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Sun H, Zhang L, Wang Z, Gu D, Zhu M, Cai Y, Li L, Tang J, Huang B, Bosco B, Li N, Wu L, Wu W, Li L, Liang Y, Luo L, Liu Q, Zhu Y, Sun J, Shi L, Xia T, Yang C, Xu Q, Han X, Zhang W, Liu J, Meng D, Shao H, Zheng X, Li S, Pan H, Ke J, Jiang W, Zhang X, Han X, Chu J, An H, Ge J, Pan C, Wang X, Li K, Wang Q, Ding Q. Single-cell transcriptome analysis indicates fatty acid metabolism-mediated metastasis and immunosuppression in male breast cancer. Nat Commun 2023; 14:5590. [PMID: 37696831 PMCID: PMC10495415 DOI: 10.1038/s41467-023-41318-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
Male breast cancer (MBC) is a rare but aggressive malignancy with cellular and immunological characteristics that remain unclear. Here, we perform transcriptomic analysis for 111,038 single cells from tumor tissues of six MBC and thirteen female breast cancer (FBC) patients. We find that that MBC has significantly lower infiltration of T cells relative to FBC. Metastasis-related programs are more active in cancer cells from MBC. The activated fatty acid metabolism involved with FASN is related to cancer cell metastasis and low immune infiltration of MBC. T cells in MBC show activation of p38 MAPK and lipid oxidation pathways, indicating a dysfunctional state. In contrast, T cells in FBC exhibit higher expression of cytotoxic markers and immune activation pathways mediated by immune-modulatory cytokines. Moreover, we identify the inhibitory interactions between cancer cells and T cells in MBC. Our study provides important information for understanding the tumor immunology and metabolism of MBC.
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Affiliation(s)
- Handong Sun
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Lishen Zhang
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Zhonglin Wang
- Department of Breast Surgery, The Second People's Hospital of Lianyungang, 41 Hailian East Road, 222006, Lianyungang, China
| | - Danling Gu
- National Health Commission Key Laboratory of Antibody Techniques, Department of Cell Biology, Jiangsu Provincial Key Laboratory of Human Functional Genomics, School of Basic Medical Sciences, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
| | - Mengyan Zhu
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Yun Cai
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Lu Li
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Jiaqi Tang
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Bin Huang
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Bakwatanisa Bosco
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Ning Li
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Lingxiang Wu
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Wei Wu
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Liangyu Li
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Yuan Liang
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Lin Luo
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Quanzhong Liu
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China
| | - Yanhui Zhu
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Jie Sun
- Department of Breast Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, 215006, Suzhou, China
| | - Liang Shi
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Tiansong Xia
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Chuang Yang
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Qitong Xu
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Xue Han
- Department of Pathology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Weiming Zhang
- Department of Pathology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China
| | - Jianxia Liu
- Department of Breast Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, 215006, Suzhou, China
| | - Dong Meng
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000, Wuxi, China
| | - Hua Shao
- Department of Breast Surgery, The Second People's Hospital of Lianyungang, 41 Hailian East Road, 222006, Lianyungang, China
| | - Xiangxin Zheng
- Department of Breast Surgery, Affiliated Suqian Hospital of Xuzhou Medical University, 138 Huanghe South Road, 223800, Suqian, China
| | - Shuqin Li
- The Affiliated Lianyungang Hospital of Xuzhou Medical University, 6 Zhenhua East Road, 222006, Lianyungang, China
| | - Hua Pan
- Liyang People's Hospital, 70 Jianshe West Road, 213300, Liyang, China
| | - Jing Ke
- The Affiliated Hospital of Nantong University, 20 Xisi Road, 226300, Nantong, China
| | - Wenying Jiang
- Department of Breast Surgery, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, 213000, Changzhou, China
| | - Xiaolan Zhang
- Department of Breast Surgery, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 29 Xinglong Lane, 213000, Changzhou, China
| | - Xuedong Han
- Department of Breast and Thyroid Surgery, Huai'an First People's Hospital, Nanjing Medical University, 1 Huanghe West Road, 223300, Huai'an, China
| | - Jian Chu
- Department of General Surgery, the First People's Hospital of Yancheng, 66 Renmin South Road, 224001, Yancheng, China
| | - Hongyin An
- Department of General Surgery, the First People's Hospital of Yancheng, 66 Renmin South Road, 224001, Yancheng, China
| | - Juyan Ge
- Department of Pathology, The Second People's Hospital of Lianyungang, 41 Hailian East Road, 222006, Lianyungang, China
| | - Chi Pan
- Department of Breast Surgery, the Second Affiliated Hospital, Zhejiang University, College of Medicine, 88 Jiefang Road, 310009, Hangzhou, China
| | - Xiuxing Wang
- National Health Commission Key Laboratory of Antibody Techniques, Department of Cell Biology, Jiangsu Provincial Key Laboratory of Human Functional Genomics, School of Basic Medical Sciences, Nanjing Medical University, 211166, Nanjing, Jiangsu, China
- Institute for Brain Tumors, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kening Li
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China.
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China.
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China.
| | - Qianghu Wang
- Department of Bioinformatics, Nanjing Medical University, 101 Longmian Avenue, 211166, Nanjing, China.
- Collaborative Innovation Center for Personalized Cancer Medicine, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, 211166, Nanjing, Jiangsu, China.
- The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, 210002, Nanjing, China.
- Biomedical Big Data Center, Nanjing Medical University, 211166, Nanjing, Jiangsu, China.
| | - Qiang Ding
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, China.
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3
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Chung SH, de Geus SWL, Shewmaker G, Romatoski KS, Drake FT, Ko NY, Merrill AL, Hirsch AE, Tseng JF, Sachs TE, Cassidy MR. Axillary Lymph Node Dissection is Associated with Improved Survival Among Men with Invasive Breast Cancer and Sentinel Node Metastasis. Ann Surg Oncol 2023; 30:5610-5618. [PMID: 37204557 DOI: 10.1245/s10434-023-13475-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/21/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Male breast cancer (MBC) is rare, and management is extrapolated from trials that enroll only women. It is unclear whether contemporary axillary management based on data from landmark trials in women may also apply to men with breast cancer. This study aimed to compare survival in men with positive sentinel lymph nodes after sentinel lymph node biopsy (SLNB) alone versus complete axillary dissection (ALND). PATIENTS AND METHODS Using the National Cancer Database, men with clinically node-negative, T1 and T2 breast cancer and 1-2 positive sentinel nodes who underwent SLNB or ALND were identified from 2010 to 2020. Both 1:1 propensity score matching and multivariate regression were used to identify patient and disease variables associated with ALND versus SLNB. Survival between ALND and SLNB were compared using Kaplan-Meier methods. RESULTS A total of 1203 patients were identified: 61.1% underwent SLNB alone and 38.9% underwent ALND. Treatment in academic centers (36.1 vs. 27.7%; p < 0.0001), 2 positive lymph nodes on SLNB (32.9 vs. 17.3%, p < 0.0001) and receipt or recommendation of chemotherapy (66.5 vs. 52.2%, p < 0.0001) were associated with higher likelihood of ALND. After propensity score matching, ALND was associated with superior survival compared with SLNB (5-year overall survival of 83.8 vs. 76.0%; log-rank p = 0.0104). DISCUSSION The results of this study suggest that among patients with early-stage MBC with limited sentinel lymph node metastasis, ALND is associated with superior survival compared with SLNB alone. These findings indicate that it may be inappropriate to extrapolate the results of the ACOSOG Z0011 and EORTC AMAROS trials to MBC.
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Affiliation(s)
- Sophie H Chung
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Susanna W L de Geus
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Grant Shewmaker
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kelsey S Romatoski
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Frederick T Drake
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Naomi Y Ko
- Section of Hematology/Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Andrea L Merrill
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Ariel E Hirsch
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Jennifer F Tseng
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Teviah E Sachs
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Michael R Cassidy
- Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
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