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Li N, Li JW, Qian Y, Liu YJ, Qi XZ, Chen YL, Gao Y, Chang C. Axillary lymph node metastasis in pure mucinous carcinoma of breast: clinicopathologic and ultrasonographic features. BMC Med Imaging 2024; 24:108. [PMID: 38745134 PMCID: PMC11094983 DOI: 10.1186/s12880-024-01290-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/03/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The purpose of this research is to study the sonographic and clinicopathologic characteristics that associate with axillary lymph node metastasis (ALNM) for pure mucinous carcinoma of breast (PMBC). METHODS A total of 176 patients diagnosed as PMBC after surgery were included. According to the status of axillary lymph nodes, all patients were classified into ALNM group (n = 15) and non-ALNM group (n = 161). The clinical factors (patient age, tumor size, location), molecular biomarkers (ER, PR, HER2 and Ki-67) and sonographic features (shape, orientation, margin, echo pattern, posterior acoustic pattern and vascularity) between two groups were analyzed to unclose the clinicopathologic and ultrasonographic characteristics in PMBC with ALNM. RESULTS The incidence of axillary lymph node metastasis was 8.5% in this study. Tumors located in the outer side of the breast (upper outer quadrant and lower outer quadrant) were more likely to have lymphatic metastasis, and the difference between the two group was significantly (86.7% vs. 60.3%, P = 0.043). ALNM not associated with age (P = 0.437). Although tumor size not associated with ALNM(P = 0.418), the tumor size in ALNM group (32.3 ± 32.7 mm) was bigger than non-ALNM group (25.2 ± 12.8 mm). All the tumors expressed progesterone receptor (PR) positively, and 90% of all expressed estrogen receptor (ER) positively, human epidermal growth factor receptor 2 (HER2) were positive in two cases of non-ALNM group. Ki-67 high expression was observed in 36 tumors in our study (20.5%), and it was higher in ALNM group than non-ALNM group (33.3% vs. 19.3%), but the difference wasn't significantly (P = 0.338). CONCLUSIONS Tumor location is a significant factor for ALNM in PMBC. Outer side location is more easily for ALNM. With the bigger size and/or Ki-67 higher expression status, the lymphatic metastasis seems more likely to present.
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Affiliation(s)
- Na Li
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jia-Wei Li
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yu Qian
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ya-Jing Liu
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiu-Zhu Qi
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ya-Ling Chen
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yi Gao
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Cai Chang
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Rosano D, Sofyali E, Dhiman H, Ghirardi C, Ivanoiu D, Heide T, Vingiani A, Bertolotti A, Pruneri G, Canale E, Dewhurst HF, Saha D, Slaven N, Barozzi I, Li T, Zemlyanskiy G, Phillips H, James C, Győrffy B, Lynn C, Cresswell GD, Rehman F, Noberini R, Bonaldi T, Sottoriva A, Magnani L. Long-term Multimodal Recording Reveals Epigenetic Adaptation Routes in Dormant Breast Cancer Cells. Cancer Discov 2024; 14:866-889. [PMID: 38527495 PMCID: PMC11061610 DOI: 10.1158/2159-8290.cd-23-1161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/10/2024] [Accepted: 02/20/2024] [Indexed: 03/27/2024]
Abstract
Patients with estrogen receptor-positive breast cancer receive adjuvant endocrine therapies (ET) that delay relapse by targeting clinically undetectable micrometastatic deposits. Yet, up to 50% of patients relapse even decades after surgery through unknown mechanisms likely involving dormancy. To investigate genetic and transcriptional changes underlying tumor awakening, we analyzed late relapse patients and longitudinally profiled a rare cohort treated with long-term neoadjuvant ETs until progression. Next, we developed an in vitro evolutionary study to record the adaptive strategies of individual lineages in unperturbed parallel experiments. Our data demonstrate that ETs induce nongenetic cell state transitions into dormancy in a stochastic subset of cells via epigenetic reprogramming. Single lineages with divergent phenotypes awaken unpredictably in the absence of recurrent genetic alterations. Targeting the dormant epigenome shows promising activity against adapting cancer cells. Overall, this study uncovers the contribution of epigenetic adaptation to the evolution of resistance to ETs. SIGNIFICANCE This study advances the understanding of therapy-induced dormancy with potential clinical implications for breast cancer. Estrogen receptor-positive breast cancer cells adapt to endocrine treatment by entering a dormant state characterized by strong heterochromatinization with no recurrent genetic changes. Targeting the epigenetic rewiring impairs the adaptation of cancer cells to ETs. See related commentary by Llinas-Bertran et al., p. 704. This article is featured in Selected Articles from This Issue, p. 695.
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Affiliation(s)
- Dalia Rosano
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Center, The Institute of Cancer Research, London, United Kingdom
| | - Emre Sofyali
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Heena Dhiman
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Center, The Institute of Cancer Research, London, United Kingdom
| | - Chiara Ghirardi
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Diana Ivanoiu
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Timon Heide
- Human Technopole, Milan, Italy
- Centre for Evolution and Cancer, Institute of Cancer Research, London, United Kingdom
| | | | | | - Giancarlo Pruneri
- Istituto Nazionale Tumori, Milan, Italy
- Department of Oncology and Haematology-Oncology, University of Milano, Milano, Italy
| | - Eleonora Canale
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Hannah F. Dewhurst
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Debjani Saha
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Neil Slaven
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley
| | - Iros Barozzi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Centre for Cancer Research, Medical University of Vienna, Austria
| | - Tong Li
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Grigory Zemlyanskiy
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Henry Phillips
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Chela James
- Human Technopole, Milan, Italy
- Centre for Evolution and Cancer, Institute of Cancer Research, London, United Kingdom
| | - Balázs Győrffy
- Department of Bioinformatics, Semmelweis University, Budapest, Hungary
- RCNS Cancer Biomarker Research Group, Budapest, Hungary
- Department of Biophysics, Medical School, University of Pecs, Pecs, Hungary
| | - Claire Lynn
- Centre for Evolution and Cancer, Institute of Cancer Research, London, United Kingdom
| | - George D. Cresswell
- Centre for Evolution and Cancer, Institute of Cancer Research, London, United Kingdom
| | - Farah Rehman
- Charing Cross Hospital, Imperial College NHS Trust, London, United Kingdom
| | - Roberta Noberini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Tiziana Bonaldi
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Haematology-Oncology, University of Milano, Milano, Italy
| | - Andrea Sottoriva
- Human Technopole, Milan, Italy
- Centre for Evolution and Cancer, Institute of Cancer Research, London, United Kingdom
| | - Luca Magnani
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Center, The Institute of Cancer Research, London, United Kingdom
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Sanli AN, Tekcan Sanli DE, Aydogan F, Altundag MK. Should the Breast Cancer Staging System be Revised? Am Surg 2024; 90:1066-1073. [PMID: 38128067 DOI: 10.1177/00031348231223074] [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] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether breast cancer patients at stage T2N0 with tumor size ≥4 cm and <4 cm. METHOD Patients with T2N0 stage breast cancer diagnosed between 2010 and 2019 were analyzed in 2 groups as <4 cm (T2a) and ≥4 cm (T2b) in the study using the SEER 17 Research Plus database. The patients' clinicopathological characteristics and oncological outcomes were included. Group comparisons of prognostic factors, overall survival (OS), and cancer-specific survival (CSS) were made. RESULTS In this study, which involved 70971 patients, the T2a group had higher 5-year OS rate (87.2 ± .2 vs 80.8 ± .5%) and 5-year CSS rate (93.7 ± .1% vs 89.4 ± .4%) than the T2b group (P < .001). Univariate analysis revealed that the overall risk of death was 1.5 times higher in T2b than T2a (HR: 1.533 [95% CI: 1.450-1.622], P < .001), whereas multivariate analysis demonstrated the risk was 1.4 times higher (HR: 1.384 [95% CI: 1.307-1.466], P < .001). The risk of cancer-specific death was 1.7 times higher in univariate analysis (HR: 1.691 [95% CI: 1.561-1.832], P < .001) and 1.4 times higher in multivariate analysis (HR: 1.420 [95% CI: 1.309-1.541], P < .001). CONCLUSION Overall survival and BCSS rates in stage T2b breast cancer patients are significantly lower than in T2a patients. Tumor size ≥4 cm in breast cancer is a negative predictor of prognosis.
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Affiliation(s)
- Ahmet Necati Sanli
- Department of General Surgery, Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
| | | | - Fatih Aydogan
- Department of General Surgery, Kirklareli University, Faculty of Medicine, Kirklareli, Turkey
- Breast Health Center, Memorial Bahcelievler Hospital, Istanbul, Turkey
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Liu R, Chen J, Cao W, Li T, Liao Y, Li Y. Risk factors and prognosis of sentinel lymph node metastasis in breast-conserving breast cancer: A retrospective study based on the SEER database. Medicine (Baltimore) 2024; 103:e37263. [PMID: 38428869 PMCID: PMC10906604 DOI: 10.1097/md.0000000000037263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/24/2024] [Indexed: 03/03/2024] Open
Abstract
At present, the risk factors and prognosis of sentinel lymph node metastasis (SLNM) are analyzed based on the study of axillary lymph node metastasis, but whether there is a difference between the two is unclear. Therefore, an accurate and appropriate predictive model needs to be proposed to evaluate patients undergoing sentinel lymph node biopsy (SLNB) for breast cancer. We selected 16983 women with breast cancer from the Surveillance Epidemiology and End Results (SEER) database. They were randomly assigned to two cohorts, one for development (n = 11891) and one for validation (n = 5092). multi-factor logistics regression was used to distinguish risk factors affecting SLNM. The potential prognostic factors were identified using the COX regression analysis. The hazard ratio (HR) and 95% confidence interval (95%CI) were calculated for all results. Multiple Cox models are included in the nomogram, with a critical P value of .05. In order to evaluate the model's performance, Concordance index and receiver operating characteristic curves were used. Six independent risk factors affecting SLNM were screened out from the Logistic regression, including tumor location, number of regional lymph nodes (2-5), ER positive, PR positive, tumor size (T2-3), and histological grade (Grade II-III) are independent risk factors for SLNM in patients (P < .05). Eight prognostic factors were screened out in the multivariate COX regression analysis (P < .05): Age: Age 60 to 79 years, Age ≥ 80 years; Race; Histological grading: Grade II, Grade III; No radiotherapy; Tumor size: T2, T3; ER positive:, sentinel lymph node positive, married. Histological grade, tumor location, T stage, ER status, PR status and the number of SLNB are significantly correlated with axillary SLNM. Age, ethnicity, histological grade, radiotherapy, tumor size, ER status, SLN status, and marital status were independent risk factors for Breast cancer specific survival (BCSS). Moreover, the survival rate of patients with 3 positive SLNs was not significantly different from that with one or two positive SLNs, We concluded that patients with stage N1 breast cancer were exempt from axillary lymph node dissection, which is worthy of further study.
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Affiliation(s)
- Ruihao Liu
- Emergency Department, The First Affiliated Hospital of Nanchang University Ganjiang New Area Hospital, Nanchang, China
| | - Jian Chen
- General Surgery Department, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Cao
- General Surgery Department, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Li
- Gynecology and Obstetrics, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yulong Liao
- Emergency Department, The First Affiliated Hospital of Nanchang University Ganjiang New Area Hospital, Nanchang, China
| | - Yingliang Li
- General Surgery Department, First Affiliated Hospital of Nanchang University, Nanchang, China
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Merino MM, Garcia-Sanz JA. Stemming Tumoral Growth: A Matter of Grotesque Organogenesis. Cells 2023; 12:cells12060872. [PMID: 36980213 PMCID: PMC10047265 DOI: 10.3390/cells12060872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
The earliest metazoans probably evolved from single-celled organisms which found the colonial system to be a beneficial organization. Over the course of their evolution, these primary colonial organisms increased in size, and division of labour among the cells became a remarkable feature, leading to a higher level of organization: the biological organs. Primitive metazoans were the first organisms in evolution to show organ-type structures, which set the grounds for complex organs to evolve. Throughout evolution, and concomitant with organogenesis, is the appearance of tissue-specific stem cells. Tissue-specific stem cells gave rise to multicellular living systems with distinct organs which perform specific physiological functions. This setting is a constructive role of evolution; however, rebel cells can take over the molecular mechanisms for other purposes: nowadays we know that cancer stem cells, which generate aberrant organ-like structures, are at the top of a hierarchy. Furthermore, cancer stem cells are the root of metastasis, therapy resistance, and relapse. At present, most therapeutic drugs are unable to target cancer stem cells and therefore, treatment becomes a challenging issue. We expect that future research will uncover the mechanistic “forces” driving organ growth, paving the way to the implementation of new strategies to impair human tumorigenesis.
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Affiliation(s)
- Marisa M. Merino
- Department of Biochemistry, Faculty of Sciences, University of Geneva, 1205 Geneva, Switzerland
- Correspondence: (M.M.M.); (J.A.G.-S.)
| | - Jose A. Garcia-Sanz
- Department of Molecular Biomedicine, Centro de Investigaciones Biologicas Margarita Salas, Spanish National Research Council (CIB-CSIC), 28040 Madrid, Spain
- Correspondence: (M.M.M.); (J.A.G.-S.)
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Mekhileri NV, Major G, Lim K, Mutreja I, Chitcholtan K, Phillips E, Hooper G, Woodfield T. Biofabrication of Modular Spheroids as Tumor-Scale Microenvironments for Drug Screening. Adv Healthc Mater 2022:e2201581. [PMID: 36495232 DOI: 10.1002/adhm.202201581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/13/2022] [Indexed: 12/14/2022]
Abstract
To streamline the drug discovery pipeline, there is a pressing need for preclinical models which replicate the complexity and scale of native tumors. While there have been advancements in the formation of microscale tumor units, these models are cell-line dependent, time-consuming and have not improved clinical trial success rates. In this study, two methods for generating 3D tumor microenvironments are compared, rapidly fabricated hydrogel microspheres and traditional cell-dense spheroids. These modules are then bioassembled into 3D printed thermoplastic scaffolds, using an automated biofabrication process, to form tumor-scale models. Modules are formed with SKOV3 and HFF cells as monocultures and cocultures, and the fabrication efficiency, cell architecture, and drug response profiles are characterized, both as single modules and as multimodular constructs. Cell-encapsulated Gel-MA microspheres are fabricated with high-reproducibility and dimensions necessary for automated tumor-scale bioassembly regardless of cell type, however, only cocultured spheroids form compact modules suitable for bioassembly. Chemosensitivity assays demonstrate the reduced potency of doxorubicin in coculture bioassembled constructs and a ≈five-fold increase in drug resistance of cocultured cells in 3D modules compared with 2D monolayers. This bioassembly system is efficient and tailorable so that a variety of relevant-sized tumor constructs could be developed to study tumorigenesis and modernize drug discovery.
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Affiliation(s)
- Naveen Vijayan Mekhileri
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Gretel Major
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Khoon Lim
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Isha Mutreja
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Kenny Chitcholtan
- Department of Obstetrics and Gynaecology, Gynaecological Cancer Research Group, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Elisabeth Phillips
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Gary Hooper
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, Canterbury, 8011, New Zealand
| | - Tim Woodfield
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, Canterbury, 8011, New Zealand
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Wang H, Ma L, Zhang Y, Wang O, Wei Z, Xie X, Zha X, Zeng J, Lv Q, Ren Y, Wang H, Du F, Cao S. RecurIndex assay as an aid for adjuvant chemotherapy decisions in HR-positive HER2-negative breast cancer patients. Front Oncol 2022; 12:896431. [PMID: 36568204 PMCID: PMC9769189 DOI: 10.3389/fonc.2022.896431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022] Open
Abstract
Background Adjuvant chemotherapy is a major adjuvant treatment modality for hormonal receptor (HR)-positive and HER2-negative early breast cancer, but only 2%-20% of patients derive practical benefits. How to balance its potential benefits and risks becomes a challenging clinical problem. The purpose of this study was to assess whether RecurIndex assay could serve as an aid for adjuvant chemotherapy decisions in Chinese patients with HR-positive HER2-negative early breast cancer. Methods The tissue samples of pT1-2N0 HR-positive HER2-negative breast cancer from multiple centers were detected using RecurIndex assay, based on which the patients were assigned into low- and high-risk groups. The survival outcomes of low- and high-risk patients including those with and without adjuvant chemotherapy were compared, and the risk factors for recurrence and metastasis were identified. Results Totally 445 patients were eligible for analysis. By contrast to high-risk patients, low-risk patients represented better 7-year recurrence-free survival (RFS), distant recurrence-free survival (DRFS) and local recurrence-free survival (LRFS) rates. For low-risk patients, no significant differences were shown between those with and without adjuvant chemotherapy in 7-year RFS, DRFS and LRFS rates. These differences were also inapparent between high-risk patients with and without adjuvant chemotherapy. The multivariate model revealed high-risk patients had a significantly elevated risk of recurrence and metastasis than those at low risk. Conclusion HR-positive HER2-negative early breast cancer patients at low risk stratified by RecurIndex assay might be exempt from adjuvant chemotherapy. Whether adjuvant chemotherapy may derive survival benefits for high-risk patients still needs larger cohorts to verify.
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Affiliation(s)
- Haibo Wang
- Department of Breast Center, The Affiliated Hospital of Qingdao University, Qingdao, China,*Correspondence: Haibo Wang, ; Li Ma,
| | - Li Ma
- Department of Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,*Correspondence: Haibo Wang, ; Li Ma,
| | - Yanan Zhang
- Breast Disease Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ouchen Wang
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhimin Wei
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaohong Xie
- Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoming Zha
- Breast Disease Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Zeng
- Department of Gastrointestinal and Gland Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qing Lv
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Ren
- Department of Breast Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Huimin Wang
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Furong Du
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Shangzhi Cao
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
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Park S, Ahn S, Kim JY, Kim J, Han HJ, Hwang D, Park J, Park HS, Park S, Kim GM, Sohn J, Jeong J, Song YU, Lee H, Kim SI. Blood Test for Breast Cancer Screening through the Detection of Tumor-Associated Circulating Transcripts. Int J Mol Sci 2022; 23:ijms23169140. [PMID: 36012405 PMCID: PMC9409068 DOI: 10.3390/ijms23169140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022] Open
Abstract
Liquid biopsy has been emerging for early screening and treatment monitoring at each cancer stage. However, the current blood-based diagnostic tools in breast cancer have not been sufficient to understand patient-derived molecular features of aggressive tumors individually. Herein, we aimed to develop a blood test for the early detection of breast cancer with cost-effective and high-throughput considerations in order to combat the challenges associated with precision oncology using mRNA-based tests. We prospectively evaluated 719 blood samples from 404 breast cancer patients and 315 healthy controls, and identified 10 mRNA transcripts whose expression is increased in the blood of breast cancer patients relative to healthy controls. Modeling of the tumor-associated circulating transcripts (TACTs) is performed by means of four different machine learning techniques (artificial neural network (ANN), decision tree (DT), logistic regression (LR), and support vector machine (SVM)). The ANN model had superior sensitivity (90.2%), specificity (80.0%), and accuracy (85.7%) compared with the other three models. Relative to the value of 90.2% achieved using the TACT assay on our test set, the sensitivity values of other conventional assays (mammogram, CEA, and CA 15-3) were comparable or much lower, at 89%, 7%, and 5%, respectively. The sensitivity, specificity, and accuracy of TACTs were appreciably consistent across the different breast cancer stages, suggesting the potential of the TACTs assay as an early diagnosis and prediction of poor outcomes. Our study potentially paves the way for a simple and accurate diagnostic and prognostic tool for liquid biopsy.
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Affiliation(s)
- Sunyoung Park
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju 26493, Korea
| | - Sungwoo Ahn
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju 26493, Korea
| | - Jee Ye Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jungho Kim
- Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan, Busan 46252, Korea
| | - Hyun Ju Han
- Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Dasom Hwang
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju 26493, Korea
| | - Jungmin Park
- Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Hyung Seok Park
- Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Gun Min Kim
- Department of Medical Oncology, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Joohyuk Sohn
- Department of Medical Oncology, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Yong Uk Song
- Division of Business Administration, College of Government and Business, Yonsei University, Wonju 26493, Korea
| | - Hyeyoung Lee
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju 26493, Korea
- Correspondence: (H.L.); (S.I.K.)
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (H.L.); (S.I.K.)
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No significant relationship exists between tumor size and prognosis in distant metastatic hepatocellular carcinoma: a propensity score matching analysis based on SEER database. BMC Gastroenterol 2022; 22:274. [PMID: 35655184 PMCID: PMC9161599 DOI: 10.1186/s12876-022-02355-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 05/23/2022] [Indexed: 12/30/2022] Open
Abstract
Abstract
Background
Previous studies have shown that tumor size has an impact on the prognosis of hepatocellular carcinoma (HCC). Whether tumor size is related to the prognosis of distant metastatic HCC is unclear. The purpose of this study was to investigate the effect of tumor size on the prognosis of distant metastatic HCC.
Methods
Data on patients with HCC were collected from the (SEER) database of surveillance, epidemiology and final results. Propensity score matching (PSM) was used to reduce confounding factors and comprehensively evaluate the clinicopathological features and prognosis of distant metastatic HCC.
Results
There were 189 patients with distant metastatic HCC whose tumor size was ≤ 50 mm and 615 patients with a tumor size > 50 mm. The tumor sizes of distant metastatic HCC patients were associated with race, grade, surgical treatment, N and AFP. The Kaplan–Meier analysis showed that the mortality rate of patients with a tumor size > 50 mm was higher than that of patients with a tumor size ≤ 50 mm (p = 0.00062). However, there were no significant differences in mortality rates after adjusting for confounding variables by using propensity score matching (p = 0.23).
Conclusion
This propensity score matching study provides the best data in support of the following assertions: tumor size is not an independent prognostic factor for distant metastatic HCC.
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The Role of US in Depicting Axillary Metastasis in High-Risk Breast Cancer Patients. J Pers Med 2021; 11:jpm11121379. [PMID: 34945851 PMCID: PMC8704519 DOI: 10.3390/jpm11121379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/04/2021] [Accepted: 12/13/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose: The aim of this study is to evaluate the role of US in depicting axillary nodal disease in high-risk patients with and without pathogenic mutations. Methods: The retrospective study included consecutive high-risk breast cancer (BC) patients who underwent a multigene testing panel for hereditary cancers, pre-operative axillary US and breast/axillary surgery. The group was divided into patients with pathogenic mutations (PM group) and patients without PM. Statistical analyses were performed using GraphPad Prism by applying Chi-square and Fisher exact tests, with a reference p-value < 0.05 and a CI of 95%. Results: Out of 190 patients with BC, 96 (51%) were negative and 94 (49%) were positive for PM as follows: 28 (25.5%) BRCA1, 16 (17%) BRCA2, 15 (16%) CHECK2, 14 (14%) RAD Group, 7 (7%) PALB, 6 (6%) NBN, 3 (3%) TP53 and ATM and 2 (2%) BARD1. US was positive in 88 of the patients, 36 with PM and 52 without PM. US and surgery (≥N1 stage) were both positive in 31 (62%) of PM patients and 44 (88%) of patients without genetic changes. There were 19 (61%) false negative US examinations in the PM group and 6 (13%) in the group without genetic changes, respectively. If the US is positive, there is a 2.6 times greater risk of positive nodes in PM patients (p-value < 0.000, 95% CI = 4.2–37.9), and a 6.2 times greater risk of positive nodes in patients without genetic changes (p-value < 0.000, 95%CI = 8.4–37.4). In the PM group, US compared to surgery reached a sensitivity = 62, with PPV = 86 and NPV = 67. In the BRCA1/2 subgroup, there is 2.5 greater times risk of nodal disease if the US is positive (p-value = 0.001, 95%CI = 2.6–76). In patients without PM, US compared to surgery reached a sensitivity = 88, PPV = 84 and NPV = 86. Conclusion: US is more sensitive in depicting axillary nodal disease in high-risk patients without PM compared to PM patients. Furthermore, there are more false negative US examinations in PM patients, compared to surgery patients.
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11
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Shamis SAK, McMillan DC, Edwards J. The relationship between hypoxia-inducible factor 1α (HIF-1α) and patient survival in breast cancer: Systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 159:103231. [PMID: 33482350 DOI: 10.1016/j.critrevonc.2021.103231] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/06/2021] [Accepted: 01/16/2021] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Hypoxia is a characteristic of many solid tumours and results in an increase in expression of HIF-1α. Many studies have investigated the prognostic value of HIF-1α expression in breast cancer (BC), however, the prognostic value remains unclear. Therefore, a systematic review and meta-analysis was undertaken to determine the prognostic value of HIF-1α in BC patients. METHODS The electronic databases PubMed and Web of science were systematically searched to identify relevant papers. The clinical outcomes included disease-free survival (DFS), recurrence-free survival (RFS) and overall survival (OS) in BC patients. Review Manager version 5.4 was employed to analysis data from 30 eligible studies (containing 6201patients). RESULTS High expression of HIF-1α was associated with poorer DFS and OS. There was an effect of survival analysis, study region, antibodies used, scoring and threshold methods on HIF-1α expression. CONCLUSION HIF-1α overexpression was significantly associated with poorer DFS and OS in breast cancer patients.
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Affiliation(s)
- Suad A K Shamis
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences- University of Glasgow, Royal Infirmary, Glasgow, UK; Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK.
| | - Donald C McMillan
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences- University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Joanne Edwards
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK
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Fujioka T, Kubota K, Mori M, Katsuta L, Kikuchi Y, Kimura K, Kimura M, Adachi M, Oda G, Nakagawa T, Kitazume Y, Tateishi U. Virtual Interpolation Images of Tumor Development and Growth on Breast Ultrasound Image Synthesis With Deep Convolutional Generative Adversarial Networks. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:61-69. [PMID: 32592409 DOI: 10.1002/jum.15376] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/15/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES We sought to generate realistic synthetic breast ultrasound images and express virtual interpolation images of tumors using a deep convolutional generative adversarial network (DCGAN). METHODS After retrospective selection of breast ultrasound images of 528 benign masses, 529 malignant masses, and 583 normal breasts, 20 synthesized images of each were generated by the DCGAN. Fifteen virtual interpolation images of tumors were generated by changing the value of the input vector. A total of 60 synthesized images and 20 virtual interpolation images were evaluated by 2 readers, who scored them on a 5-point scale (1, very good; to 5, very poor) and then answered whether the synthesized image was benign, malignant, or normal. RESULTS The mean score of overall quality for synthesized images was 3.05, and that of the reality of virtual interpolation images was 2.53. The readers classified the generated images with a correct answer rate of 92.5%. CONCLUSIONS A DCGAN can generate high-quality synthetic breast ultrasound images of each pathologic tissue and has the potential to create realistic virtual interpolation images of tumor development.
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Affiliation(s)
- Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunori Kubota
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Radiology, Dokkyo Medical University, Tochigi, Japan
| | - Mio Mori
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Leona Katsuta
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Kikuchi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Kimura
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mizuki Kimura
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mio Adachi
- Department of Surgery, Division of Breast Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Goshi Oda
- Department of Surgery, Division of Breast Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Nakagawa
- Department of Surgery, Division of Breast Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshio Kitazume
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan
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Bonneau C, Eliès A, Kieffer Y, Bourachot B, Ladoire S, Pelon F, Hequet D, Guinebretière JM, Blanchet C, Vincent-Salomon A, Rouzier R, Mechta-Grigoriou F. A subset of activated fibroblasts is associated with distant relapse in early luminal breast cancer. Breast Cancer Res 2020; 22:76. [PMID: 32665033 PMCID: PMC7362513 DOI: 10.1186/s13058-020-01311-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/30/2020] [Indexed: 12/21/2022] Open
Abstract
Background Early luminal breast cancer (BC) represents 70% of newly diagnosed BC cases. Among them, small (under 2 cm) BC without lymph node metastasis (classified as T1N0) have been rarely studied, as their prognosis is generally favorable. Nevertheless, up to 5% of luminal T1N0 BC patients relapse with distant metastases that ultimately prove fatal. The aim of our work was to identify the mechanisms involved in metastatic recurrence in these patients. Methods Our study addresses the role that autonomous and non-autonomous tumor cell features play with regard to distant recurrence in early luminal BC patients. We created a cohort of T1N0 luminal BC patients (tumors between 0.5–2 cm without lymph node metastasis) with metastatic recurrence (“cases”) and corresponding “controls” (without relapse) matched 1:1 on main prognostic factors: age, grade, and proliferation. We deciphered different characteristics of cancer cells and their tumor micro-environment (TME) by deep analyses using immunohistochemistry. We performed in vitro functional assays and highlighted a new mechanism of cooperation between cancer cells and one particular subset of cancer-associated fibroblasts (CAF). Results We found that specific TME features are indicative of relapse in early luminal BC. Indeed, quantitative histological analyses reveal that “cases” are characterized by significant accumulation of a particular CAF subset (CAF-S1) and decrease in CD4+ T lymphocytes, without any other association with immune cells. In multivariate analysis, TME features, in particular CAF-S1 enrichment, remain significantly associated with recurrence, thereby demonstrating their clinical relevance. Finally, by performing functional analyses, we demonstrated that CAF-S1 pro-metastatic activity is mediated by the CDH11/osteoblast cadherin, consistent with bones being a major site of metastases in luminal BC patients. Conclusions This study shows that distant recurrence in T1N0 BC is strongly associated with the presence of CAF-S1 fibroblasts. Moreover, we identify CDH11 as a key player in CAF-S1-mediated pro-metastatic activity. This is independent of tumor cells and represents a new prognostic factor. These results could assist clinicians in identifying luminal BC patients with high risk of relapse. Targeted therapies against CAF-S1 using anti-FAP antibody or CDH11-targeting compounds might help in preventing relapse for such patients with activated stroma.
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Affiliation(s)
- Claire Bonneau
- Stress and Cancer Laboratory, Equipe labelisée Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Inserm U830, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Department of Surgery, Institut Curie Hospital Group, 35 rue Dailly, 92210, Saint-Cloud, France
| | - Antoine Eliès
- Stress and Cancer Laboratory, Equipe labelisée Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Inserm U830, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Department of Surgery, Institut Curie Hospital Group, 35 rue Dailly, 92210, Saint-Cloud, France
| | - Yann Kieffer
- Stress and Cancer Laboratory, Equipe labelisée Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Inserm U830, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France
| | - Brigitte Bourachot
- Stress and Cancer Laboratory, Equipe labelisée Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Inserm U830, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France
| | - Sylvain Ladoire
- Inserm U1231, Chemotherapy and immune response, Center Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Floriane Pelon
- Stress and Cancer Laboratory, Equipe labelisée Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.,Inserm U830, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France
| | - Delphine Hequet
- Department of Surgery, Institut Curie Hospital Group, 35 rue Dailly, 92210, Saint-Cloud, France
| | - Jean-Marc Guinebretière
- Department of Pathology, Institut Curie Hospital Group, 35 rue Dailly, 92210, Saint-Cloud, France
| | - Christophe Blanchet
- Inserm U1231, Chemotherapy and immune response, Center Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France
| | - Anne Vincent-Salomon
- Department of Pathology, Institut Curie Hospital Group, 26, rue d'Ulm, 75248, Paris, France
| | - Roman Rouzier
- Department of Surgery, Institut Curie Hospital Group, 35 rue Dailly, 92210, Saint-Cloud, France.,Inserm U900, Cancer et génome : bioinformatique, biostatistiques et épidémiologie, Institut Curie, 35 rue Dailly, 92210, Saint-Cloud, France.,UR 7285, Risques cliniques et sécurité en santé des femmes et en santé périnatale, Versailles Saint Quentin en Yvelines University, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France
| | - Fatima Mechta-Grigoriou
- Stress and Cancer Laboratory, Equipe labelisée Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France. .,Inserm U830, Institut Curie, PSL Research University, 26, rue d'Ulm, F-75005, Paris, France.
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Ultrasound-Guided Core-Needle Biopsy of Suspicious Breast Lesions. JOURNAL OF INTERDISCIPLINARY MEDICINE 2020. [DOI: 10.2478/jim-2020-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: Breast cancer is the female cancer with the highest mortality. While early detection is a public health priority in Western European countries, a screening program in our country has yet to be implemented. The best diagnostic accuracy is achieved through the use of triple assessment: clinical examination, imaging, and core-needle biopsy where indicated. Prognosis is influenced by clinical, histological, and biological factors, and therapy is most effective when individually tailored.
Aim of the study: To analyze the clinical, histological, and immunohistochemical characteristics of the biopsied nodules and summarize our experience from the last three years.
Material and Methods: We retrospectively analyzed data from 137 patients who underwent core-needle biopsy between 2017 and 2019. Imaging score was assigned based on ultrasound examination or mammography. Clinical and pathological parameters were recorded, followed by statistical processing of the data.
Results: The mean age of the patients was 58 ± 14 years, lesions had a mean size of 22.83 ± 14.10 mm. Most nodules (n = 63, 47.01%) were located in the upper-outer quadrant, and bilateral presence was found in 4 (3.08%) cases. We found a significant positive correlation between lesion size and the patients’ age (Spearman r = 0.356; 95% CI 0.186, 0.506; p = 0.000). The malignancy rates within the Breast Imaging Reporting and Data System (BI-RADS) categories were as follows: 0% for „4a”, 31.58% for „4b”, 71.42% for „4c”, and 97.72% for „5”. Most malignancies (n = 73, 78.35%) were represented by invasive ductal carcinoma of no special type, 58.43% (n = 52) were grade 2, 89.13% (n = 82) were estrogen receptor positive, and Luminal B-like type was the most common (n = 63, 78.75%).
Conclusions: The mean size of tumors was larger than the average size at discovery described in the literature. In our region, age and tumor size are positively correlated. Preoperative histological results may indicate the reliability of the imaging risk stratification system. Most cases can benefit from adjuvant endocrine therapy.
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Ozmen V, Ilgun S, Celet Ozden B, Ozturk A, Aktepe F, Agacayak F, Elbuken F, Alco G, Ordu C, Erdogan Iyigun Z, Emre H, Pilancı K, Soybir G, Ozmen T. Comparison of breast cancer patients who underwent partial mastectomy (PM) with mini latissimus dorsi flap (MLDF) and subcutaneous mastectomy with implant (M + I) regarding quality of life (QOL), cosmetic outcome and survival rates. World J Surg Oncol 2020; 18:87. [PMID: 32370753 PMCID: PMC7201547 DOI: 10.1186/s12957-020-01858-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/20/2020] [Indexed: 01/12/2023] Open
Abstract
PURPOSE The latissimus dorsi muscle has long been used in breast cancer (BC) patients for reconstruction. This study aimed to compare early stage BC patients who had partial mastectomy (PM) with mini latissimus dorsi flap (MLDF) and subcutaneous mastectomy with implant (MI) with respect to quality of life (QoL), cosmetic outcome (CO), and survival rates. PATIENTS AND METHODS The data of patients who underwent PM + MLDF (Group 1) and M + I (Group 2) between January 2010 and January 2018 were evaluated. Both groups were compared in terms of demographics, clinical and pathological characteristics, surgical morbidity, survival, quality of life, and cosmetic results. The EORTC-QLQ C30 and EORTC-QLO BR23 questionnaires and the Japanese Breast Cancer Society (JBCS) Cosmetic Evaluation Scale were used to assess the quality of life and the cosmetic outcome, respectively. RESULTS A total of 317 patients were included in the study, 242 (76.3%) of them in group 1 and 75 (23.6%) of them in group 2. Median follow-up time was 56 (14-116) months. There were no differences identified between the groups in terms of tumor histology, hormonal receptors and HER-2 positivity, surgical morbidity, and 5-year overall and disease-free survival. Group 2 patients were significantly younger than group 1 (p = 0.003). The multifocality/multicentricity rate was higher in group 2 (p ≤ 0.001), whereas tumor size (p = 0.009), body mass index (BMI, p = 0.006), histological grade (p ≤ 0.001), lymph node positivity (p = 0.002), axillary lymph node dissection (ALND) rate (p = 0.005), and presence of lympho-vascular invasion (LVI, p = 0.013) were significantly higher in group 1. When the quality of life was assessed by using the EORTC QLQ C30 and BR23 questionnaires, it was seen that the body image perception (p < 0.001) and nausea/vomiting score (p = 0.024) were significantly better in PM + MLDF group whereas physical function score was significantly better in M + I group (p = 0.012). When both groups were examined in terms of cosmesis with JBCS Cosmetic Evaluation Scale, good cosmetic evaluation score was significantly higher in patients in MLDF group (p = 0.01). DISCUSSION The results of this study indicate that in comparison to M + I procedure, the PM + MLDF procedure provides significantly superior results in terms of body image and cosmetic result with similar morbidity and oncologic outcomes. In selected patients with small breasts and a high tumor/breast ratio, PM + MLDF may be an alternative to subcutaneous mastectomy and implant.
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Affiliation(s)
- Vahit Ozmen
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Istanbul, Turkey
| | - Serkan Ilgun
- Department of General Surgery, School of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Burcu Celet Ozden
- Department of Plastic and Reconstructive Surgery, School of Medicine, Altinbas University, Istanbul, Turkey
| | - Alper Ozturk
- Department of General Surgery, School of Medicine, Biruni University, Istanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Filiz Agacayak
- Department of Radiology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Filiz Elbuken
- Department of Radiology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Gul Alco
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Cetin Ordu
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Zeynep Erdogan Iyigun
- Department of Physical Therapy and Rehabilitation, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Hocaoglu Emre
- Department of Plastic & Reconstructive Surgery, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Kezban Pilancı
- Department of Medical Oncology, Bahcesehir Memorial Hospital, Istanbul, Turkey
| | - Gursel Soybir
- Department of General Surgery, Sisli Memorial Hospital, Istanbul, Turkey
| | - Tolga Ozmen
- Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Krishna Latha T, Verma A, Thakur GK, Banerjee B, Kaur N, Singh UR, Sharma S. Down Regulation of KAI1/CD82 in Lymph Node Positive and Advanced T-Stage Group in Breast Cancer Patients. Asian Pac J Cancer Prev 2019; 20:3321-3329. [PMID: 31759355 PMCID: PMC7063004 DOI: 10.31557/apjcp.2019.20.11.3321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metastasis represents a deadly aspect of any cancer including breast cancer, given its high prevalence; treatment of metastatic breast cancer remains a clinically unmet need, which necessitates the exploration of metastasis suppressor genes (MSGs). KAI-1/CD82 is an important member of MSGs; the role of KAI1 has been well explored in prostate cancer, however its role in breast cancer is not fully explored and in fact the results of breast cancer studies are contentious. Thus, the present study aimed to investigate expression of KAI1 at both transcriptional and translational levels in the tissue of breast cancer patients and benign breast disease. Further, we analysed the relationship between expression levels of KAI1 and clinicopathological parameters in breast cancer patients. MATERIALS AND METHODS mRNA expression was studied by Real time PCR and protein expression was analyzed by both Western blot and Immunohistochemistry. RESULTS The results of the study indicate that KAI1 expression was remarkably decreased in breast cancer both at the gene and the protein levels (P < 0.05) compared to benign breast disease. In addition, KAI1 expression levels were strongly associated with axillary lymph node status and advanced T stage (p < 0.05), however no association was found with tumor grade, age, menopausal status and receptor status like ER, PR and Her2. CONCLUSION Low expression of KAI1 might be helpful for predicting the lymph node metastasis and T staging, thus predicts malignant prognosis of breast cancer.<br />.
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Affiliation(s)
- Thammineni Krishna Latha
- Department of Biochemistry University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
| | - Ankur Verma
- Department of Pathology, University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
| | - Gaurav Kumar Thakur
- Department of Biochemistry University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
| | - Basudev Banerjee
- Department of Biochemistry University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
| | - Navneet Kaur
- Department of Surgery, University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
| | - Usha Rani Singh
- Department of Pathology, University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences and GTB Hospital , University of Delhi, Dilshad Garden, Delhi, India
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Taheri M, Tavakol M, Akbari ME, Anoshirvani AA, Aghabozorgi R, Almasi-Hashiani A, Abbasi M. Socioeconomic inequalities in metastasis, recurrence, stage and grade of breast cancer: a hospital-based retrospective cohort study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E262-E269. [PMID: 31650064 PMCID: PMC6797882 DOI: 10.15167/2421-4248/jpmh2019.60.3.1162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/17/2019] [Indexed: 01/04/2023]
Abstract
Introduction This study aims to estimate the Socio-Economic Status (SES) inequality on the metastasis, recurrence, stage and grade in Breast Cancer (BC). Methods This retrospective cohort study conducted on 411 BC patients in Arak, Iran. Asset-based questionnaire used to estimate the household SES. For calculate of SES inequality was used from Concentration Index (C). Moreover for investigate the association between recurrence and metastasis with other variables were used from multilevel logistic regression and analysis of variance were used to investigate the relationship between SES and other variables. The data were analyzed with Stata (v.13) software. Results Results of analysis of variance showed statistical significant relationship between SES with, insurance, surgery, grade, stage, recurrence and metastasis (p-value < 0.05). Moreover the Odds Ratio (OR) were significant of recurrence with age, academic level of education, supplementary insurance history of BC in first-degree relatives, stage and grade, also, metastasis with age of > 80 years, insurance, supplementary insurance, history of BC in first-degree relatives, chemotherapy, radiotherapy, stage and grade four. The total C index obtained 0.015 (0.002, 0.026), 0.011 (0.003, 0.031), – 0.014 (– 0.034, – 0.001) and – 0.042 (– 0.061, – 0.002) for metastasis, recurrence, stage and grade of BC respectively. Conclusions Our results showed evidence of inequality in the metastasis, recurrence, stage and grade in BC patients.
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Affiliation(s)
- M Taheri
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Tavakol
- Sociology Department, School of Social Sciences, University of Tehran, Tehran, Iran
| | - M E Akbari
- Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A A Anoshirvani
- Department of Hematology and Medical Oncology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - R Aghabozorgi
- Department of Hematology and Medical Oncology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - A Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - M Abbasi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mao X, Zhou M, Fan C, Chen B, Jin F. Timescale of tumor volume of a young breast cancer patient with luminal B subtype: A case report. Medicine (Baltimore) 2019; 98:e17659. [PMID: 31651890 PMCID: PMC6824670 DOI: 10.1097/md.0000000000017659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
RATIONALE It is largely unknown about the tumor growth of breast cancer naturally. We devised and analyzed an appropriate mathematical tool of the equations that describe how fast tumors grow without treatment on the basis of the ellipsoid shape of solid breast cancer. PATIENT CONCERNS A 31-year-old woman presented with a painless palpable lump in her left breast for 5 months. DIAGNOSIS Infiltrated ductal breast cancer (histologic grade II) of luminal B INTERVENTIONS:: The patient did not receive any therapy due to her private reasons for 2 years, the analysis of the tumor volume growth was done regarding the growth rate of the tumor in the absence of intervention. OUTCOMES After 2 years of diagnosis of breast cancer, the tumor mass occupied the whole left breast with skin implanted and nipple abnormality. As this case indicated that the tumor's early growth rate was very slow. When the tumor volume reached 300 cm, its fast growth began without treatment. Later growth approached the maximum, when the tumor volume was more than 800 cm. LESSONS The tumor growth is segmental without therapy. Early diagnosis and treatment is the key to good prognosis for every breast cancer patient.
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Affiliation(s)
- Xiaoyun Mao
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Ming Zhou
- Institute of Mathematics, University of Rostock, Ulmenstrasse 69, Haus 3, Rostock, Germany
| | - Chuifeng Fan
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Bo Chen
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Feng Jin
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
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Zhang Y, Li J, Fan Y, Li X, Qiu J, Zhu M, Li H. Risk factors for axillary lymph node metastases in clinical stage T1-2N0M0 breast cancer patients. Medicine (Baltimore) 2019; 98:e17481. [PMID: 31577783 PMCID: PMC6783158 DOI: 10.1097/md.0000000000017481] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/16/2019] [Accepted: 09/12/2019] [Indexed: 02/05/2023] Open
Abstract
Axillary lymph node metastasis (ALNM) is commonly the earliest detectable clinical manifestation of breast cancer when distant metastasis emerges. This study aimed to explore the influencing factors of ALNM and develop models that can predict its occurrence preoperatively.Cases of sonographically visible clinical stage T1-2N0M0 breast cancers treated with breast and axillary surgery at West China Hospital were retrospectively reviewed. Univariate and multivariate logistic regression analyses were performed to evaluate associations between ALNM and variables. Decision tree analyses were performed to construct predictive models using the C5.0 packages.Of the 1671 tumors, 541 (32.9%) showed axillary lymph node positivity on final surgical histopathologic analysis. In multivariate logistic regression analysis, tumor size (P < .001), infiltration of subcutaneous adipose tissue (P < .001), infiltration of the interstitial adipose tissue (P = .031), and tumor quadrant locations (P < .001) were significantly correlated with ALNM. Furthermore, the accuracy in the decision tree model was 69.52%, and the false-negative rate (FNR) was 74.18%. By using the error-cost matrix algorithm, the FNR significantly decreased to 14.75%, particularly for nodes 5, 8, and 13 (FNR: 11.4%, 9.09%, and 14.29% in the training set and 18.1%,14.71%, and 20% in the test set, respectively).In summary, our study demonstrated that tumor lesion boundary, tumor size, and tumor quadrant locations were the most important factors affecting ALNM in cT1-2N0M0 stage breast cancer. The decision tree built using these variables reached a slightly higher FNR than sentinel lymph node dissection in predicting ALNM in some selected patients.
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Affiliation(s)
| | - Ji Li
- Department of Breast Surgery
- Anesthesia surgery center
| | | | | | | | - Mou Zhu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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20
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Kubitschke H, Wolf B, Morawetz E, Horn LC, Aktas B, Behn U, Höckel M, Käs J. Roadmap to Local Tumour Growth: Insights from Cervical Cancer. Sci Rep 2019; 9:12768. [PMID: 31484955 PMCID: PMC6726627 DOI: 10.1038/s41598-019-49182-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 08/21/2019] [Indexed: 12/25/2022] Open
Abstract
Wide tumour excision is currently the standard approach to surgical treatment of solid cancers including carcinomas of the lower genital tract. This strategy is based on the premise that tumours exhibit isotropic growth potential. We reviewed and analysed local tumour spreading patterns in 518 patients with cancer of the uterine cervix who underwent surgical tumour resection. Based on data obtained from pathological examination of the surgical specimen, we applied computational modelling techniques to simulate local tumour spread in order to identify parameters influencing preferred infiltration patterns and used area-proportional Euler diagrams to detect and confirm ordered patterns of tumour spread. Some anatomical structures, e.g. tissues of the urinary bladder, were significantly more likely to be infiltrated than other structures, e.g. the ureter and the rectum. Computational models assuming isotropic growth could not explain these infiltration patterns. Introducing ontogenetic distance of a tissue relative to the uterine cervix as a parameter led to accurate predictions of the clinically observed infiltration likelihoods. The clinical data indicates that successive infiltration likelihoods of ontogenetically distant tissues are nearly perfect subsets of ontogenetically closer tissues. The prevailing assumption of isotropic tumour extension has significant shortcomings in the case of cervical cancer. Rather, cervical cancer spread seems to follow ontogenetically defined trajectories.
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Affiliation(s)
- Hans Kubitschke
- Peter Debye Institute for Soft Matter Physics, Leipzig University, Leipzig, Germany
| | - Benjamin Wolf
- Department of Gynecology, Women's and Children's Centre, University Hospital Leipzig, Leipzig, Germany.,Leipzig School of Radical Pelvic Surgery, Leipzig University, Leipzig, Germany
| | - Erik Morawetz
- Peter Debye Institute for Soft Matter Physics, Leipzig University, Leipzig, Germany
| | - Lars-Christian Horn
- Division of Gynecologic, Breast and Perinatal Pathology, University Hospital Leipzig, Leipzig, Germany
| | - Bahriye Aktas
- Department of Gynecology, Women's and Children's Centre, University Hospital Leipzig, Leipzig, Germany.,Leipzig School of Radical Pelvic Surgery, Leipzig University, Leipzig, Germany
| | - Ulrich Behn
- Institute of Theoretical Physics, Leipzig University, Leipzig, Germany
| | - Michael Höckel
- Department of Gynecology, Women's and Children's Centre, University Hospital Leipzig, Leipzig, Germany.,Leipzig School of Radical Pelvic Surgery, Leipzig University, Leipzig, Germany
| | - Josef Käs
- Peter Debye Institute for Soft Matter Physics, Leipzig University, Leipzig, Germany.
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21
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Prognostic factors influencing prognosis in early breast cancer patients. MENOPAUSE REVIEW 2019; 18:82-88. [PMID: 31485204 PMCID: PMC6719640 DOI: 10.5114/pm.2019.86833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/05/2019] [Indexed: 12/28/2022]
Abstract
Aim of the study The present study showed the clinicopathological characteristics and survival of early breast cancer (BC) patients. Material and methods A total of 236 patients were included in the study. The mean follow-up time was 59.5 months (range: 12-204 months). The inclusion criteria consisted of female patients aged > 20 years and early BC patients (stages I and IIA). Results The mean age at diagnosis was 51.2 years (range, 23-83 years), and 55.9% of patients were aged ≥ 50 years. Most patients (92.8%) did not have lymph node metastasis, and luminal B had the highest prevalence (54.2%) in patients. The eight-year overall survival (OS) and disease-free survival (DFS) rates were 98.3% and 92.3%, respectively. Stage IIA and Ki67 index ≥ 14% were more prevalent in the patients with tumour size of 2 ≤ T ≤ 5 cm compared to another tumour size group and Ki67 index. Conclusions The mean age at diagnosis in this study was in agreement with other studies reported in various areas, but with a higher percentage for elderly patients compared to some previous studies. In addition, the survival rate in the present study was higher than the results of previous studies. Future studies need to investigate these factors in a higher number of patients and in different areas and should select similar stages for early BC.
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22
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Thammineni KL, Thakur GK, Kaur N, Banerjee BD. Significance of MMP-9 and VEGF-C expression in North Indian women with breast cancer diagnosis. Mol Cell Biochem 2019; 457:93-103. [PMID: 30993496 DOI: 10.1007/s11010-019-03515-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/08/2019] [Indexed: 11/25/2022]
Abstract
Metastasis accounts for the majority of cancer-associated mortality and renders the targeted therapy fruitless in the patients of breast cancer. Matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF-C) are thought to be involved in tumor progression and metastasis. The aim of this study was to investigate the expression of MMP-9 and VEGF-C at both mRNA and protein levels in breast cancer and to correlate with lymph node metastasis and other clinicopathological characteristics. Biopsy specimens (N = 100) of breast cancer & benign breast disease (N = 100) were investigated for the mRNA expression of MMP-9 and VEGF-C by Real-time PCR and Protein expression by Western blot. Elevated levels of MMP-9 (p < 0.001) and VEGF-C (p < 0.001) expression were detected in breast cancer with corresponding to benign breast disease. Additionally, we found significantly increased levels of MMP-9 and VEGF-C in node-positive group with respect to node-negative group. Moreover, the levels of MMP-9 were significantly increased in larger tumor size (T3/T4) (p < 0.05) as compared to smaller size (T1/T2), which suggests that MMP-9 plays an important role in the progression of breast cancer. VEGF-C expression was associated with the TNM stage of tumor (p < 0.05). Further, a significant positive correlation was established between the mRNA levels of these two genes (p < 0.001). However, we could not obtain any significant correlation between expression of these genes with other clinicopathological parameters like tumor grade, age, menopausal status, and receptor status like ER, PR, and Her2. This study suggests that the high expression of MMP-9 and VEGF-C could act as markers for the tumor presence in breast cancer. In addition, this study recommends that expression of MMP-9 and VEGF-C was significantly associated with lymph node status and may provide valuable diagnosis of lymph node metastasis in breast cancer patients. Further, MMP-9 expression was associated with the tumor size and VEGF-C expression was correlated with the staging of the tumor, although no association was observed with other clinicopathological variables.
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Affiliation(s)
- Krishna Latha Thammineni
- Environmental Biochemistry and Molecular Biology Laboratory, Department of Biochemistry, University College of Medical Sciences & G.T.B. Hospital (University of Delhi), Dilshad Garden, Delhi, 110095, India
| | - Gaurav K Thakur
- Environmental Biochemistry and Molecular Biology Laboratory, Department of Biochemistry, University College of Medical Sciences & G.T.B. Hospital (University of Delhi), Dilshad Garden, Delhi, 110095, India
| | - Navneet Kaur
- Department of Surgery, University College of Medical Sciences & G.T.B. Hospital (University of Delhi), Dilshad Garden, Delhi, 110095, India
| | - Basu Dev Banerjee
- Environmental Biochemistry and Molecular Biology Laboratory, Department of Biochemistry, University College of Medical Sciences & G.T.B. Hospital (University of Delhi), Dilshad Garden, Delhi, 110095, India.
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23
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Long-Term Outcomes of Immunohistochemically Defined Subtypes of Breast Cancer Less Than or Equal to 2 cm After Breast-Conserving Surgery. J Surg Res 2018; 236:288-299. [PMID: 30694768 DOI: 10.1016/j.jss.2018.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/20/2018] [Accepted: 11/19/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Molecular subtype predicts the prognosis of early-stage breast cancer patients. We assessed the long-term outcomes of breast cancer ≤2 cm treated with breast-conserving surgery (BCS) and stratified according to an immunohistochemically (IHC)-based subtype definition. METHODS This retrospective study was conducted from a prospectively collected database. Included patients had pT1, any N, M0 breast cancer after BCS (without anti-HER2 therapy) and available information on estrogen receptor (ER), progesterone receptor (PR), HER2 status, Ki-67 index. Five IHC-defined subtypes were identified: luminal A-like (ER and/or PR-positive/HER2-negative/Ki-67 < 20%), luminal B-like/HER2-negative (ER and/or PR-positive/HER2-negative/Ki-67 ≥ 20%), luminal B-like/HER2-positive (ER and/or PR-positive/HER2-positive/any Ki-67 value), HER2-positive/nonluminal (ER and PR-negative/HER2-positive), and triple-negative (ER and PR-negative/HER2-negative). RESULTS We analyzed 184 (65%) luminal A-like, 57 (20%) luminal B-like/HER2-negative, 17 (6%) luminal B-like/HER2-positive, 6 (2%) HER2-positive/nonluminal, and 18 (7%) triple-negative patients. Median follow-up was 112 (interquartile range 94-125) mo. The cumulative 5- and 10-y local recurrence (LR) rates were 1.5% and 4%, respectively. The cumulative 5- and 10-y distant recurrence (DR) rates were 3% and 8%, respectively. The Cox regression revealed that HER2-positive/nonluminal subtypes had the highest risk of LR (P = 0.0025). The luminal B-like/HER2-positive subtypes had the highest risk of DR (P = 0.0019). HER2 positivity carried a higher risk of DR in women with luminal breast cancer who completed 5 y of adjuvant hormonal therapy (P = 0.02). CONCLUSIONS The IHC-defined subtype impacts on the prognosis of breast cancer ≤2 cm after BCS, determining significant differences in LR and DR rates. In the pre-"anti-HER2 therapy" era, patients with HER2-positive/nonluminal or luminal B-like/HER2-positive subtype had worse long-term outcomes than those with luminal A-like subtype.
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Guerrini G, Criscuoli M, Filippi I, Naldini A, Carraro F. Inhibition of smoothened in breast cancer cells reduces CAXII expression and cell migration. J Cell Physiol 2018; 233:9799-9811. [PMID: 30132883 DOI: 10.1002/jcp.26947] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/12/2018] [Indexed: 12/13/2022]
Abstract
Breast cancer (BC) relapse and metastasis are the leading cause of death and, together with drug resistance, keep mortality still high. The Hedgehog (Hh) pathway is expressed during embryogenesis, organogenesis and in adult tissue homeostasis and its aberrant activation is often associated with cancer. Carbonic anhydrase (CA) enzymes are important during development; they play a key role in controlling several cellular mechanisms, such as pH regulation, survival, and migration, and they are aberrantly expressed in cancer. The goal of this study was to investigate the interplay between the Hh pathway and CAXII in terms of BC cell migration. We here demonstrated that smoothened (SMO) silencing resulted in a reduction of CAXII expression at mRNA and protein level. This led to a decrease in cell migration, which was restored when cells were treated with an SMO agonist, Sag dihydrochloride (SAG), but not when cells were cotreated with SAG and the CAs inhibitor Acetazolamide. This suggested that the ability of SAG to promote cell migration was impaired when CAXII was inhibited. The reduction was also confirmed within hypoxic and inflammatory microenvironment, typical of BC, indicating a key role of the Hh pathway in controlling CAXII expression. Our results may contribute to further understand the physiology of BC cells and indicate that the Hh pathway controls BC cell migration and cell invasion also through CAXII, with important implications in identifying novel therapeutic targets.
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Affiliation(s)
- Giuditta Guerrini
- Department of Molecular and Developmental Medicine, Cellular and Molecular Physiology Unit, University of Siena, Siena, Italy
| | - Mattia Criscuoli
- Department of Molecular and Developmental Medicine, Cellular and Molecular Physiology Unit, University of Siena, Siena, Italy
| | - Irene Filippi
- Department of Molecular and Developmental Medicine, Cellular and Molecular Physiology Unit, University of Siena, Siena, Italy.,Istituto Toscano Tumori, Firenze, Italy
| | - Antonella Naldini
- Department of Molecular and Developmental Medicine, Cellular and Molecular Physiology Unit, University of Siena, Siena, Italy
| | - Fabio Carraro
- Department of Molecular and Developmental Medicine, Cellular and Molecular Physiology Unit, University of Siena, Siena, Italy.,Istituto Toscano Tumori, Firenze, Italy
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