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Sansano I, Vieites B, Sancho de Salas M, García C, Amendoeira I, Bernet L, Pérez-García JM, Espinosa-Bravo M, Rubio IT, Ramón Y Cajal S, Peg V. Axillary staging based on molecular analysis: Results of the B-CLOSER-II study. Pathol Res Pract 2020; 216:153197. [PMID: 32919301 DOI: 10.1016/j.prp.2020.153197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Axillary staging (pN) is a strong predictor of outcome in early stage breast cancer yet following the publication of the Z0011 trial there has been an increasing tendency to spare lymph node dissection. Automated molecular detection of cytokeratin 19mRNA by one-step nucleic acid amplification (OSNA) has been demonstrated to be an accurate method to assess sentinel lymph node (SLN) metastasis. In this study we compare histological and molecular methods following complete axillary lymph node dissection (cALND), determine whether molecular axillary staging affects survival, and evaluate the predictive and prognostic value of total tumor load in ALND (AD-TTL) and in all positive nodes (G-TTL). MATERIAL AND METHODS Axillary lymph nodes were collected from 102 patients with primary breast cancer with histological confirmation of axillary involvement (cN+) or positive SLN. The central 1-mm portion of each non-SLN was processed for hematoxylin-eosin staining and the remaining tissue was analyzed by OSNA. RESULTS Non-SLNs were diagnosed as positive in 72 out of 102 patients (70.6 %) on OSNA compared with only 53 (52 %) on histology (p < 0.01). Thirteen patients would have changed staging if the diagnoses provided had been by molecular methods (p < 0.01), but without a change in prognosis. AD-TTL and G-TTL were predictive of recurrence and mortality. CONCLUSIONS Compared to molecular detection, histological examination significantly underestimates the frequency of axillary node metastases. However, the increase in pN did not show a clinical effect on survival in those patients.
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Affiliation(s)
- Irene Sansano
- Pathology Department, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain; Departament de Ciències morfològiques, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain
| | - Begoña Vieites
- Pathology department, Hospital Universitario Virgen del Rocío, Avda de Manuel Siurot s/n. 41013 Sevilla, Spain
| | - Magdalena Sancho de Salas
- Pathology Department, Hospital Universitario de Salamanca Complejo Asistencial Universitario de Salamanca, Paseo de San Vicente 58-182. 37007 Salamanca, Spain
| | - Carmen García
- Pathology Department, Hospital Universitario de Salamanca Complejo Asistencial Universitario de Salamanca, Paseo de San Vicente 58-182. 37007 Salamanca, Spain
| | - Isabel Amendoeira
- Pathology Department Centro Hospitalar Universitário de S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Ipatimup - Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
| | - Laia Bernet
- Pathology Department, Hospital Universitario de La Ribera, Ctra. Corbera, km 1, 46600 Alcira, Valencia, Spain
| | | | - Martín Espinosa-Bravo
- Breast Cancer Unit, Hospital Universitari Valld'Hebron. Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain
| | - Isabel T Rubio
- Breast Cancer Unit, Clínica Universitaria de Navarra, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain
| | - Santiago Ramón Y Cajal
- Pathology Department, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain; Departament de Ciències morfològiques, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain; Spanish Medical Research Network Centre in Oncology (CIBERONC), Spain
| | - Vicente Peg
- Pathology Department, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain; Departament de Ciències morfològiques, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129 08035 Barcelona, Spain; Spanish Medical Research Network Centre in Oncology (CIBERONC), Spain.
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Chang HY, Tseng YK, Chen YC, Shu CW, Lin MI, Liou HH, Fu TY, Lin YC, Ger LP, Yeh MH, Liu PF. High snail expression predicts a poor prognosis in breast invasive ductal carcinoma patients with HER2/EGFR-positive subtypes. Surg Oncol 2018; 27:314-320. [PMID: 29937187 DOI: 10.1016/j.suronc.2018.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/02/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND High Snail expression is known as a poor prognostic factor in breast cancer. However, its prognostic impact for breast cancer with different molecular subtypes is still controversial. METHODS Snail expression was examined by immunohistochemistry in tissue microarray slides of 85 corresponding tumor-adjacent normal (CTAN) and 247 breast invasive ductal carcinoma (IDC) tissues. Multivariable Cox regression analysis was used to assess the impact of Snail expression on survival rate by different molecular subtypes of breast IDC patients. RESULTS The level of Snail expression in IDC tumor tissues was significantly higher than that in CTAN tissues. Moreover, high Snail expression had direct impacts on poor disease specific survival (DSS) and disease-free survival (DFS) in breast IDC patients with human epidermal growth factor receptor 2 (HER2)-positive and human epidermal growth factor receptor (EGFR)-positive statuses as well as the HER2 intrinsic subtype. Additionally, breast IDC patients with a combination of three prognostic factors, including high Snail expression and HER2-positive and EGFR-positive statuses, had much poor DSS and DFS with a statistically significant linear trend. CONCLUSION High Snail expression could predict a poor prognosis for breast IDC patients with HER2/EGFR-positive subtypes.
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MESH Headings
- Adult
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Case-Control Studies
- ErbB Receptors/metabolism
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Snail Family Transcription Factors/metabolism
- Survival Rate
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Affiliation(s)
- Hui-Yu Chang
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Yu-Kai Tseng
- Department of Orthopedics, Show Chwan Memorial Hospital, Changhua 50008, Taiwan; Department of Orthopedics, National Cheng Kung University Hospital, Tainan 70401, Taiwan
| | - Yu-Chia Chen
- Department of General Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Chih-Wen Shu
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Miaw-I Lin
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Huei-Han Liou
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Ting-Ying Fu
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Yun-Chung Lin
- Department of Pathology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Luo-Ping Ger
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Ming-Hsin Yeh
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Pei-Feng Liu
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan; Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan.
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