (5%) with an ERBB2 gene fusion, and 1 (5%) with an ERBB2 copy number gain (amplification). The enrichment of ERBB2 mutations/fusion in CDH1-mutated ILC (5 of 22, 23%) compared with the 5 ERBB2 mutations in a series of 286 non-CDH1-mutated breast cancers from which the ILC cases were obtained (5 of 286, 2%) was significant (P = 0.0006). CONCLUSIONS Comprehensive genomic profiling of relapsed CDH1-mutated ILC revealed actionable genomic alterations in 86% of cases, featured a high incidence of ERBB2 alterations, and can reveal actionable alterations that can inform treatment decisions for patients with ILC.
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Affiliation(s)
- Jeffrey S Ross
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, New York 12208, USA.
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Giricz O, Reynolds PA, Ramnauth A, Liu C, Wang T, Stead L, Childs G, Rohan T, Shapiro N, Fineberg S, Kenny PA, Loudig O. Hsa-miR-375 is differentially expressed during breast lobular neoplasia and promotes loss of mammary acinar polarity. J Pathol 2011; 226:108-19. [PMID: 21953071 DOI: 10.1002/path.2978] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 07/04/2011] [Accepted: 07/23/2011] [Indexed: 02/02/2023]
Abstract
Invasive lobular carcinoma (ILC) of the breast, characterized by loss of E-cadherin expression, accounts for 5-15% of invasive breast cancers and it is believed to arise via a linear histological progression. Genomic studies have identified a clonal relationship between ILC and concurrent lobular carcinoma in situ (LCIS) lesions, suggesting that LCIS may be a precursor lesion. It has been shown that an LCIS diagnosis confers a 15-20% risk of progression to ILC over a lifetime. Currently no molecular test or markers can identify LCIS lesions likely to progress to ILC. Since microRNA (miRNA) expression changes have been detected in a number of other cancer types, we explored whether their dysregulation might be detected during progression from LCIS to ILC. Using the Illumina miRNA profiling platform, designed for simultaneous analysis of 470 mature miRNAs, we analysed the profiles of archived normal breast epithelium, LCIS lesions found alone, LCIS lesions concurrent with ILC, and the concurrent ILCs as a model of linear histological progression towards ILC. We identified two sets of differentially expressed miRNAs, the first set highly expressed in normal epithelium, including hsa-miR-224, -139, -10b, -450, 140, and -365, and the second set up-regulated during lobular neoplasia progression, including hsa-miR-375, -203, -425-5p, -183, -565, and -182. Using quantitative RT-PCR, we validated a trend of increasing expression for hsa-miR-375, hsa-miR-182, and hsa-miR-183 correlating with ILC progression. As we detected increased expression of hsa-miR-375 in LCIS lesions synchronous with ILC, we sought to determine whether hsa-miR-375 might induce phenotypes reminiscent of lobular neoplasia by expressing it in the MCF-10A 3D culture model of mammary acinar morphogenesis. Increased expression of hsa-miR-375 resulted in loss of cellular organization and acquisition of a hyperplastic phenotype. These data suggest that dysregulated miRNA expression contributes to lobular neoplastic progression.
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Affiliation(s)
- Orsi Giricz
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY, USA
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Rendi MH, Dintzis SM, Lehman CD, Calhoun KE, Allison KH. Lobular In-Situ Neoplasia on Breast Core Needle Biopsy: Imaging Indication and Pathologic Extent Can Identify Which Patients Require Excisional Biopsy. Ann Surg Oncol 2011; 19:914-21. [DOI: 10.1245/s10434-011-2034-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Indexed: 11/18/2022]
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14
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Gomes DS, Balabram D, Porto SS, Gobbi H. Lobular neoplasia: frequency and association with other breast lesions. Diagn Pathol 2011; 6:74. [PMID: 21827679 PMCID: PMC3170574 DOI: 10.1186/1746-1596-6-74] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/09/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Using new molecular biology techniques, recent studies have implicated a common evolutionary pathway between lobular neoplasia, lobular carcinomas, and columnar cell lesions. Our aims were to assess the frequency of lobular neoplasia in a series of breast biopsies that were performed and examined in the same institution and to analyze the association between subtypes of lobular neoplasia and benign and malignant breast lesions. METHODS Cases were selected after reviewing archived pathological reports in the Breast Pathology Laboratory, School of Medicine of Federal University of Minas Gerais (1999-2008). Cases of lobular neoplasia were reviewed and classified as atypical lobular hyperplasia, ductal involvement by cells of atypical lobular hyperplasia, lobular carcinoma in situ, and pleomorphic lobular carcinoma in situ. Coexistence of lobular neoplasia with other breast lesions, including columnar cell lesions, invasive ductal carcinoma and invasive lobular carcinoma, was evaluated. The association between lobular neoplasia and breast lesions was analyzed by Fisher's exact test and chi-square test for linear trend. RESULTS We analyzed 5650 breast specimens, selecting 135 breast specimens (2.4%) that had a diagnosis of lobular neoplasia, corresponding to 106 patients. Hematoxylin and eosin-stained slides were available for 84 cases, 5 of which were excluded because they contained only "indeterminate" in situ lesions. Of the 79 remaining cases, columnar cell lesions were present in 78.5%, primarily with columnar cell changes without atypia (67.7%). Invasive carcinoma was present in 45.6% of cases of lobular neoplasia--a similar frequency (47.2%) as invasive ductal carcinoma and invasive lobular carcinoma. We noted a significant linear trend (p < 0.03) of a higher frequency of invasive carcinomas that were concomitant with lobular carcinoma in situ compared with atypical lobular hyperplasia. Invasive lobular carcinomas were associated with lobular carcinoma in situ in 33% of cases, compared with 2.8% of atypical lobular hyperplasia cases. CONCLUSIONS Our findings confirm a frequent association between lobular neoplasia and columnar cell lesions, the majority of which lacked atypia. We also observed a greater frequency of invasive carcinoma, more commonly invasive lobular carcinoma, associated with more developed forms of lobular neoplasia (lobular carcinoma in situ).
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Affiliation(s)
- Douglas S Gomes
- Breast Pathology Laboratory, School of Medicine, Federal University of Minas Gerais (UFMG), Av, Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais 30130-100, Brazil
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