1
|
Yamaguchi R, Watanabe H, Mihara Y, Yamaguchi M, Tanaka M. Histopathology of non-mass-like breast lesions on ultrasound. J Med Ultrason (2001) 2023; 50:375-380. [PMID: 36773105 PMCID: PMC10354136 DOI: 10.1007/s10396-023-01286-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/30/2022] [Indexed: 02/12/2023]
Abstract
There have been several investigations of non-mass-like (NML) lesions on ultrasound (US) since Uematsu first described this approach, and it is a relatively new concept for breast examination. However, the results have varied, and there have been only a few studies related to the detailed histopathology of NML lesions on US. Here, we review the histopathology of NML lesions. NML lesions are pathologically benign, atypical, or malignant. There are two major findings of NML lesions on US: architectural distortion and calcifications. Architectural distortion pathologically indicates a fibrous change with ductal proliferation, invasive breast carcinoma, and carcinoma in situ. Histopathologically, microcalcifications are seen in both benign and malignant lesions, and it is important to distinguish between these lesions among NML lesions, particularly fibrocystic changes including adenosis and hyperplasia in the case of benign lesions and carcinoma in situ (ductal and lobular) in the case of malignant lesions. The differential major points may be whether NML lesions are associated with abundant hyperechoic foci, which indicate comedo necrosis on histology. They are usually high-grade carcinoma in situ that may be positive for HER2 or triple negativity. A recent report indicated that low-grade carcinoma in situ showed better survival than higher-grade carcinoma in situ, which is often accompanied by comedo necrosis on histology, reflecting visible microcalcification on US. NML lesions are considered to include a certain rate of low-grade carcinoma in situ. Therefore, more caution may be needed when detecting and managing NML lesions to avoid overdiagnosis and overtreatment as a result of this recent "low-risk ductal carcinoma in situ" concept.
Collapse
Affiliation(s)
- Rin Yamaguchi
- Department of Pathology and Laboratory Medicine, Kurume University Medical Center, 155-1 Kokubu, Kurume, Fukuoka, 839-0863, Japan.
| | - Hidetaka Watanabe
- Department of Surgery, Japan Community Healthcare Organization Kurume General Hospital, Kurume, Fukuoka, Japan
| | - Yutaro Mihara
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Miki Yamaguchi
- Department of Surgery, Japan Community Healthcare Organization Kurume General Hospital, Kurume, Fukuoka, Japan
| | - Maki Tanaka
- Department of Surgery, Japan Community Healthcare Organization Kurume General Hospital, Kurume, Fukuoka, Japan
| |
Collapse
|
2
|
Solek J, Chrzanowski J, Cieslak A, Zielinska A, Piasecka D, Braun M, Sadej R, Romanska HM. Subtype-Specific Tumour Immune Microenvironment in Risk of Recurrence of Ductal Carcinoma In Situ: Prognostic Value of HER2. Biomedicines 2022; 10:biomedicines10051061. [PMID: 35625798 PMCID: PMC9138378 DOI: 10.3390/biomedicines10051061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 11/16/2022] Open
Abstract
Increasing evidence suggests that the significance of the tumour immune microenvironment (TIME) for disease prognostication in invasive breast carcinoma is subtype-specific but equivalent studies in ductal carcinoma in situ (DCIS) are limited. The purpose of this paper is to review the existing data on immune cell composition in DCIS in relation to the clinicopathological features and molecular subtype of the lesion. We discuss the value of infiltration by various types of immune cells and the PD-1/PD-L1 axis as potential markers of the risk of recurrence. Analysis of the literature available in PubMed and Medline databases overwhelmingly supports an association between densities of infiltrating immune cells, traits of immune exhaustion, the foci of microinvasion, and overexpression of HER2. Moreover, in several studies, the density of immune infiltration was found to be predictive of local recurrence as either in situ or invasive cancer in HER2-positive or ER-negative DCIS. In light of the recently reported first randomized DCIS trial, relating recurrence risk with overexpression of HER2, we also include a closing paragraph compiling the latest mechanistic data on a functional link between HER2 and the density/composition of TIME in relation to its potential value in the prognostication of the risk of recurrence.
Collapse
Affiliation(s)
- Julia Solek
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 92-213 Lodz, Poland; (J.S.); (A.Z.); (M.B.)
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 90-419 Lodz, Poland; (J.C.); (A.C.)
| | - Jedrzej Chrzanowski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 90-419 Lodz, Poland; (J.C.); (A.C.)
| | - Adrianna Cieslak
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 90-419 Lodz, Poland; (J.C.); (A.C.)
| | - Aleksandra Zielinska
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 92-213 Lodz, Poland; (J.S.); (A.Z.); (M.B.)
| | - Dominika Piasecka
- Department of Molecular Enzymology and Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Marcin Braun
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 92-213 Lodz, Poland; (J.S.); (A.Z.); (M.B.)
| | - Rafal Sadej
- Department of Molecular Enzymology and Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdansk, 80-210 Gdansk, Poland;
- Correspondence: (R.S.); (H.M.R.); Tel.: +48-58-349-14-69 (R.S.); +48-42-272-56-05 (H.M.R.)
| | - Hanna M. Romanska
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 92-213 Lodz, Poland; (J.S.); (A.Z.); (M.B.)
- Correspondence: (R.S.); (H.M.R.); Tel.: +48-58-349-14-69 (R.S.); +48-42-272-56-05 (H.M.R.)
| |
Collapse
|
3
|
Bartlett JM, Sgroi DC, Treuner K, Zhang Y, Piper T, Salunga RC, Ahmed I, Doos L, Thornber S, Taylor KJ, Brachtel EF, Pirrie SJ, Schnabel CA, Rea DW. Breast Cancer Index Is a Predictive Biomarker of Treatment Benefit and Outcome from Extended Tamoxifen Therapy: Final Analysis of the Trans-aTTom Study. Clin Cancer Res 2022; 28:1871-1880. [PMID: 35144966 PMCID: PMC9306281 DOI: 10.1158/1078-0432.ccr-21-3385] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/09/2021] [Accepted: 02/08/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE The Breast Cancer Index (BCI) HOXB13/IL17BR (H/I) ratio predicts benefit from extended endocrine therapy in hormone receptor-positive (HR+) early-stage breast cancer. Here, we report the final analysis of the Trans-aTTom study examining BCI (H/I)'s predictive performance. EXPERIMENTAL DESIGN BCI results were available for 2,445 aTTom trial patients. The primary endpoint of recurrence-free interval (RFI) and secondary endpoints of disease-free interval (DFI) and disease-free survival (DFS) were examined using Cox proportional hazards regression and log-rank test. RESULTS Final analysis of the overall study population (N = 2,445) did not show a significant improvement in RFI with extended tamoxifen [HR, 0.90; 95% confidence interval (CI), 0.69-1.16; P = 0.401]. Both the overall study population and N0 group were underpowered due to the low event rate in the N0 group. In a pre-planned analysis of the N+ subset (N = 789), BCI (H/I)-High patients derived significant benefit from extended tamoxifen (9.7% absolute benefit: HR, 0.33; 95% CI, 0.14-0.75; P = 0.016), whereas BCI (H/I)-Low patients did not (-1.2% absolute benefit; HR, 1.11; 95% CI, 0.76-1.64; P = 0.581). A significant treatment-to-biomarker interaction was demonstrated on the basis of RFI, DFI, and DFS (P = 0.037, 0.040, and 0.025, respectively). BCI (H/I)-High patients remained predictive of benefit from extended tamoxifen in the N+/HER2- subgroup (9.4% absolute benefit: HR, 0.35; 95% CI, 0.15-0.81; P = 0.047). A three-way interaction evaluating BCI (H/I), treatment, and HER2 status was not statistically significant (P = 0.849). CONCLUSIONS Novel findings demonstrate that BCI (H/I) significantly predicts benefit from extended tamoxifen in HR+ N+ patients with HER2- disease. Moreover, BCI (H/I) demonstrates significant treatment to biomarker interaction across survival outcomes.
Collapse
Affiliation(s)
- John M.S. Bartlett
- University of Edinburgh, Edinburgh, United Kingdom
- Ontario Institute of Cancer Research, Ontario, Canada
| | | | - Kai Treuner
- Biotheranostics, Inc., San Diego, California
| | - Yi Zhang
- Biotheranostics, Inc., San Diego, California
| | - Tammy Piper
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - Ikhlaaq Ahmed
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - Lucy Doos
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - Sarah Thornber
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | | | | | - Sarah J. Pirrie
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | | | - Daniel W. Rea
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| |
Collapse
|
4
|
Han D, Shen R, Yue M, Zhao M, Yu Y, Yao J, Liu Y. Relationship between the changes of positivity rate of HER2 expression and the diameter of invasive lesions in early breast cancer and its clinical significance. Pathol Res Pract 2022; 233:153877. [DOI: 10.1016/j.prp.2022.153877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/27/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
|
5
|
Tumour-infiltrating lymphocytes in non-invasive breast cancer: A systematic review and meta-analysis. Breast 2021; 59:183-192. [PMID: 34273666 PMCID: PMC8319525 DOI: 10.1016/j.breast.2021.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 11/20/2022] Open
Abstract
Background The role of tumour infiltrating lymphocytes (TILs) as a biomarker in non-invasive breast cancer is unclear. This meta-analysis assessed the prognostic impact of TIL levels in patients with non-invasive breast cancer. Methods Systematic literature search was performed to identify studies assessing local recurrence in patients with non-invasive breast cancer according to TIL levels (high vs. low). Subgroup analyses per local recurrence (invasive and non-invasive) were performed. Secondary objectives were the association between TIL levels and non-invasive breast cancer subtypes, age, grade and necrosis. Odds ratios (ORs) and 95% confidence intervals (CI) were extracted from each study and a pooled analysis was conducted with random-effect model. Results Seven studies (N = 3437) were included in the present meta-analysis. High-TILs were associated with a higher likelihood of local recurrence (invasive or non-invasive, N = 2941; OR 2.05; 95%CI, 1.03–4.08; p = 0.042), although with a lower likelihood of invasive local recurrence (N = 1722; OR 0.69; 95%CI, 0.49–0.99; p = 0.042). High-TIL levels were associated with triple-negative (OR 3.84; 95%CI, 2.23–6.61; p < 0.001) and HER2-positive (OR 6.27; 95%CI, 4.93–7.97; p < 0.001) subtypes, high grade (OR 5.15; 95%CI, 3.69–7.19; p < 0.001) and necrosis (OR 3.09; 95%CI, 2.33–4.10; p < 0.001). Conclusions High-TIL levels were associated with more aggressive tumours, a higher likelihood of local recurrence (invasive or non-invasive) but a lower likelihood of invasive local recurrence in patients with non-invasive breast cancer. The prognostic role of TILs in non-invasive breast cancer is unknown. We observed an association between high-TILs and local recurrence. High-TILs were associated with triple-negative and HER2+ subtypes, high grade and necrosis. Non-invasive lesions with aggressive characteristics may also be more immunogenic. Patients with low-TILs showed a higher likelihood of presenting an invasive recurrence.
Collapse
|
6
|
Zhang H, Moisini I, Turner BM, Wang X, Dhakal A, Yang Q, Kovar S, Schiffhauer LM, Hicks DG. Significance of HER2 in Microinvasive Breast Carcinoma. Am J Clin Pathol 2021; 156:155-165. [PMID: 33491064 DOI: 10.1093/ajcp/aqaa222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES We compared the clinicopathologic features, clinical management, and outcomes of human epidermal growth factor receptor 2 (HER2)-expressing and nonexpressing microinvasive breast carcinomas (MiBC) to explore the significance of HER2 in MiBC. METHODS Clinicopathologic and follow-up information of cases with final diagnosis of MiBC with known HER2 status between 2007 and 2019 were analyzed. RESULTS Nineteen (41.3%) HER2-positive (HER2+) and 27 (58.7%) HER2-negative (HER2-) MiBCs were identified. HER2 positivity was likely to be associated with high nuclear grade, presence of tumor-infiltrating lymphocytes, hormonal receptor negativity, and increased Ki-67 in both microinvasive and associated in situ carcinomas. Nodal metastases were found in 2 ER+/HER2- cases (5.3%). One HER2+ case was found to have isolated tumor cells in the axillary node. The majority of patients with HER2+ MiBCs (76.5%) did not receive HER2-targeted therapy. All patients with available follow-up were alive without recurrence or distant metastasis, with a median follow-up of 38 months. CONCLUSIONS Similar to the larger size of invasive breast carcinomas, HER2 positivity is associated with high-grade morphologic features in MiBCs. However, HER2 overexpression in MiBCs does not appear to be associated with nodal metastasis or worse outcome in our study cohort. The role of HER2-targeted therapy in this clinical setting merits additional study.
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
| | - Bradley M Turner
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Xi Wang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Ajay Dhakal
- Department of Hematology and Oncology, University of Rochester Medical Center, Rochester, NY
| | - Qi Yang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Sierra Kovar
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Linda M Schiffhauer
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - David G Hicks
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| |
Collapse
|
7
|
Xu FF, Zheng SF, Xu C, Cai G, Wang SB, Qi WX, Wang CF, Chen JY, Lu C. Prognostic and predictive significance of tumor infiltrating lymphocytes for ductal carcinoma in situ. Oncoimmunology 2021; 10:1875637. [PMID: 33796401 PMCID: PMC7993193 DOI: 10.1080/2162402x.2021.1875637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study aims to identify the density of TILs in ductal carcinoma in situ (DCIS) in terms of prognostic significance with recurrence and the benefit of whole breast irradiation (WBI). The clinicopathological data of DCIS patients from Jan 2009 to Dec 2016 who received breast-conserving surgery (BCS) were retrospectively reviewed. Cox regression analysis was used to confirm independent prognostic factors of ipsilateral breast tumor recurrence (IBTR). Kaplan–Meier method was utilized to analyze IBTR and values of WBI. Touching-tumor-infiltrating lymphocytes (TILs) were defined by TILs touching or within one lymphocyte cell thickness from the malignant ducts’ basement membrane. In total, 129 patients were enrolled in this analysis with 98 patients who received WBI. After a median follow-up of 53.0 months, there were 16 IBTR events with five invasive IBTRs. Univariate and multivariate analyses showed that touching-TILs >5 were an independent prognostic factor for higher IBTR (HR = 6.17, 95%CI 1.95–19.56, p < .01). The whole cohort was classified into two subgroups: dense group (>5 touching-TILs per duct) and sparse group (≤5 touching-TILs per duct). Dense touching-TILs were associated with unfavorable biologic characteristics. The 5-y rate of IBTR between dense and sparse group was 29.0% versus 4.5% (p < .01). For the sparse group, WBI significantly reduced the rate of 5-y-IBTR risk from 13.2% to 1.7% (p = .02), but there was no benefit of WBI in the dense group. Touching-TILs density was heterogeneous in patients with DCIS. Sparse touching-TILs were associated with better prognosis and benefit from WBI. Dense touching-TILs not only were associated with a higher risk of IBTR but also lack of benefit from WBI.
Collapse
Affiliation(s)
- Fei-Fei Xu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Sai-Fang Zheng
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cheng Xu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Gang Cai
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shu-Bei Wang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei-Xiang Qi
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chao-Fu Wang
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Yi Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cao Lu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
8
|
Akashi M, Yamaguchi R, Kusano H, Obara H, Yamaguchi M, Toh U, Akiba J, Kakuma T, Tanaka M, Akagi Y, Yano H. Diverse histomorphology of HER2‐positive breast carcinomas based on differential ER expression. Histopathology 2020; 76:560-571. [DOI: 10.1111/his.14003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 09/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Momoko Akashi
- Department of Pathology Kurume University School of Medicine Kurume Fukuoka Japan
- Department of Surgery Kurume University School of Medicine Kurume Fukuoka Japan
| | - Rin Yamaguchi
- Department of Pathology Kurume University School of Medicine Kurume Fukuoka Japan
- Department of Pathology and Laboratory Medicine Kurume University Medical Centre Kurume Fukuoka Japan
| | - Hironori Kusano
- Department of Pathology Kurume University School of Medicine Kurume Fukuoka Japan
| | - Hitoshi Obara
- Biostatistics Centre Kurume University School of Medicine Kurume Fukuoka Japan
| | - Miki Yamaguchi
- Department of Surgery Japan Community Healthcare Organization Kurume General HospitalKurume Fukuoka Japan
| | - Uhi Toh
- Department of Surgery Kurume University School of Medicine Kurume Fukuoka Japan
| | - Jun Akiba
- Department of Diagnostic Pathology Kurume University Hospital Kurume Fukuoka Japan
| | - Tatsuyuki Kakuma
- Biostatistics Centre Kurume University School of Medicine Kurume Fukuoka Japan
| | - Maki Tanaka
- Department of Surgery Japan Community Healthcare Organization Kurume General HospitalKurume Fukuoka Japan
| | - Yoshito Akagi
- Department of Surgery Kurume University School of Medicine Kurume Fukuoka Japan
| | - Hirohisa Yano
- Department of Pathology Kurume University School of Medicine Kurume Fukuoka Japan
| |
Collapse
|
9
|
Lv S, Wang S, Qiao G, Wang X, Zhou X, Yan F, Li Y, Wang S, Morse MA, Hobeika A, Ren J, Lyerly HK. Functional CD3+CD8+PD1− T Cell Accumulation and PD-L1 Expression Increases During Tumor Invasion in DCIS of the Breast. Clin Breast Cancer 2019; 19:e617-e623. [DOI: 10.1016/j.clbc.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 04/01/2019] [Indexed: 01/21/2023]
|
10
|
Estrogen Receptor-positive Ductal Carcinoma In Situ Frequently Overexpresses HER2 Protein Without Gene Amplification. Am J Surg Pathol 2019; 43:1221-1228. [DOI: 10.1097/pas.0000000000001300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
11
|
Prognostic role of immune infiltrates in breast ductal carcinoma in situ. Breast Cancer Res Treat 2019; 177:17-27. [PMID: 31134489 DOI: 10.1007/s10549-019-05272-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/06/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Ductal carcinoma in situ (DCIS) of the breast is often regarded as a non-obligate precursor to invasive breast carcinoma but current diagnostic tools are unable to accurately predict the invasive potential of DCIS. Infiltration of immune cells into the tumour and its microenvironment is often an early event at the site of tumourigenesis. These immune infiltrates may be potential predictive and/or prognostic biomarkers for DCIS. This review aims to discuss recent findings pertaining to the potential prognostic significance of immune infiltrates as well as their evaluation in DCIS. METHODS A literature search on PubMed was conducted up to 28th January 2019. Search terms used were "DCIS", "ductal carcinoma in situ", "immune", "immunology", "TIL", "TIL assessment", and "tumour-infiltrating lymphocyte". Search filters for "Most Recent" and "English" were applied. Information from published papers related to the research topic were synthesised and summarised for this review. RESULTS Studies have revealed that immune infiltrates play a role in the biology and microenvironment of DCIS, as well as treatment response. There is currently no consensus on the evaluation of TILs in DCIS for clinical application. CONCLUSIONS This review highlights the recent findings on the potential influence and prognostic value of immunological processes on DCIS progression, as well as the evaluation of TILs in DCIS. Further characterisation of the immune milieu of DCIS is recommended to better understand the immune response in DCIS progression and recurrence.
Collapse
|
12
|
Dieci MV, Radosevic-Robin N, Fineberg S, van den Eynden G, Ternes N, Penault-Llorca F, Pruneri G, D’Alfonso TM, Demaria S, Castaneda C, Sanchez J, Badve S, Michiels S, Bossuyt V, Rojo F, Singh B, Nielsen T, Viale G, Kim SR, Hewitt S, Wienert S, Loibl S, Rimm D, Symmans F, Denkert C, Adams S, Loi S, Salgado R. Update on tumor-infiltrating lymphocytes (TILs) in breast cancer, including recommendations to assess TILs in residual disease after neoadjuvant therapy and in carcinoma in situ: A report of the International Immuno-Oncology Biomarker Working Group on Breast Cancer. Semin Cancer Biol 2018; 52:16-25. [DOI: 10.1016/j.semcancer.2017.10.003] [Citation(s) in RCA: 232] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022]
|
13
|
Beguinot M, Dauplat MM, Kwiatkowski F, Lebouedec G, Tixier L, Pomel C, Penault-Llorca F, Radosevic-Robin N. Analysis of tumour-infiltrating lymphocytes reveals two new biologically different subgroups of breast ductal carcinoma in situ. BMC Cancer 2018; 18:129. [PMID: 29394917 PMCID: PMC5797400 DOI: 10.1186/s12885-018-4013-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/22/2018] [Indexed: 12/16/2022] Open
Abstract
Background Tumour-infiltrating lymphocytes (TILs) have been demonstrated to significantly influence prognosis and response to therapy of invasive breast cancer (IBC). Thus, it has been suggested that TIL density or/and immunophenotype could serve as biomarkers for selection of IBC patients for immunotherapy. However, much less is known about significance of TILs in breast ductal carcinoma in situ (DCIS). Methods We retrospectively investigated TIL density and immunophenotype in 96 pure DCIS and 35 microinvasive carcinomas (miCa). TIL density was assessed on H&E-stained breast biopsy sections as the percentage of tumour stromal area occupied by TILs, and classified into 4 grades: 0 (0%–9%), 1 (10–29%), 2 (30–49%) and 3 (50%–100%). TIL immunophenotype was assessed by immunohistochemistry for CD8, CD4, FoxP3, CD38 or CD20. Results Compared to pure DCIS, miCa contained significantly more cases with TIL density grade 3 (p = 0.028). Concordantly, CD8+, CD4+ and CD38+ cells were more numerous in miCa than in pure DCIS. In the pure DCIS subgroup with TIL density grades 2 and 3, all TIL subpopulations were more numerous than in the pure DCIS with TIL density grades 0 and 1, however the ratio between T-lymphocytes (CD8+ and CD4+) and B-lymphocytes (CD20+) was significantly lower (p = 0.029). On the other side, this ratio was significantly higher in miCa, in comparison with pure DCIS having TIL density grades 2 and 3 (p = 0.017). By cluster analysis of tumour cell pathobiological features we demonstrated similarity between miCa and the pure DCIS with TIL density grades 2 and 3. The only significant difference between those two categories was in the ratio of T- to B-TILs, higher in miCa. Conclusion Results indicate that TIL density level can distinguish 2 biologically different DCIS subgroups, one of which (DCIS with ≥30% TILs, the TIL-rich DCIS) is like miCa. Similarity of TIL-rich pure DCIS and miCa as well as the role of B-lymphocytes in DCIS invasiveness are worth further investigating with regards to the potential development of immunotherapy-based prevention of DCIS progression. Electronic supplementary material The online version of this article (10.1186/s12885-018-4013-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Marie Beguinot
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.,Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,Master Program « Biology & Health », University Paris-East Val-de-Marne (UPEC), 61 avenue du General de Gaulle, 94010, Creteil, France
| | - Marie-Melanie Dauplat
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,Present Address: Department of Pathology, Paoli-Calmettes Comprehensive Cancer Centre, 232 boulevard Sainte-Marguerite, 13009, Marseilles, France
| | - Fabrice Kwiatkowski
- Department of Clinical Research, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Guillaume Lebouedec
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Lucie Tixier
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Christophe Pomel
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Frederique Penault-Llorca
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France.,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France
| | - Nina Radosevic-Robin
- Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, BP392, 63011, Clermont-Ferrand, France. .,University Clermont Auvergne, INSERM U1240, Jean Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63011, Clermont-Ferrand, France.
| |
Collapse
|