scholarly journals Systemic immune reaction in axillary lymph nodes adds to tumor-infiltrating lymphocytes in triple-negative breast cancer prognostication

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fangfang Liu ◽  
Thomas Hardiman ◽  
Kailiang Wu ◽  
Jelmar Quist ◽  
Patrycja Gazinska ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Immune Responses ◽  
Lymph Nodes ◽  
Triple Negative ◽  
Tumor Infiltrating Lymphocytes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Her2 Positive ◽  
Local Immunity ◽  
Infiltrating Lymphocytes

AbstractThe level of stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative (TNBC) and HER2-positive breast cancers convey prognostic information. The importance of systemic immunity to local immunity is unknown in breast cancer. We previously demonstrated that histological alterations in axillary lymph nodes (LNs) carry clinical relevance. Here, we capture local immune responses by scoring TILs at the primary tumor and systemic immune responses by recording the formation of secondary follicles, also known as germinal centers, in 2,857 cancer-free and involved axillary LNs on haematoxylin and eosin (H&E) stained sections from a retrospective cohort of 161 LN-positive triple-negative and HER2-positive breast cancer patients. Our data demonstrate that the number of germinal center formations across all cancer-free LNs, similar to high levels of TILs, is associated with a good prognosis in low TILs TNBC. This highlights the importance of assessing both primary and LN immune responses for prognostication and for future breast cancer research.

scholarly journals Immunomodulating Therapies in Breast Cancer—From Prognosis to Clinical Practice

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4883
Author(s):  
Marcus Schmidt ◽  
Anne-Sophie Heimes
Keyword(s):  
Breast Cancer ◽  
Immune Responses ◽  
Triple Negative Breast Cancer ◽  
Immune Checkpoint ◽  
Triple Negative ◽  
Immune Cell ◽  
Checkpoint Inhibitors ◽  
Tumor Infiltrating Lymphocytes ◽  
Response To Chemotherapy ◽  
Infiltrating Lymphocytes

The role of the immune system in breast cancer has been debated for decades. The advent of technologies such as next generation sequencing (NGS) has elucidated the crucial interplay between somatic mutations in tumors leading to neoantigens and immune responses with increased tumor-infiltrating lymphocytes and improved prognosis of breast cancer patients. In particular, triple-negative breast cancer (TNBC) has a higher mutational burden compared to other breast cancer subtypes. In addition, higher levels of tumor-associated antigens suggest that immunotherapies are a promising treatment option, specifically for TNBC. Indeed, higher concentrations of tumor-infiltrating lymphocytes are associated with better prognosis and response to chemotherapy in TNBC. An important target within the cancer immune cell cycle is the “immune checkpoint”. Immune checkpoint inhibitors (ICPis) block the interaction of certain cell surface proteins that act as “brakes” on immune responses. Recent studies have shown that ICPis improve survival in both early and advanced TNBC. However, this comes at the price of increased toxicity, particularly immune-mediated toxicity. As an alternative approach, individualized mRNA vaccination strategies against tumor-associated neoantigens represent another promising approach leading to neoantigen-specific immune responses. These novel strategies should help to improve treatment outcomes, especially for patients with triple negative breast cancer.

Safety and effectiveness of dose dense neoadjuvant chemotherapy in patients with stage II/III breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11566-e11566
Author(s):  
S. Koya ◽  
Y. Li ◽  
S. A. McDaniel ◽  
A. F. LoBuglio ◽  
H. Krontiras ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Triple Negative ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Free Survival ◽  
Significant Difference ◽  
Grade 3 ◽  
Dose Dense

e11566 Background: NSABP B-18 randomized women with operable breast cancer to receive chemotherapy (AC) either pre- or postoperatively; in the study there was no significant difference in disease free survival (DFS) or overall survival (OS) among patients in either group. Pathologic complete response rate (pCR) was directly proportional to DFS and OS. Dose dense adjuvant chemotherapy (ATC) has shown a statistically significant improvement in DFS and OS. Methods: We performed a single institution review of pts enrolled in a neoadjuvant trial and who received dose dense neoadjuvant chemotherapy (doxorubicin 60 mg/m2 IV Q2wks x4, paclitaxel 175 mg/m2 IV Q2wks x4, and cyclophosphamide 600 mg/m2 IV Q2wks x4) to assess response rates, safety, and DFS. Women with newly diagnosed breast cancer, T ≥ 3cm, any N, M0 were enrolled. Results: Since 02/2003, 43 pts were enrolled (mean age 47.6, range 28–64) and received dose dense chemotherapy. 41.4% of the pts were triple negative and 14.6% were Her2+ by FISH or IHC. The median follow-up is 49 months (range 8–69). Two patients dropped out without finishing therapy. Forty one pts completed dose dense chemotherapy and proceeded to surgery. 17 pts (41.4%) achieved a pCR in the breast and of those 14 pts were also negative in the axillary lymph nodes (34.1% pCR in the breast and lymph nodes). 10 of the 17 pts with pCR in the breast (8 out of the 14 pts with pCR in breast and axillary lymph nodes) were triple negative. 18 pts (43.9%) achieved PR, 3 pts (7.31%) had SD and 3 pts (7.31%) had PD. Up to November 2008, 7 pts who did not have a pCR have relapsed (4 triple negative, 1 Her2+, 1 ER/PR positive and 1 ER negative, PR positive) with a relapsed free survival rate of 85%. Hematologic toxicity consisted of grade 3 anemia in 2 patients with no grade 4 anemia, no G4 thrombocytopenia and febrile neutropenia in 2 pts. Non-hematologic grade 3 or 4 toxicity consisted of mediport thrombosis in 2 pts, hyperglycemia in 2 pts, syncope in 1 pt, neuropathy in 1 pt, and varicella zoster in 1 pt. Conclusions: Our results show that dose dense neoadjuvant chemotherapy achieves a pCR (breast + node) in about 1/3 of patients (34%) with tolerable toxicity; although the number of patients is limited, our data suggest that triple negative breast cancer seems to be the most sensitive tumor to this regimen. No significant financial relationships to disclose.

Implications of high tumor infiltrating lymphocytes (TIL) in HER2-positive and triple-negative breast cancer (TNBC).

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 592-592 ◽  
Author(s):  
Vassiliki Kotoula ◽  
Kyriakos Chatzopoulos ◽  
Sotiris Lakis ◽  
Zoi Alexopoulou ◽  
Eleni Timotheadou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Tumor Infiltrating Lymphocytes ◽  
Her2 Positive ◽  
Infiltrating Lymphocytes

scholarly journals Male Triple Negative Axillary Accessory Breast Cancer, a Case Report

2021 ◽  
Author(s):  
Chao li ◽  
Biao Qian
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ki 67 ◽  
Breast Invasive Ductal Carcinoma ◽  
Accessory Breast

Abstract Background: Breast cancer is the most common malignancy among women worldwide. In men, cases of breast cancer are few and accounts for less than 1% of all cases of breast cancer. Majority of male breast cancer is hormone receptor-positive. The incidence of male axillary accessory breast cancer derived from axillary accessory breast is very low. Here we report a case of male triple negative axillary accessory breast cancer.Case presentation: We present a case of a male triple negative axillary accessory breast cancer in a 67-year-old man that progressively increased in size through a period of 1 year. We performed right accessory breast resection and right axillary lymph nodes dissection. Postoperative pathological analysis revealed right accessory breast invasive ductal carcinoma with apocrine metaplasia. The tumor size was 3.5 * 3.3cm. In addition, 5 metastatic lymph nodes were seen in 27 axillary lymph nodes. Immunohistochemistry showed ER (-), PR (-), Ki-67 30%, HER2 (2 +), GATA-3 (+), GCDFP-15(+), and AR (+). Fish test obtained a negative result. The patient was treated with adjuvant chemotherapy and radiotherapy.Conclusion: Male triple negative axillary accessory breast cancer is rare. Treatment of male triple negative axillary accessory breast cancer is similar to that of women patients. Most patients undergo surgery and adjuvant chemotherapy.

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