Discordance of Hormonal Receptor, Human Epidermal Growth Factor Receptor-2, and Ki-67 between Primary Breast Cancer and Synchronous Axillary Node Metastasis

2018 ◽  
Vol 227 (4) ◽  
pp. e6
Author(s):  
Kosho Yamanouchi ◽  
Hiroko Kinoe ◽  
Sayaka Kuba ◽  
Michi Morita ◽  
Chika Sakimura ◽  
...  
2021 ◽  
Author(s):  
Young Joo Lee ◽  
Young Sol Hwang ◽  
Junetae Kim ◽  
Sei-Hyun Ahn ◽  
Byung Ho Son ◽  
...  

Abstract PurposeWe aimed to develop a prediction MammaPrint (MMP) genomic risk assessment nomogram model for hormone-receptor-positive and human epidermal growth factor receptor-2 (HER2)-negative breast cancer and minimal axillary burden (N0-1) tumors using clinicopathological factors of patients who underwent an MMP test for decision making regarding adjuvant chemotherapy.MethodsA total of 409 T1-3 N0-1 M0 hormone receptor-positive and HER2-negative breast cancer patients whose MMP genomic risk results were available at Asan Medical Center from 2017 to 2020 were enrolled. Patients were randomly assigned to training and validation subsets and logistic regression was performed. ResultsThe primary cohort (n = 409) included 216 (53.1%) T2-3 and 388 (94.8%) N1 patients. No patients were estrogen-receptor-negative or -weak, 175 (42.7%) had a high proliferation index (Ki-67 ≥ 20%), and 225 (55.0%) were premenopausal. Multivariate analysis revealed that the age at diagnosis, progesterone receptor (PR) score, nuclear grade, and Ki-67 were significantly associated with MMP risk results. We developed an MMP low-risk predictive nomogram. The area under the receiver operating characteristic curve was 0.82 (95% confidence interval [CI], 0.77 to 0.87). When applied to the validation group, the nomogram was accurate with an area under the curve of 0.77 (95% CI, 0.68 to 0.86).Conclusion Our nomogram, which incorporates four traditional prognostic factors, i.e., age, PR, nuclear grade, and Ki-67, could predict the probability of obtaining a low MMP risk in a cohort of intermediate clinical risk patients. This nomogram can aid the selection of patients who need additional MMP testing.


Author(s):  
Swathi R. Shetty ◽  
Ragini Yeeravalli ◽  
Tanya Bera ◽  
Amitava Das

: Epidermal growth factor receptor (EGFR), a type-I transmembrane protein with intrinsic tyrosine kinase activity is activated by peptide growth factors such as EGF, epigen, amphiregulin, etc. EGFR plays a vital role in regulating cell growth, migration, and differentiation in various tissue-specific cancers. It has been reported to be overexpressed in lung, head, and neck, colon, brain, pancreatic, and breast cancer that trigger tumor progression and drug resistance. EGFR overexpression alters the signaling pathway and induces cell division, invasion, and cell survival. Our prior studies demonstrated that EGFR inhibition modulates chemosensitivity in breast cancer stem cells thereby serving as a potential drug target for breast cancer mitigation. Tyrosine kinase inhibitors (Lapatinib, Neratinib) and monoclonal antibodies (Trastuzumab) targeting EGFR have been developed and approved by the US FDA for clinical use against breast cancer. This review highlights the critical role of EGFR in breast cancer progression and enumerates the various approaches being undertaken to inhibit aggressive breast cancers by suppressing the downstream pathways. Further, the mechanisms of action of potential molecules at various stages of drug development as well as clinically approved drugs for breast cancer treatment are illustrated.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ilana Schlam ◽  
Sandra M. Swain

AbstractHuman epidermal growth factor receptor 2 (HER2) positive breast cancer accounts for 20–25% of all breast cancers. Multiple HER2-targeted therapies have been developed over the last few years, including the tyrosine kinase inhibitors (TKI) lapatinib, neratinib, tucatinib, and pyrotinib. These drugs target HER2 and other receptors of the epidermal growth factor receptor family, therefore each has unique efficacy and adverse event profile. HER2-directed TKIs have been studied in the early stage and advanced settings and have shown promising responses. There is increasing interest in utilizing these drugs in combination with chemotherapy and /or other HER2-directed agents in patients with central nervous system involvement, TKIs have shown to be effective in this setting for which treatment options have been previously limited and the prognosis remains poor. The aim of this review is to summarize currently approved TKIs for HER2+ breast, key clinical trials, and their use in current clinical practice.


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