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Pereira A, Siegrist J, Lizarraga S, Pérez-Medina T. Clustering Molecular Subtypes in Breast Cancer, Immunohistochemical Parameters and Risk of Axillary Nodal Involvement. J Pers Med 2022; 12:jpm12091404. [PMID: 36143189 PMCID: PMC9505126 DOI: 10.3390/jpm12091404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: To establish similarities in the risk of axillary lymph node metastasis between different groups of women with breast cancer according to immunohistochemical (IHC) parameters. (2) Methods: Data was collected retrospectively, from 2000 to 2013, of 1058 node-positive breast tumours. All patients were divided according to the St Gallen 2013 criteria and IHC features. The proportion of axillary involvement (pN > pN0; pN > pN1mi; pN > pN1) was calculated for each group. Similarities in axillary nodal dissemination were explored by cluster analysis and association between IHC and risk of axillary disease was studied with multivariate analysis. (3) Results: Among clinico-pathological surrogates of intrinsic subtypes, axillary involvement was more frequent in Luminal-B like HER2 negative (45.8%) and less frequent in Luminal-B HER2 positive (33.8%; p = 0.044). Axillary macroscopic involvement was more frequent in Luminal-B like HER2 negative (37.9%) and HER2 positive (37.8%) and less frequent in Luminal-B HER2 positive (25.5%) and Luminal-A like (25.6%; p = 0.002). Axillary involvement ≥pN2 was significantly less frequent in Luminal-A like (7.4%; p < 0.001). Luminal-A with Luminal-B HER2 positive, and triple-negative with Erb-B2 overexpressing tumours were clustered together regarding any axillary involvement, macroscopic disease or ≥pN2. Among the defined subgroups, axillary metastases were more frequent when Ki67 was higher. In a multivariate analysis, Ki67>14% were associated with a risk of axillary metastases (HR: 1.31; 95% CI, 1.51−6.80; p < 0.037). (4) Conclusions: there are two lymphatic drainage pathways of the breast according to the expression of hormone receptor-related genes. Positive-ER tumors are associated with lower axillary involvement and negative-ER tumors and Ki67 > 14% with higher nodal involvement.
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Affiliation(s)
- Augusto Pereira
- Department of Gynecologic Surgery, Puerta de Hierro University Hospital, 28222 Madrid, Spain
- Correspondence:
| | - Jaime Siegrist
- Division of Gynecologic Oncology, La Paz University Hospital, 28046 Madrid, Spain
| | - Santiago Lizarraga
- Department of Obstetrics and Gynecology, Gregorio Marañon University General Hospital, 28009 Madrid, Spain
| | - Tirso Pérez-Medina
- Department of Gynecologic Surgery, Puerta de Hierro University Hospital, 28222 Madrid, Spain
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Dosh ZN, Muslim LM, Hasan MMSM, Al Janabi A. CORRELATION BETWEEN PRIMARY TUMOR SIZES WITH PROGNOSTIC MARKERS IN BREAST CARCINOMA IN IRAQI WOMEN: IMMUNOHISTOCHEMICAL STUDY. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2771-2778. [PMID: 36591767 DOI: 10.36740/wlek202211210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: The study aimed assessment of immunohistochemical expression of ER, PR, Ki-67 and HER2 in breast carcinoma, studied the relation between size of primary tumor and these markers and distribution of molecular subtypes between both study groups. PATIENTS AND METHODS Materials and methods: The study was implemented immunohistochemistry laboratories of Al-Sadder Teaching Medical City in Al Najaf during the period from September 2020-september2021, forty four women with breast carcinoma who undergone modified radical mastectomy were involved in this study, aged between 29 -81 years, mean age being 47.3 yr. we divided study group into two categories; depending on tumor size, with cutoff point of 2 cm. Envision technique applied for evaluation of expression of ER, PR, Ki-67 and HER2. RESULTS Results: Among all patients, ER expressed in 70.45%, PR in 68.18%, HER2/neu in 18.18%, High ki-67 index in 52.27%. CONCLUSION Conclusions: Molecular subtype luminal A tend to occur in smaller tumor size compared to basal subtype which tend to occur in larger size of tumors. Breast carcinoma tumor size showed no significant correlation regarding histological grade, immunohistochemical expression of ER, PR, HER2, and Ki-67 labeling index.
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Affiliation(s)
- Zainab Nassir Dosh
- DEPARTMENT OF PATHOLOGY AND FORENSIC MEDICINE, FACULTY OF MEDICINE, UNIVERSITY OF KUFA, NAJAF, IRAQ
| | | | | | - Asaad Al Janabi
- DEPARTMENT OF PATHOLOGY AND FORENSIC MEDICINE, FACULTY OF MEDICINE, UNIVERSITY OF KUFA, NAJAF, IRAQ
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Li Y, Ma L. Nomograms predict survival of patients with lymph node-positive, luminal a breast cancer. BMC Cancer 2021; 21:965. [PMID: 34454451 PMCID: PMC8401066 DOI: 10.1186/s12885-021-08642-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background To develop nomograms for the prediction of the 1-, 3-, and 5-year overall survival (OS) and breast cancer-specific survival (BCSS) for patients with lymph node positive, luminal A breast cancer. Methods Thirty-nine thousand fifty-one patients from The Surveillance, Epidemiology, and End Results (SEER) database were included in our study and were set into a training group (n = 19,526) and a validation group (n = 19,525). Univariate analysis and Cox proportional hazards analysis were used to select variables and set up nomogram models on the basis of the training group. Kaplan-Meier curves and the log-rank test were adopted in the survival analysis and curves plotting. C-index, calibration plots and ROC curves were used to performed internal and external validation on the training group and validation group. Results Following independent factors were included in our nomograms: Age, marital status, grade, ethnic group, T stage, positive lymph nodes numbers, Metastasis, surgery, radiotherapy, chemotherapy. In both the training group and testing group, the calibration plots show that the actual and nomogram-predicted survival probabilities are consistent greatly. The C-index values of the nomograms in the training and validation cohorts were 0.782 and 0.806 for OS and 0.783 and 0.804 for BCSS, respectively. The ROC curves show that our nomograms have good discrimination. Conclusions The nomograms may assist clinicians predict the 1-, 3-, and 5-year OS and BCSS of patients with lymph node positive, luminal A breast cancer.
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Affiliation(s)
- Yilun Li
- The Fourth Hospital of Hebei Medical University, No. 169 Tianshan Street, Yuhua District, Shi Jiazhuang City, Hebei Province, China
| | - Li Ma
- The Fourth Hospital of Hebei Medical University, No. 169 Tianshan Street, Yuhua District, Shi Jiazhuang City, Hebei Province, China.
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Zhang W, Xu J, Wang K, Tang XJ, Liang H, He JJ. Independent risk factors for axillary lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes. BMC WOMENS HEALTH 2020; 20:143. [PMID: 32646416 PMCID: PMC7350751 DOI: 10.1186/s12905-020-01004-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 06/26/2020] [Indexed: 12/24/2022]
Abstract
Background The benefit of axillary lymph node dissection (ALND) in breast cancer patients with one or two positive sentinel lymph nodes (SLNs) remains inconclusive. The purpose of this study was to identify risk factors independently associated with axillary lymph node (ALN) metastasis. Methods We retrospectively analyzed data from 389 Chinese breast cancer patients with one or two positive SLNs who underwent ALND. Univariate and multivariate logistic regression analyses were performed to identify ALN metastasis-associated risk factors. Results Among the 389 patients, 174 (44.7%) had ALN metastasis, while 215 (55.3%) showed no evidence of ALN metastasis. Univariate analysis revealed significant differences in age (< 60 or ≥ 60 years), human epidermal growth factor receptor-2 (Her-2) status, and the ratio of positive to total SLNs between the ALN metastasis and non-metastasis groups (P < 0.05). The multivariate analysis indicated that age, the ratio of positive to total SLNs, and occupations were significantly different between the two groups. Lastly, younger age (< 60 years), a higher ratio of positive to total SLNs, and manual labor jobs were independently associated with ALN metastasis (P < 0.05). Conclusions The risk of ALN metastasis in breast cancer patients with one or two positive SLNs can be further increased by younger age, manual labor jobs, and a high ratio of positive to total SLNs. Our findings may also aid in identifying which patients with one or two positive SLNs may not require ALND.
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Affiliation(s)
- Wei Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Rd., Xi'an, 710061, Shaanxi, China
| | - Jing Xu
- Department of Geriatric Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Ke Wang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Rd., Xi'an, 710061, Shaanxi, China
| | - Xiao-Jiang Tang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Rd., Xi'an, 710061, Shaanxi, China
| | - Hua Liang
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Jian-Jun He
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Rd., Xi'an, 710061, Shaanxi, China.
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Dass TA, Rakesh S, Prakash KP, Singh C. Correlation of Various Biomarkers with Axillary Nodal Metastases: Can a Panel of Such Biomarkers Guide Selective Use of Axillary Surgery in T1 Breast Cancer? Indian J Surg Oncol 2016; 6:346-51. [PMID: 27065659 DOI: 10.1007/s13193-015-0424-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 05/19/2015] [Indexed: 11/26/2022] Open
Abstract
To evaluate the correlation of various clinic-pathological variables with axillary nodal involvement in T1 breast cancer & to identify a sub-group of T1 cancers, on the basis of observed variables, with a low risk of axillary nodal metastases. Clinico-pathological variables observed included tumor size, lymphovascular invasion (LVI), histological grade of tumor, tumor palpability, estrogen/progesterone (ER/PR) & her2/neu receptors, age, family history, histological type of tumor, axillary nodal metastases for 100 patients without clinically palpable nodes who underwent axillary lymph node dissection in Bombay Hospital & Medical Research Center from March, 2009. Data compiled was analyzed by univariate & multivariate analysis. All the variables viz. tumor size, LVI, histological grade, tumor palpability & ER/PR/Her2 receptor profile, which were found to be significantly associated with axillary lymph node involvement (ALNI) on univariate analysis were also found to be independent predictors of ALNI on multivariate analysis. Age of the patient, family history & histological type of tumor were not significantly correlated with ALNI. None of the 12 patients with tumor biomarker profile of T1a-b tumors without LVI & with histological grade I, had ALNI. The risk of ALNI can be predicted by using various tumor biomarker variables. Based on the predicted risk of ALNI, the management strategy for axilla can be individualized. The omission of operative axillary staging may be considered in patients with low predictive risk of ALNI.
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Affiliation(s)
- Tufale A Dass
- Surgical Oncology Department, Bombay Hospital & Medical Research Centre, Doctors quarters, MRC Building, Room no 725, New-marine lines-12, Mumbai, 400020 India
| | - Sharma Rakesh
- Surgical Oncology Department, Bombay Hospital & Medical Research Centre, Doctors quarters, MRC Building, Room no 725, New-marine lines-12, Mumbai, 400020 India
| | - K Patil Prakash
- Surgical Oncology Department, Bombay Hospital & Medical Research Centre, Doctors quarters, MRC Building, Room no 725, New-marine lines-12, Mumbai, 400020 India
| | - Chandraveer Singh
- Surgical Oncology Department, Bombay Hospital & Medical Research Centre, Doctors quarters, MRC Building, Room no 725, New-marine lines-12, Mumbai, 400020 India
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Farid RM, Ahmed NS. Histolopathologic approach to direct the management of the axilla in early breast cancer patients. APMIS 2014; 122:1032-41. [DOI: 10.1111/apm.12256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 01/06/2014] [Indexed: 12/23/2022]
Affiliation(s)
- Rola M Farid
- Department of Pathology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Naglaa S Ahmed
- Department of Pathology; Faculty of Medicine; Ain Shams University; Cairo Egypt
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Cakir M, Tekin A, Kücükkartallar T, Vatansev C, Aksoy F, Kartal A, Tuncer FB. Axillary lymph node status in multicentric breast tumors and breast tumors with nipple involvement. ACTA ACUST UNITED AC 2014; 7:394-6. [PMID: 24647779 DOI: 10.1159/000343299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Axillary lymph node dissection plays an important role in breast cancer management in terms of staging, prediction of prognosis, determination of adjuvant therapy, and local control of the primary tumor. The objective of this study was to evaluate the axillary lymph node involvement in multicentric breast tumors and breast tumors with nipple involvement in comparison with unifocal tumors. PATIENTS AND METHODS We reviewed the records of 267 patients with stage I or IIA disease. The rates of axillary lymph node metastasis (ALNM) in patients with unifocal tumors, multicentric tumors, or nipple involvement were compared. RESULTS 209 (78%) patients had unifocal tumors, 24 (8%) had multicentric tumors, and 34 (12%) had nipple involvement. The incidence of ALNM was 9.76% in patients with unifocal tumors, 24.84% in patients with multicentric tumors, and 36.71% in patients with nipple involvement. Hence, the incidence of ALNM was significantly higher in patients with nipple involvement or multicentric tumors than in patients with unifocal tumors. CONCLUSION Our data suggest that compared to unifocal tumors, breast tumors with nipple involvement or multiple foci show a significantly higher incidence of ALNM which is a predictor of a poor prognosis.
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Affiliation(s)
- Murat Cakir
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
| | - Ahmet Tekin
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
| | - Tevfik Kücükkartallar
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
| | - Celalettin Vatansev
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
| | - Faruk Aksoy
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
| | - Adil Kartal
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
| | - Fatma B Tuncer
- Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey
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Deb S, Jene N, Fox SB. Genotypic and phenotypic analysis of familial male breast cancer shows under representation of the HER2 and basal subtypes in BRCA-associated carcinomas. BMC Cancer 2012; 12:510. [PMID: 23146383 PMCID: PMC3561656 DOI: 10.1186/1471-2407-12-510] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 10/05/2012] [Indexed: 01/07/2023] Open
Abstract
Background Male breast cancer (MBC) is an uncommon and relatively uncharacterised disease accounting for <1% of all breast cancers. A significant proportion occurs in families with a history of breast cancer and in particular those carrying BRCA2 mutations. Here we describe clinicopathological features and genomic BRCA1 and BRCA2 mutation status in a large cohort of familial MBCs. Methods Cases (n=60) included 3 BRCA1 and 25 BRCA2 mutation carries, and 32 non-BRCA1/2 (BRCAX) carriers with strong family histories of breast cancer. The cohort was examined with respect to mutation status, clinicopathological parameters including TNM staging, grade, histological subtype and intrinsic phenotype. Results Compared to the general population, MBC incidence was higher in all subgroups. In contrast to female breast cancer (FBC) there was greater representation of BRCA2 tumours (41.7% vs 8.3%, p=0.0008) and underrepresentation of BRCA1 tumours (5.0% vs 14.4%, p=0.0001). There was no correlation between mutation status and age of onset, disease specific survival (DSS) or other clincopathological factors. Comparison with sporadic MBC studies showed similar clinicopathological features. Prognostic variables affecting DSS included primary tumour size (p=0.003, HR:4.26 95%CI 1.63-11.11), age (p=0.002, HR:4.09 95%CI 1.65-10.12), lymphovascular (p=0.019, HR:3.25 95%CI 1.21-8.74) and perineural invasion (p=0.027, HR:2.82 95%CI 1.13-7.06). Unlike familial FBC, the histological subtypes seen in familial MBC were more similar to those seen in sporadic MBC with 46 (76.7%) pure invasive ductal carcinoma of no special type (IDC-NST), 2 (3.3%) invasive lobular carcinomas and 4 (6.7%) invasive papillary carcinoma. A further 8 (13.3%) IDC-NST had foci of micropapillary differentiation, with a strong trend for co-occurrence in BRCA2 carriers (p=0.058). Most tumours were of the luminal phenotype (89.7%), with infrequent HER2 (8.6%) and basal (1.7%) phenotype tumours seen. Conclusion MBC in BRCA1/2 carriers and BRCAX families is different to females. Unlike FBC, a clear BRCA1 phenotype is not seen but a possible BRCA2 phenotype of micropapillary histological subtype is suggested. Comparison with sporadic MBCs shows this to be a high-risk population making further recruitment and investigation of this cohort of value in further understanding these uncommon tumours.
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Affiliation(s)
- Siddhartha Deb
- Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, 3002, Australia.
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Xie F, Yang H, Wang S, Zhou B, Tong F, Yang D, Zhang J. A logistic regression model for predicting axillary lymph node metastases in early breast carcinoma patients. SENSORS (BASEL, SWITZERLAND) 2012; 12:9936-50. [PMID: 23012578 PMCID: PMC3444135 DOI: 10.3390/s120709936] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 07/09/2012] [Accepted: 07/09/2012] [Indexed: 01/17/2023]
Abstract
Nodal staging in breast cancer is a key predictor of prognosis. This paper presents the results of potential clinicopathological predictors of axillary lymph node involvement and develops an efficient prediction model to assist in predicting axillary lymph node metastases. Seventy patients with primary early breast cancer who underwent axillary dissection were evaluated. Univariate and multivariate logistic regression were performed to evaluate the association between clinicopathological factors and lymph node metastatic status. A logistic regression predictive model was built from 50 randomly selected patients; the model was also applied to the remaining 20 patients to assess its validity. Univariate analysis showed a significant relationship between lymph node involvement and absence of nm-23 (p = 0.010) and Kiss-1 (p = 0.001) expression. Absence of Kiss-1 remained significantly associated with positive axillary node status in the multivariate analysis (p = 0.018). Seven clinicopathological factors were involved in the multivariate logistic regression model: menopausal status, tumor size, ER, PR, HER2, nm-23 and Kiss-1. The model was accurate and discriminating, with an area under the receiver operating characteristic curve of 0.702 when applied to the validation group. Moreover, there is a need discover more specific candidate proteins and molecular biology tools to select more variables which should improve predictive accuracy.
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Affiliation(s)
| | | | - Shu Wang
- Breast Disease Center, Peking University, People's Hospital, Beijing 100044, China; E-Mails: (F.X.); (H.Y.); (B.Z.); (F.T.); (D.Y.); (J.Z.)
| | - Bo Zhou
- Breast Disease Center, Peking University, People's Hospital, Beijing 100044, China; E-Mails: (F.X.); (H.Y.); (B.Z.); (F.T.); (D.Y.); (J.Z.)
| | - Fuzhong Tong
- Breast Disease Center, Peking University, People's Hospital, Beijing 100044, China; E-Mails: (F.X.); (H.Y.); (B.Z.); (F.T.); (D.Y.); (J.Z.)
| | - Deqi Yang
- Breast Disease Center, Peking University, People's Hospital, Beijing 100044, China; E-Mails: (F.X.); (H.Y.); (B.Z.); (F.T.); (D.Y.); (J.Z.)
| | - Jiaqing Zhang
- Breast Disease Center, Peking University, People's Hospital, Beijing 100044, China; E-Mails: (F.X.); (H.Y.); (B.Z.); (F.T.); (D.Y.); (J.Z.)
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Mak H, Naba A, Varma S, Schick C, Day A, SenGupta SK, Arpin M, Elliott BE. Ezrin phosphorylation on tyrosine 477 regulates invasion and metastasis of breast cancer cells. BMC Cancer 2012; 12:82. [PMID: 22397367 PMCID: PMC3372425 DOI: 10.1186/1471-2407-12-82] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 03/07/2012] [Indexed: 11/11/2022] Open
Abstract
Background The membrane cytoskeletal crosslinker, ezrin, a member of the ERM family of proteins, is frequently over-expressed in human breast cancers, and is required for motility and invasion of epithelial cells. Our group previously showed that ezrin acts co-operatively with the non-receptor tyrosine kinase, Src, in deregulation of cell-cell contacts and scattering of epithelial cells. In particular, ezrin phosphorylation on Y477 by Src is specific to ezrin within the ERM family, and is required for HGF-induced scattering of epithelial cells. We therefore sought to examine the role of Y477 phosphorylation in ezrin on tumor progression. Methods Using a highly metastatic mouse mammary carcinoma cell line (AC2M2), we tested the effect of over-expressing a non-phosphorylatable form of ezrin (Y477F) on invasive colony growth in 3-dimensional Matrigel cultures, and on local invasion and metastasis in an orthotopic engraftment model. Results AC2M2 cells over-expressing Y477F ezrin exhibited delayed migration in vitro, and cohesive round colonies in 3-dimensional Matrigel cultures, compared to control cells that formed invasive colonies with branching chains of cells and numerous actin-rich protrusions. Moreover, over-expression of Y477F ezrin inhibits local tumor invasion in vivo. Whereas orthotopically injected wild type AC2M2 tumor cells were found to infiltrate into the abdominal wall and visceral organs within three weeks, tumors expressing Y477F ezrin remained circumscribed, with little invasion into the surrounding stroma and abdominal wall. Additionally, Y477F ezrin reduces the number of lung metastatic lesions. Conclusions Our study implicates a role of Y477 ezrin, which is phosphorylated by Src, in regulating local invasion and metastasis of breast carcinoma cells, and provides a clinically relevant model for assessing the Src/ezrin pathway as a potential prognostic/predictive marker or treatment target for invasive human breast cancer.
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Affiliation(s)
- Hannah Mak
- Division of Cancer Biology and Genetics, Cancer Research Institute, Queen's University, Kingston, ON, K7L 3N6, Canada
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Lewis EI, Ozonoff A, Nguyen CP, Kim M, Slanetz PJ. Breast Cancer Close to the Nipple: Does This Increase the Risk of Nodal Metastasis at Diagnosis? Can Assoc Radiol J 2011; 62:209-14. [DOI: 10.1016/j.carj.2010.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 03/13/2010] [Accepted: 03/21/2010] [Indexed: 10/19/2022] Open
Abstract
Background Previous studies of patients with invasive breast cancer examined, with mixed results, tumour location as a predictor of axillary lymph node metastasis. This study assessed whether tumour location in relation to the nipple impacts the presence of axillary lymph node metastasis at the time of diagnosis. Methods A retrospective review was undertaken of the medical records and available imaging of 285 patients diagnosed with invasive breast cancer between January 2001 to June 2007 at Boston University Medical Center. The incidence of axillary lymph node metastasis was correlated with tumour location in relation to the posterior nipple line to control for variation in breast size. Bivariate analysis identified significant variables that were applied to a multiple logistic regression model. Results Axillary lymph node metastasis was not significantly associated with tumour proximity to the nipple. In the multivariate logistic regression analysis, known prognostic factors for axillary metastasis, such as surgical size, lymphovascular invasion, and age of diagnosis, were significant, whereas breast density, palpability, and histologic grade were no longer significant. Conclusions Our study found that there was no evidence that correlates intramammary tumour proximity to the nipple with the presence of axillary lymph node metastasis at diagnosis. However, known prognostic factors, such as lymphovascular invasion, surgical size, and younger age at diagnosis, are strong independent predictors for axillary lymph node involvement.
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Affiliation(s)
- Erin I. Lewis
- Department of Radiology, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts, USA
| | - Al Ozonoff
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Cheri P. Nguyen
- Department of Radiology, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Michael Kim
- Department of Radiology, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts, USA
| | - Priscilla J. Slanetz
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Lee JH, Kim SH, Suh YJ, Shim BY, Kim HK. Predictors of axillary lymph node metastases (ALNM) in a Korean population with T1-2 breast carcinoma: triple negative breast cancer has a high incidence of ALNM irrespective of the tumor size. Cancer Res Treat 2010; 42:30-6. [PMID: 20369049 DOI: 10.4143/crt.2010.42.1.30] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 12/18/2009] [Indexed: 11/21/2022] Open
Abstract
PURPOSE We estimated the likelihood of breast cancer patients having axillary lymph node metastases (ALNM) based on a variety of clinical and pathologic factors. MATERIALS AND METHODS Three hundred sixty-one breast cancer patients without distant metastases and who underwent breast conserving surgery and axillary lymph node dissection (ALND) (level I and II) or modified radical mastectomy (MRM) were identified, and we retrospectively reviewed their pathology records and treatment charts. RESULTS Positive axillary lymph nodes were detected in 104 patients for an overall incidence of 28.8%: 2 patients (5%) with T1a tumor, 5 (9.2%) with T1b tumor, 24 (21.8%) with T1c tumor and 73 (44.2%) with T2 tumor. On the multivariate analysis, an increased tumor size (adjusted OR=11.87, p=0.02), the presence of lymphovascular invasion (adjusted OR=7.41, p<0.01), a triple negative profile (ER/PR-, Her2-) (adjusted OR=2.09, p=0.04) and a palpable mass at the time of diagnosis (adjusted OR=2.31, p=0.03) were all significant independent factors for positive ALNM. CONCLUSION In our study, the tumor size, the presence of lymphovascular invasion, a triple negative profile and a palpable mass were the independent predictive factors for ALNM. The tumor size was the strongest predictor of ALNM. Thus, the exact estimation of the extent of tumor is necessary for clinicians to optimize the patients' care. Patients with a triple negative profile have a high incidence of ALNM irrespective of the tumor size.
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Affiliation(s)
- Jong Hoon Lee
- Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University College of Medicine, Suwon, Korea
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Lee JH, Kim SH, Suh YJ, Shim BY. Predictors of 4 or More Positive Axillary Nodes in Patients with Node-positive T1-2 Breast Carcinoma: The Indications for Adjuvant Irradiation of the Level III Axilla and Supraclavicular Fossa. J Breast Cancer 2010. [DOI: 10.4048/jbc.2010.13.2.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jong Hoon Lee
- Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Sung Hwan Kim
- Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Young Jin Suh
- Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Byoung Yong Shim
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
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Dunn M, Morgan MB, Beer TW, Chen KTK, Acker SM. Histologic mimics of perineural invasion. J Cutan Pathol 2009; 36:937-42. [DOI: 10.1111/j.1600-0560.2008.01197.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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15
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Susini T, Nori J, Olivieri S, Molino C, Marini G, Bianchi S, Vezzosi V, Livi L, Mascalchi M, Scarselli G. Predicting the status of axillary lymph nodes in breast cancer: A multiparameter approach including axillary ultrasound scanning. Breast 2009; 18:103-8. [DOI: 10.1016/j.breast.2009.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Revised: 01/31/2009] [Accepted: 02/02/2009] [Indexed: 12/11/2022] Open
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Results of pancreaticoduodenectomy in patients with periampullary adenocarcinoma: perineural growth more important prognostic factor than tumor localization. Ann Surg 2008; 248:97-103. [PMID: 18580212 DOI: 10.1097/sla.0b013e31817b6609] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To study the impact of perineural growth as a prognostic factor in periampullary adenocarcinoma (pancreatic head, ampulla of Vater, distal bile duct, and duodenal carcinoma). SUMMARY BACKGROUND DATA Pancreatic head carcinoma is considered to have the worst prognosis of the periampullary carcinomas. Several other prognostic factors for periampullary tumors have been identified, eg, lymph node status, free resection margins, tumor size and differentiation, and vascular invasion. The impact of perineural growth as a prognostic factor in relation to the site of origin of periampullary carcinomas is unknown. METHODS Data of 205 patients with periampullary carcinomas were retrieved from our prospective database. Pancreaticoduodenectomy was performed in 121 patients. Their clinicopathological data were reviewed and analyzed in a multivariate analysis. RESULTS Perineural growth was present in 49% of the cases (37 of the 51 patients with pancreatic head carcinoma; 7 of the 30 patients with ampulla of Vater carcinoma; 7 of the 19 with distal bile duct carcinoma; and 8 of the 21 with duodenal carcinoma). Overall 5-year survival was 32.6% with a median survival of 20.7 months. Median survival in tumors with perineural growth was 13.1 months compared with 36.0 months in tumors without perineural growth (P < 0.0001) Using multivariate analysis, the following unfavorable prognostic factors were identified: perineural growth (RR = 2.90, 95% CI 1.62-5.22), nonradical resection (RR = 2.28, 95% CI 1.19-4.36), positive lymph nodes (RR = 1.96, 95% CI 1.11-3.45), and angioinvasion (RR = 1.79, 95% CI 1.05-3.06). Portal or superior mesenteric vein reconstruction and tumor localization were not of statistical significance. CONCLUSION Perineural growth is a more important risk factor for survival than the primary site of periampullary carcinomas.
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