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James J, Law M, Sengupta S, Saunders C. Assessment of the axilla in women with early-stage breast cancer undergoing primary surgery: a review. World J Surg Oncol 2024; 22:127. [PMID: 38725006 PMCID: PMC11084006 DOI: 10.1186/s12957-024-03394-6] [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: 10/06/2023] [Accepted: 04/28/2024] [Indexed: 05/12/2024] Open
Abstract
Sentinel node biopsy (SNB) is routinely performed in people with node-negative early breast cancer to assess the axilla. SNB has no proven therapeutic benefit. Nodal status information obtained from SNB helps in prognostication and can influence adjuvant systemic and locoregional treatment choices. However, the redundancy of the nodal status information is becoming increasingly apparent. The accuracy of radiological assessment of the axilla, combined with the strong influence of tumour biology on systemic and locoregional therapy requirements, has prompted many to consider alternative options for SNB. SNB contributes significantly to decreased quality of life in early breast cancer patients. Substantial improvements in workflow and cost could accrue by removing SNB from early breast cancer treatment. We review the current viewpoints and ideas for alternative options for assessing and managing a clinically negative axilla in patients with early breast cancer (EBC). Omitting SNB in selected cases or replacing SNB with a non-invasive predictive model appear to be viable options based on current literature.
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Affiliation(s)
- Justin James
- Eastern Health, Melbourne, Australia.
- Monash University, Melbourne, Australia.
- Department of Breast and Endocrine Surgery, Maroondah Hospital, Davey Drive, Ringwood East, Melbourne, VIC, 3135, Australia.
| | - Michael Law
- Eastern Health, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - Shomik Sengupta
- Eastern Health, Melbourne, Australia
- Monash University, Melbourne, Australia
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2
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Rajput S, Sharma PK, Malviya R. Biomarkers and Treatment Strategies for Breast Cancer Recurrence. Curr Drug Targets 2023; 24:1209-1220. [PMID: 38164731 DOI: 10.2174/0113894501258059231103072025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/14/2023] [Accepted: 10/03/2023] [Indexed: 01/03/2024]
Abstract
Despite recent treatment advancements, breast cancer remains a life-threatening disease. Although treatment is successful in the early stages, a significant proportion of individuals with breast cancer eventually experience a recurrence of the disease. Breast tumour recurrence poses a significant medical issue. Despite tumours being a primary cause of mortality, there remains a limited understanding of the fundamental mechanisms underlying tumour recurrence. The majority of the time, after surgery or medical treatment, this metastatic disease manifests itself after the disease is undiagnosed for a considerable amount of time. This phenomenon is commonly referred to as a relapse or recurrence. Metastatic breast cancer has the potential to recur at varying intervals, ranging from a few months to several decades following the initial diagnosis and treatment. This article aimed to summarise the primary causes of breast cancer recurrence and highlight the key issues that need to be addressed in order to effectively decrease the mortality rate among breast cancer patients. This article discusses various therapeutic approaches currently employed and emerging treatment strategies that hold the potential for the complete cure of cancer.
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Affiliation(s)
- Shivam Rajput
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Pramod Kumar Sharma
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Rishabha Malviya
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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3
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Cui R, Chen P, Wang Y, Lu R, Ji M, Hou P, Qu Y. Cohesin RAD21 Gene Promoter Methylation Correlated with Better Prognosis in Breast Cancer Patients. Cytogenet Genome Res 2022; 162:109-118. [PMID: 35654004 DOI: 10.1159/000524735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/25/2022] [Indexed: 12/18/2022] Open
Abstract
RAD21 plays multiple roles in numerous cancers. In breast cancer (BC), a high level of RAD21 correlates with poor disease outcomes and resistance to chemotherapy. However, data regarding RAD21 promoter methylation in BC tissue and its correlation with clinical outcomes in patients with BC remain limited. Here, we investigated the clinicopathological features associated with the methylation status of RAD21 in BC to figure out its possible role in pathogenesis and the formation of breast carcinogenesis. The methylation status of the RAD21 gene was significantly associated with better clinical outcomes in patients with BC.
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Affiliation(s)
- Rongrong Cui
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Pu Chen
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuanyuan Wang
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Rong Lu
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meiju Ji
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Peng Hou
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yiping Qu
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Radio Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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4
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Yang PT, Wu WS, Wu CC, Shih YN, Hsieh CH, Hsu JL. Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning. Open Med (Wars) 2021; 16:754-768. [PMID: 34027105 PMCID: PMC8122465 DOI: 10.1515/med-2021-0282] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/11/2021] [Accepted: 04/03/2021] [Indexed: 11/15/2022] Open
Abstract
Breast cancer is one of the most common cancers in women all over the world. Due to the improvement of medical treatments, most of the breast cancer patients would be in remission. However, the patients have to face the next challenge, the recurrence of breast cancer which may cause more severe effects, and even death. The prediction of breast cancer recurrence is crucial for reducing mortality. This paper proposes a prediction model for the recurrence of breast cancer based on clinical nominal and numeric features. In this study, our data consist of 1,061 patients from Breast Cancer Registry from Shin Kong Wu Ho-Su Memorial Hospital between 2011 and 2016, in which 37 records are denoted as breast cancer recurrence. Each record has 85 features. Our approach consists of three stages. First, we perform data preprocessing and feature selection techniques to consolidate the dataset. Among all features, six features are identified for further processing in the following stages. Next, we apply resampling techniques to resolve the issue of class imbalance. Finally, we construct two classifiers, AdaBoost and cost-sensitive learning, to predict the risk of recurrence and carry out the performance evaluation in three-fold cross-validation. By applying the AdaBoost method, we achieve accuracy of 0.973 and sensitivity of 0.675. By combining the AdaBoost and cost-sensitive method of our model, we achieve a reasonable accuracy of 0.468 and substantially high sensitivity of 0.947 which guarantee almost no false dismissal. Our model can be used as a supporting tool in the setting and evaluation of the follow-up visit for early intervention and more advanced treatments to lower cancer mortality.
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Affiliation(s)
- Pei-Tse Yang
- Department of Computer Science and Information Engineering, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
| | - Wen-Shuo Wu
- Department of Computer Science and Information Engineering, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
| | - Chia-Chun Wu
- Department of Computer Science and Information Engineering, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
| | - Yi-Nuo Shih
- Department of Occupational Therapy, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
| | - Chung-Ho Hsieh
- Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China
| | - Jia-Lien Hsu
- Department of Computer Science and Information Engineering, Fu Jen Catholic University, New Taipei City, Taiwan, Republic of China
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5
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Paula LM, De Moraes LHF, Do Canto AL, Dos Santos L, Martin AA, Rogatto SR, De Azevedo Canevari R. Analysis of molecular markers as predictive factors of lymph node involvement in breast carcinoma. Oncol Lett 2017; 13:488-496. [PMID: 28123587 DOI: 10.3892/ol.2016.5438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 09/15/2016] [Indexed: 11/06/2022] Open
Abstract
Nodal status is the most significant independent prognostic factor in breast cancer. Identification of molecular markers would allow stratification of patients who require surgical assessment of lymph nodes from the large numbers of patients for whom this surgical procedure is unnecessary, thus leading to a more accurate prognosis. However, up to now, the reported studies are preliminary and controversial, and although hundreds of markers have been assessed, few of them have been used in clinical practice for treatment or prognosis in breast cancer. The purpose of the present study was to determine whether protein phosphatase Mg2+/Mn2+ dependent 1D, β-1,3-N-acetylglucosaminyltransferase, neural precursor cell expressed, developmentally down-regulated 9, prohibitin, phosphoinositide-3-kinase regulatory subunit 5 (PIK3R5), phosphatidylinositol-5-phosphate 4-kinase type IIα, TRF1-interacting ankyrin-related ADP-ribose polymerase 2, BCL2 associated agonist of cell death, G2 and S-phase expressed 1 and PAX interacting protein 1 genes, described as prognostic markers in breast cancer in a previous microarray study, are also predictors of lymph node involvement in breast carcinoma Reverse transcription-quantitative polymerase chain reaction analysis was performed on primary breast tumor tissues from women with negative lymph node involvement (n=27) compared with primary tumor tissues from women with positive lymph node involvement (n=23), and was also performed on primary tumors and paired lymph node metastases (n=11). For all genes analyzed, only the PIK3R5 gene exhibited differential expression in samples of primary tumors with positive lymph node involvement compared with primary tumors with negative lymph node involvement (P=0.0347). These results demonstrate that the PIK3R5 gene may be considered predictive of lymph node involvement in breast carcinoma. Although the other genes evaluated in the present study have been previously characterized to be involved with the development of distant metastases, they did not have predictive potential.
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Affiliation(s)
- Luciana Marques Paula
- Laboratory of Molecular Biology of Cancer, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | | | - Abaeté Leite Do Canto
- Center for Diagnostic Medicine, Pathology and Cytology (CIPAX), São José dos Campos, 12243-000 São Paulo, Brazil
| | - Laurita Dos Santos
- Laboratory of Biomedical Vibrational Spectroscopy, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | - Airton Abrahão Martin
- Laboratory of Biomedical Vibrational Spectroscopy, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | - Silvia Regina Rogatto
- NeoGene Laboratory, Urology Department, Sao Paulo State University, Botucatu, 18618-000 São Paulo, Brazil
| | - Renata De Azevedo Canevari
- Laboratory of Molecular Biology of Cancer, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
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6
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Callegari CC, Cavalli IJ, Lima RS, Jucoski TS, Torresan C, Urban CA, Kuroda F, Anselmi KF, Cavalli LR, Ribeiro EM. Copy number and expression analysis of FOSL1, GSTP1, NTSR1, FADD and CCND1 genes in primary breast tumors with axillary lymph node metastasis. Cancer Genet 2016; 209:331-9. [DOI: 10.1016/j.cancergen.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 05/02/2016] [Accepted: 06/06/2016] [Indexed: 12/20/2022]
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7
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Bonin S, Pracella D, Barbazza R, Sulfaro S, Stanta G. In stage II/III lymph node-positive breast cancer patients less than 55 years of age, keratin 8 expression in lymph node metastases but not in the primary tumour is an indicator of better survival. Virchows Arch 2015; 466:571-80. [PMID: 25724181 DOI: 10.1007/s00428-015-1748-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 01/20/2015] [Accepted: 02/19/2015] [Indexed: 12/31/2022]
Abstract
Axillary lymph node status is one of the most important prognostic variables for breast cancer (BC). To investigate and understand the clinical, histopathological and biological factors that affect prognosis in node-positive young breast cancer patients, we compared the phenotype of 100 primary tumours with their corresponding loco-regional lymph node (LN) metastases using conventional immunohistochemistry (IHC) markers currently in use for molecular classification of breast cancer. By comparing the expression of ER, PR, HER-2, Ki67, K8, K5/6 and vimentin, we found that expression of HER-2, Ki67, K8 and vimentin is frequently lost in lymph node metastases. Between the primary tumour and corresponding lymph node metastases, expression of keratins K8 and K5/6 significantly changed. Expression of K8 in lymph node metastases, but not in primary tumours, segregates patients in two sub-groups with different outcomes. Survival of patients with K8-positive LN metastases at 5 years in comparison with patients with K8-negative LN metastases was 75 vs 48 %, at 10 years 62 vs 22 % and at 20 years 53 vs 14 % (p < 0.001). K8 immunostaining of tissue from the lymph node metastasis allows defining a sub-group of lymph node-positive BC patients with a highly unfavourable outcome, for whom therapeutic options might have to be reconsidered.
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Affiliation(s)
- Serena Bonin
- Department of Medical Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume 447, Trieste, Italy
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8
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Mittal S, Sharma A, Balaji SA, Gowda MC, Dighe RR, Kumar RV, Rangarajan A. Coordinate hyperactivation of Notch1 and Ras/MAPK pathways correlates with poor patient survival: novel therapeutic strategy for aggressive breast cancers. Mol Cancer Ther 2014; 13:3198-3209. [PMID: 25253780 PMCID: PMC4258404 DOI: 10.1158/1535-7163.mct-14-0280] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aberrant activation of Notch and Ras pathways has been detected in breast cancers. A synergy between these two pathways has also been shown in breast cell transformation in culture. Yet, the clinical relevance of Notch-Ras cooperation in breast cancer progression remains unexplored. In this study, we show that coordinate hyperactivation of Notch1 and Ras/MAPK pathways in breast cancer patient specimens, as assessed by IHC for cleaved Notch1 and pErk1/2, respectively, correlated with early relapse to vital organs and poor overall survival. Interestingly, majority of such Notch1(high)Erk(high) cases encompassed the highly aggressive triple-negative breast cancers (TNBC), and were enriched in stem cell markers. We further show that combinatorial inhibition of Notch1 and Ras/MAPK pathways, using a novel mAb against Notch1 and a MEK inhibitor, respectively, led to a significant reduction in proliferation and survival of breast cancer cells compared with individual inhibition. Combined inhibition also abrogated sphere-forming potential, and depleted the putative cancer stem-like cell subpopulation. Most importantly, combinatorial inhibition of Notch1 and Ras/MAPK pathways completely blocked tumor growth in a panel of breast cancer xenografts, including the TNBCs. Thus, our study identifies coordinate hyperactivation of Notch1 and Ras/MAPK pathways as novel biomarkers for poor breast cancer outcome. Furthermore, based on our preclinical data, we propose combinatorial targeting of these two pathways as a treatment strategy for highly aggressive breast cancers, particularly the TNBCs that currently lack any targeted therapeutic module.
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Affiliation(s)
- Suruchi Mittal
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Ankur Sharma
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Sai A. Balaji
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Manju C Gowda
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Rajan R. Dighe
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Rekha V. Kumar
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Annapoorni Rangarajan
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
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9
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Fernandez SV, Bingham C, Fittipaldi P, Austin L, Palazzo J, Palmer G, Alpaugh K, Cristofanilli M. TP53 mutations detected in circulating tumor cells present in the blood of metastatic triple negative breast cancer patients. Breast Cancer Res 2014; 16:445. [PMID: 25307991 PMCID: PMC4303125 DOI: 10.1186/s13058-014-0445-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/11/2014] [Indexed: 01/24/2023] Open
Abstract
Introduction Circulating tumor cells (CTCs) are tumor cells shed from either primary tumors or its metastases that circulate in the peripheral blood of patients with metastatic cancers. The molecular characterization of the CTCs is critical to identifying the key drivers of cancer metastasis and devising therapeutic approaches. However, the molecular characterization of CTCs is difficult to achieve because their isolation is a major technological challenge. Methods CTCs from two triple negative breast cancer patients were enriched using CellSearch and single cells selected by DEPArray™. A TP53 R110 fs*13 mutation identified by next generation sequencing in the breast and chest skin biopsies of both patients was studied in single CTCs. Results From 6 single CTC isolated from one patient, 1 CTC had TP53 R110 delC, 1 CTC showed the TP53 R110 delG mutation, and the remaining 4 single CTCs showed the wild type p53 sequence; a pool of 14 CTCs isolated from the same patient also showed TP53 R110 delC mutation. In the tumor breast tissue of this patient, only the TP53 R110 delG mutation was detected. In the second patient a TP53 R110 delC mutation was detected in the chest wall skin biopsy; from the peripheral blood of this patient, 5 single CTC and 6 clusters of 2 to 6 CTCs were isolated; 3 of the 5 single CTCs showed the TP53 R110 delC mutation and 2 CTCs showed the wild type TP53 allele; from the clusters, 5 showed the TP53 R110 delC mutation, and 1 cluster the wild type TP53 allele. Single white blood cells isolated as controls from both patients only showed the wild type TP53 allele. Conclusions We are able to isolate uncontaminated CTCs and achieve single cell molecular analysis. Our studies showed the presence of different CTC sub-clones in patients with metastatic breast cancer. Some CTCs had the same TP53 mutation as their matching tumor samples although others showed either a different TP53 mutation or the wild type allele. Our results indicate that CTCs could represent a non-invasive source of cancer cells from which to determine genetic markers of the disease progression and potential therapeutic targets. Electronic supplementary material The online version of this article (doi:10.1186/s13058-014-0445-3) contains supplementary material, which is available to authorized users.
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10
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Torresan C, Oliveira MMC, Pereira SRF, Ribeiro EMSF, Marian C, Gusev Y, Lima RS, Urban CA, Berg PE, Haddad BR, Cavalli IJ, Cavalli LR. Increased copy number of the DLX4 homeobox gene in breast axillary lymph node metastasis. Cancer Genet 2014; 207:177-87. [PMID: 24947980 DOI: 10.1016/j.cancergen.2014.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/08/2014] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
Abstract
DLX4 is a homeobox gene strongly implicated in breast tumor progression and invasion. Our main objective was to determine the DLX4 copy number status in sentinel lymph node (SLN) metastasis to assess its involvement in the initial stages of the axillary metastatic process. A total of 37 paired samples of SLN metastasis and primary breast tumors (PBT) were evaluated by fluorescence in situ hybridization, quantitative polymerase chain reaction and array comparative genomic hybridization assays. DLX4 increased copy number was observed in 21.6% of the PBT and 24.3% of the SLN metastasis; regression analysis demonstrated that the DLX4 alterations observed in the SLN metastasis were dependent on the ones in the PBT, indicating that they occur in the primary tumor cell populations and are maintained in the early axillary metastatic site. In addition, regression analysis demonstrated that DLX4 alterations (and other DLX and HOXB family members) occurred independently of the ones in the HER2/NEU gene, the main amplification driver on the 17q region. Additional studies evaluating DLX4 copy number in non-SLN axillary lymph nodes and/or distant breast cancer metastasis are necessary to determine if these alterations are carried on and maintained during more advanced stages of tumor progression and if could be used as a predictive marker for axillary involvement.
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Affiliation(s)
- Clarissa Torresan
- Department of Genetics, Federal University of Paraná, Curitiba, PR, Brazil
| | | | - Silma R F Pereira
- Department of Biology, Federal University of Maranhão, São Luis, MA, Brazil
| | | | - Catalin Marian
- Department of Biochemistry, University of Medicine and Pharmacy, Timisoara, Romania
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Rubens S Lima
- Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil
| | - Cicero A Urban
- Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil; Positivo University, Curitiba, PR, Brazil
| | - Patricia E Berg
- Department of Biochemistry and Molecular Medicine, George Washington University Medical Center, Washington, DC, USA
| | - Bassem R Haddad
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Iglenir J Cavalli
- Department of Genetics, Federal University of Paraná, Curitiba, PR, Brazil
| | - Luciane R Cavalli
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
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11
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Torstenson T, Shah-Khan MG, Hoskin TL, Morton MJ, Adamczyk DL, Jones KN, Case J, Chartier S, Boughey JC. Novel Factors to Improve Prediction of Nodal Positivity in Patients with Clinical T1/T2 Breast Cancers. Ann Surg Oncol 2013; 20:3286-93. [DOI: 10.1245/s10434-013-3110-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Indexed: 11/18/2022]
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12
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Cell proliferation of the primary tumor predicts ipsilateral axillary node disease in elderly breast cancer patients. Int J Biol Markers 2013; 28:24-31. [PMID: 23558937 DOI: 10.5301/jbm.2013.10574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2012] [Indexed: 11/20/2022]
Abstract
The present study investigated whether tumor markers such as cell proliferation and steroid receptor status, which have been shown to have relevance for important endpoints (relapse-free and overall survival), can also predict axillary disease in elderly patients with breast cancer. We evaluated 351 consecutive elderly women with breast cancer ≥70 years of age with estrogen receptor (ER)‑positive tumors with no palpable axillary nodes, for whom information on cell proliferation determined by the 3H-thymidine labeling index (TLI) and progesterone receptor (PgR) was available. Patients underwent quadrantectomy (70.1%) or quadrantectomy plus radiotherapy (29.9%) without axillary node dissection, followed by adjuvant tamoxifen for at least 2 years. Univariable (cumulative incidence curves) and multivariable analyses (Fine and Gray models) were carried out. After a median follow-up of 16 years, ipsilateral axillary relapse was not related to PgR status but was strongly associated with tumor cell proliferation in both small (pT1) and large (pT2-4b) tumors. Axillary relapse cumulative incidence increased from 1% in patients with low-TLI (≤3%), PgR-positive and pT1 tumors to a maximum of 20% in patients with high-TLI, PgR-negative and pT2-4b tumors. Tumor cell proliferation, determined by TLI at primary surgery, is an important predictor of axillary relapse in elderly ER-positive breast cancer patients and could help to identify patients who should undergo axillary surgery.
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13
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Pathways to breast cancer recurrence. ISRN ONCOLOGY 2013; 2013:290568. [PMID: 23533807 PMCID: PMC3603357 DOI: 10.1155/2013/290568] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/17/2013] [Indexed: 12/22/2022]
Abstract
Breast cancer remains a deadly disease, even with all the recent technological advancements. Early intervention has made an impact, but an overwhelmingly large number of breast cancer patients still live under the fear of “recurrent” disease. Breast cancer recurrence is clinically a huge problem and one that is largely not well understood. Over the years, a number of factors have been studied with an overarching aim of being able to prognose recurrent disease. This paper attempts to provide an overview of our current knowledge of breast cancer recurrence and its associated challenges. Through a survey of the literature on cancer stem cells (CSCs), epithelial-mesenchymal transition (EMT), various signaling pathways such as Notch/Wnt/hedgehog, and microRNAs (miRNAs), we also examine the hypotheses that are currently under investigation for the prevention of breast cancer recurrence.
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14
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Kakkad SM, Solaiyappan M, Argani P, Sukumar S, Jacobs LK, Leibfritz D, Bhujwalla ZM, Glunde K. Collagen I fiber density increases in lymph node positive breast cancers: pilot study. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:116017. [PMID: 23117811 PMCID: PMC3486274 DOI: 10.1117/1.jbo.17.11.116017] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 09/16/2012] [Accepted: 10/05/2012] [Indexed: 05/19/2023]
Abstract
Collagen I (Col1) fibers are a major structural component in the extracellular matrix of human breast cancers. In a preliminary pilot study, we explored the link between Col1 fiber density in primary human breast cancers and the occurrence of lymph node metastasis. Col1 fibers were detected by second harmonic generation (SHG) microscopy in primary human breast cancers from patients presenting with lymph node metastasis (LN+) versus those without lymph node metastasis (LN-). Col1 fiber density, which was quantified using our in-house SHG image analysis software, was significantly higher in the primary human breast cancers of LN+ (fiber volume=29.22%±4.72%, inter-fiber distance=2.25±0.45 μm) versus LN- (fiber volume=20.33%±5.56%, inter-fiber distance=2.88±1.07 μm) patients. Texture analysis by evaluating the co-occurrence matrix and the Fourier transform of the Col1 fibers proved to be significantly different for the parameters of co-relation and energy, as well as aspect ratio and eccentricity, for LN+ versus LN- cases. We also demonstrated that tissue fixation and paraffin embedding had negligible effect on SHG Col1 fiber detection and quantification. High Col1 fiber density in primary breast tumors is associated with breast cancer metastasis and may serve as an imaging biomarker of metastasis.
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MESH Headings
- Animals
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/secondary
- Collagen Type I/metabolism
- Female
- Humans
- Lymphatic Metastasis/pathology
- MCF-7 Cells
- Mice
- Mice, Nude
- Microscopy, Confocal/methods
- Optical Phenomena
- Paraffin Embedding
- Pilot Projects
- Retrospective Studies
- Tissue Fixation
- Transplantation, Heterologous
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Affiliation(s)
- Samata M. Kakkad
- The Johns Hopkins University School of Medicine, In Vivo Cellular and Molecular Imaging Center, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, Maryland
- University of Bremen, Department of Chemistry and Biology, Bremen, Germany
| | - Meiyappan Solaiyappan
- The Johns Hopkins University School of Medicine, In Vivo Cellular and Molecular Imaging Center, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, Maryland
| | - Pedram Argani
- The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
- The Johns Hopkins University School of Medicine, Pathology Department, Baltimore, Maryland
| | - Saraswati Sukumar
- The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
- The Johns Hopkins University School of Medicine, Pathology Department, Baltimore, Maryland
| | - Lisa K. Jacobs
- The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
- The Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, Maryland
| | - Dieter Leibfritz
- University of Bremen, Department of Chemistry and Biology, Bremen, Germany
| | - Zaver M. Bhujwalla
- The Johns Hopkins University School of Medicine, In Vivo Cellular and Molecular Imaging Center, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, Maryland
- The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
- Address all correspondence to: Kristine Glunde, The Johns Hopkins University School of Medicine, Department of Radiology, 212 Traylor Building, 720 Rutland Avenue, Baltimore, Maryland 21205. Tel: (410) 614-2705; Fax: (410) 614-1948; E-mail: , or Zaver M. Bhujwalla, The Johns Hopkins University School of Medicine, Department of Radiology, 208C Traylor Building, 720 Rutland Avenue, Baltimore, Maryland 21205. Tel: (410) 955-9698; Fax: (410) 614-1948; E-mail:
| | - Kristine Glunde
- The Johns Hopkins University School of Medicine, In Vivo Cellular and Molecular Imaging Center, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, Maryland
- The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
- Address all correspondence to: Kristine Glunde, The Johns Hopkins University School of Medicine, Department of Radiology, 212 Traylor Building, 720 Rutland Avenue, Baltimore, Maryland 21205. Tel: (410) 614-2705; Fax: (410) 614-1948; E-mail: , or Zaver M. Bhujwalla, The Johns Hopkins University School of Medicine, Department of Radiology, 208C Traylor Building, 720 Rutland Avenue, Baltimore, Maryland 21205. Tel: (410) 955-9698; Fax: (410) 614-1948; E-mail:
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Ansari B, Morton MJ, Adamczyk DL, Jones KN, Brodt JK, Degnim AC, Jakub JW, Lohse CM, Boughey JC. Distance of Breast Cancer From the Skin and Nipple Impacts Axillary Nodal Metastases. Ann Surg Oncol 2011; 18:3174-80. [DOI: 10.1245/s10434-011-1957-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Indexed: 12/11/2022]
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16
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Sieuwerts AM, Mostert B, Bolt-de Vries J, Peeters D, de Jongh FE, Stouthard JML, Dirix LY, van Dam PA, Van Galen A, de Weerd V, Kraan J, van der Spoel P, Ramírez-Moreno R, van Deurzen CHM, Smid M, Yu JX, Jiang J, Wang Y, Gratama JW, Sleijfer S, Foekens JA, Martens JWM. mRNA and microRNA expression profiles in circulating tumor cells and primary tumors of metastatic breast cancer patients. Clin Cancer Res 2011; 17:3600-18. [PMID: 21505063 DOI: 10.1158/1078-0432.ccr-11-0255] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Molecular characterization of circulating tumor cells (CTC) holds great promise. Unfortunately, routinely isolated CTC fractions currently still contain contaminating leukocytes, which makes CTC-specific molecular characterization extremely challenging. In this study, we determined mRNA and microRNA (miRNA) expression of potentially CTC-specific genes that are considered to be clinically relevant in breast cancer. EXPERIMENTAL DESIGN CTCs were isolated with the epithelial cell adhesion molecule-based CellSearch Profile Kit. Selected genes were measured by real-time reverse transcriptase PCR in CTCs of 50 metastatic breast cancer patients collected before starting first-line systemic therapy in blood from 53 healthy blood donors (HBD) and in primary tumors of 8 of the patients. The molecular profiles were associated with CTC counts and clinical parameters and compared with the profiles generated from the corresponding primary tumors. RESULTS We identified 55 mRNAs and 10 miRNAs more abundantly expressed in samples from 32 patients with at least 5 CTCs in 7.5 mL of blood compared with samples from 9 patients without detectable CTCs and HBDs. Clustering analysis resulted in 4 different patient clusters characterized by 5 distinct gene clusters. Twice the number of patients from cluster 2 to 4 had developed both visceral and nonvisceral metastases. Comparing transcript levels in CTCs with those measured in corresponding primary tumors showed clinically relevant discrepancies in estrogen receptor and HER2 levels. CONCLUSIONS Our study shows that molecular profiling of low numbers of CTCs in a high background of leukocytes is feasible and shows promise for further studies on the clinical relevance of molecular characterization of CTCs.
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Affiliation(s)
- Anieta M Sieuwerts
- Department of Medical Oncology, Josephine Nefkens Institute and Cancer Genomics Centre, Rotterdam, The Netherlands
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17
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The metastatic cascade is reflected in the transcriptome of metastatic canine mammary carcinomas. Vet J 2010; 190:236-243. [PMID: 21112801 DOI: 10.1016/j.tvjl.2010.10.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 10/18/2010] [Accepted: 10/25/2010] [Indexed: 01/28/2023]
Abstract
Proliferation, dedifferentiation and loss of cell-cell contacts are amongst the first steps of the metastatic cascade. The complex molecular pathways and gene expression changes associated with these events in canine mammary tumors are still largely undetermined. In this study, the transcriptome of 13 lymph node positive canine mammary carcinomas and corresponding non-neoplastic mammary glands were compared to identify the molecular pathways associated with metastatic progression. Differential gene expression was analyzed using gene set enrichment and pathway analysis and compared with gene expression data from human breast cancer. Metastatic canine carcinomas had 1312 significantly differentially expressed genes compared to normal mammary glands. This expression profile included a significant up-regulation of cell division and matrix invasion genes (MMP, SERPINE1, TIMP3). In contrast, genes associated with epithelial differentiation (EGF, EGFR, MAP2K6, STAT 5), cell adhesion (CLDN5, CTNNAL1, MUC1, PECAM1) and angiogenesis (ANGPT 2, ANGPTL1-4, FIGF, TIE1) were mostly down-regulated. Tumors had a significant decrease in membrane receptors and pathway gene expression (EGFR, FGFR1, GHR, PDGFR, TGFBR, TIE1) indicating a tendency towards independence from these proliferative stimuli. A number of the identified deregulated pathways overlapped with gene expression profiles of human breast cancer. Gene expression profiling of metastatic carcinomas, therefore, identified molecular pathways and functional gene families that are deregulated during malignant progression in canine mammary tumors.
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