Multicentric Medullary Carcinoma Breast - Uncommon Histologic Subtype

2020 ◽  
Vol 7 (43) ◽  
pp. 2511-2513
Author(s):  
Sunil Vitthalrao Jagtap ◽  
Vaidehi Dharmesh Nagar ◽  
Shubham Sunil Jagtap ◽  
Shefali Mishra
Keyword(s):  
Poor Prognosis ◽  
Triple Negative ◽  
Medullary Carcinoma ◽  
Good Prognosis ◽  
Breast Cancers ◽  
Breast Carcinomas ◽  
Histologic Subtype ◽  
Carcinoma Breast ◽  
Breast Malignancy ◽  
Regional Metastasis

Ridolfi et al. in 1977 defined medullary breast carcinoma (MBC) as one of the invasive and malignant subtypes of breast cancer.1 It is a rare breast malignancy accounting for 5 % of breast carcinomas.2 Although MBC is considered as having good prognosis, patients reported as triple-negative breast cancers are associated with aggressive clinical behaviour and poor prognosis.3 Also factors like local invasion, evidence of regional metastasis, etc. will determine the progress of this type of cancer.

Claudin 1, 3, 4, and 7 expression in triple-negative breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1070-1070
Author(s):  
Beom Seok Ko ◽  
Hee Jeong Kim ◽  
Jong Han Yu ◽  
jong Won Lee ◽  
Byung Ho Sohn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Triple Negative Breast Cancer ◽  
Poor Prognosis ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Endocrine Treatment ◽  
Lymph Node Status ◽  
High Recurrence Rate ◽  
Breast Cancers

1070 Background: Triple negative breast cancer (TNBC) often grows rapidly and has poor prognosis, with a high recurrence rate. Because conventional endocrine treatment and HER2 targeted therapy for TNBC is invalid, chemotherapy is the only systemic treatment for TNBC. It is known that several subtypes within the TNBC show different responses to chemotherapy, depending on the subtypes. Recently, a claudin (CLDN) low breast cancer has been identified, exhibiting low expressions of CLDNs 1, 3, 4 and 7. CLDNs are transmembrane proteins that seal tight junctions and are critical for maintaining cell-to-cell adhesion in epithelial cell sheets. However, their role in cancer progression remains largely unexplored. Methods: Surgically removed, formalin-fixed, paraffin-embedded breast cancers from 341 TNBC patients were analyzed to identify CLDN expression.They underwent wide local excision or mastectomy between March, 2004 and December, 2007 at the breast surgery unit of Asan Medical Central Hospital. Results: In our tumor series, we found 45.0% (153/339) of high expressing cases for CLDN1, 57.0% (192/337) for CLDN3, 57.6% (194/337) for CLDN4 and 44.0% (149/339) for CLDN7. Overall, we found 20.5% (70/341) of cases were within the low CLDN expression group and 79.5% (271/341) of tumors were within the high expression group of CLDN1, 3, 4 ,7. Although the high CLDN expression group was significantly associated with positive lymph node status and higher stage, there were no significant differences between CLDN low and high groups in disease free survival (p=0.477) or overall survival (p=0.253). Conclusions: CLDN high tumors are associated with poor prognosis features, but they are not an independent prognostic factor in TNBC patients. However, the mechanisms underlying the different roles of CLDNs in tumorigenesis are largely unclear. Studying the associations of these CLDNs with the TNBC subgroup of breast cancers might provide us with potential diagnostic biomarkers or therapeutic targets for cancer cells.

scholarly journals Role of P-53 Gene in Preventing Breast Cancer

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Inflammatory Breast Cancer ◽  
Poor Prognosis ◽  
Triple Negative ◽  
Type I ◽  
Breast Cancers ◽  
T Helper ◽  
Tp53 Mutations ◽  
Her 2

Breast cancer affects more than one million patients annually in the world and is a leading cause of mortality. Histological type, grade, tumor size, lymph node involvement, and estrogen receptor and HER-2 receptor status, all influence prognosis and the probability of response to systemic therapies. P53 gene is mutated in about 30% of breast cancers/.The possible links between alterations of p53 and clinical or pathological features of breast tumors have been widely investigated. The first study to examine gene-expression patterns of breast cancer suggested that at least four major molecular classes of breast cancer exist: luminal-like, basal-like, normal like, and HER-2 positive. Basal-like breast cancer account for 15% of breast cancers and are often described as triple negative breast cancers (TNBCs). In fact, TNBCs, defined by lack of expression of estrogen receptor, progesterone receptor, and HER2, probably include both basal-like breast cancers and some poorly differentiated luminal breast cancers. They are also associated with a younger age and a poor prognosis. TNBCs also have an increased frequency of TP53 mutations. Recently, it was shown that mutant p53 status was a strongly unfavorable prognostic factor for relapse-free survival and overall survival only in a triple negative group in patients treated with adjuvant anthracycline-containing chemotherapy. Inflammatory breast cancer (IBC) is a clinical diagnosis known as the T4d category in the TNM classification. It is a distinct clinical subtype of locally advanced breast cancer (LABC), with a particularly aggressive behavior and poor prognosis. TP53 mutations are more frequent in inflammatory breast cancer (50%) than in non-inflammatory breast cancer (20–30%). The results from these studies served as the justification for attempts to vaccinate patients using p53-derived peptides, and a number of clinical trials are in progress. The most advanced work used a long synthetic peptide mixture derived from p53 (p53-SLP; Netherlands).The vaccine is delivered in the adjuvant setting and induces T helper type I response in the majority of patients. However, the response may not be potent enough to result in clinical benefit as a mono-therapy because most patients had T-helper cells that failed to produce key cytokines, indicating that this treatment should also be associated with another type of conventional or immunotherapy therapy.

scholarly journals Sinonasal analogue HPV related breast multiphenotypic carcinoma, a report of a case with the first description in the breast

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Diana M. Oramas ◽  
Diana Bell ◽  
Lavinia P. Middleton
Keyword(s):  
High Risk ◽  
Poor Prognosis ◽  
Triple Negative ◽  
High Grade ◽  
Breast Carcinomas ◽  
Squamous Differentiation ◽  
Case Presentation ◽  
High Risk Hpv ◽  
Basal Cytokeratins ◽  
Nasal Carcinoma

Abstract Background High grade basal-like breast carcinomas are triple negative, express basal cytokeratins, and are known for the overall poor prognosis and aggressive behavior. HPV related multiphenotypic sino-nasal carcinoma has overlapping histology with basal-like breast carcinomas, but carry the defining feature of association with high risk HPV. Case presentation We present a case of a perimenopausal woman with a non-healing ulcerated lesion involving the nipple and breast following a trauma. Biopsy performed showed an HPV-positive basal-like carcinoma with squamous differentiation involving the breast, analogous to multiphenotypic carcinoma previously described in the sinonasal tract. Conclusion This is the first report of a case of a high- risk HPV related basal-like carcinoma with squamous differentiation, described in the literature. We highlight the morphology and immunophenotype of this lesion and its recognition when compared to other multiphenotypic lesions of the breast, and suggest that pathologists should consider HPV evaluation when encountering similar basal-like tumors involving the breast.

scholarly journals EGFR expression is associated with cytoplasmic staining of CXCR4 and predicts poor prognosis in triple-negative breast carcinomas

2016 ◽  
Vol 13 (2) ◽  
pp. 695-703 ◽  
Author(s):  
Rong-Hui Li ◽  
Wen-He Huang ◽  
Jun-Dong Wu ◽  
Cai-Wen Du ◽  
Guo-Jun Zhang
Keyword(s):  
Poor Prognosis ◽  
Triple Negative ◽  
Breast Carcinomas ◽  
Cytoplasmic Staining ◽  
Egfr Expression

scholarly journals TP53 Status and Response to Treatment in Breast Cancers

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Mariana Varna ◽  
Guilhem Bousquet ◽  
Louis-François Plassa ◽  
Philippe Bertheau ◽  
Anne Janin
Keyword(s):  
Poor Prognosis ◽  
Good Prognosis ◽  
Response To Treatment ◽  
Breast Cancers ◽  
Wild Type ◽  
Tumor Subtypes ◽  
Fine Regulation ◽  
Tumor Types ◽  
Tp53 Status ◽  
Different Levels

The p53 wild-type protein plays an important role in cells as is shown by its fine regulation at different levels. Since its discovery, numerous mutations have been described. In breast cancers, p53 is mutated in almost 30% of cases, with a higher frequency in some tumor subtypes.TP53mutation is reported to be a factor for good prognosis in some studies, while in others it is a factor for poor prognosis. The explanation for these different results could be linked to the fact that the studies were performed on different tumor types and with different therapy regimens.

scholarly journals Tumor-infiltrating B cells and T cells correlate with postoperative prognosis in triple-negative carcinoma of the breast

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hajime Kuroda ◽  
Tsengelmaa Jamiyan ◽  
Rin Yamaguchi ◽  
Akinari Kakumoto ◽  
Akihito Abe ◽  
...  
Keyword(s):  
B Cells ◽  
Poor Prognosis ◽  
Triple Negative ◽  
Good Prognosis ◽  
University Hospital ◽  
T Lymphocyte Subsets ◽  
Hematoxylin And Eosin ◽  
Full Face ◽  
Treg Lymphocytes ◽  
Medical University

Abstract Background In this study, we investigated CD20+ TILs in triple-negative breast cancer (TNBC) and their relationship with T lymphocyte subsets (CD4+, CD8+, CD25+, and FOXP3+), including their combined prognostic value using an immunohistochemical staining method. Methods We investigated 107 patients with TNBC for whom a full-face section stained by hematoxylin and eosin between 2006 and 2018 at Dokkyo Medical University Hospital was available. Results The strongest association of infiltrating CD20+ TILs was with CD4+ TILs. There was a significant relationship between CD20+ and CD4+ TILs (r = 0.177; p < 0.001), CD8+ TILs (r = 0.085; p = 0.002), and FOXP3+ TILs (r = 0.0043; p = 0.032). No significant relationships were observed between the CD20+ and CD25+ TILs (r = 0.012; p = 0.264). Multivariate analysis revealed that only the CD20+/FOXP3 ratio was an independent factor for relapse-free survival (p < 0.001) and overall survival (p < 0.001). Patients with tumors highly infiltrated by CD4+, CD8+, and CD20+ TILs had a good prognosis. In contrast, those with tumors weakly infiltrated by CD20+ TILs but highly infiltrated by CD25+ and FOXP3+ TILs had a poor prognosis. Conclusions CD20+ TILs may support an increase in CD4+ and CD8+ TILs, which altered the anti-tumor response, resulting in a positive prognosis. CD20+ TILs correlated with FOXP3+ Treg lymphocytes, which were reported to be correlated with a poor prognosis. Our study suggested that TIL-B cells have dual and conflicting roles in TIL-T immune reactions in TNBC.

scholarly journals Comparison of Different Molecular Subtypes with 14% Ki-67 Cut-off Threshold in Breast Cancer Patients of Pakistan- An Indication of Poor Prognosis

2021 ◽  
Vol 24 (11) ◽  
pp. 837-844
Author(s):  
Mehreen Mushtaq ◽  
Summaya Sohail Chaudry ◽  
Ahmareen Khalid Sheikh ◽  
Nazia Khan ◽  
Asma Khattak ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Triple Negative ◽  
Molecular Subtypes ◽  
Histological Grade ◽  
High Expression ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Ki 67 ◽  
Therapeutic Decisions

Background: Ki-67 is a proliferation marker that is used not only to categorize patients in luminal A and B subtypes of breast cancers, but also to determine the aggressiveness of the disease in triple negative and human epidermal growth factor 2 (HER2) over expressed molecular subtypes. The present study was designed to evaluate the role of Ki-67 with cut off value of 14% in molecular subgroups and its association with patient prognosis. Methods: Immunostaining was performed on histopathologically confirmed sections (n = 278) to assess expression of Ki-67, estrogen receptor (ER), progesterone receptor (PR) and HER2. Immunoreactivity of molecules was recorded as percentage scoring. Results: Adopting a cut off value of 14%, Ki-67 was high in 88%of the cases included in the study. High Ki-67 was significantly associated with pathological parameters including histological grade, advanced stage and nodal/distant metastasis. Immunoexpression of ER, PR and HER2 also showed strong correlation with high expression of Ki-67. Based on the St. Gallen classification, the cases were categorized into luminal A (10%) and luminal B (51%), triple negative (20%) and HER2 enriched (18%). Ki-67 index was also significantly high in 98% of HER2 enriched and 95% of TNBC patients. Interestingly, Ki-67 score with cut off value of 14% proved to be significant in deciphering prognosis in luminal patients. Moreover, high expression of Ki-67 also proved to be a marker of poor prognosis, especially in triple negative patients. Conclusion: We suggest that utilization of IHC4 status i.e. ER, PR, HER2 and Ki-67 along with pathological findings and molecular subtyping can considerably affect clinical as well as therapeutic decisions.

Targeting triple-negative breast cancer by conversion into HER2-positive cancer: A novel therapeutic approach.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11534-e11534
Author(s):  
Christof Bernemann ◽  
Carolin Huelsewig ◽  
Ludwig Kiesel ◽  
Cornelia Liedtke
Keyword(s):  
Breast Cancer ◽  
Cell Lines ◽  
Small Molecule ◽  
Triple Negative Breast Cancer ◽  
Poor Prognosis ◽  
Triple Negative ◽  
Breast Cancer Cell Lines ◽  
Breast Cancers ◽  
Clinical Tool ◽  
Her2 Positive

e11534 Background: Triple negative breast cancer (TNBC) is defined by the lack of estrogen-receptor alpha (ERα) and progesterone receptor (PGR) expression as well as absence of human epidermal growth factor receptor2 (HER2/neu) overexpression. This type of breast cancer is characterized by a poor prognosis and significantly reduced survival rate compared to other BC subtypes. This is mostly due to the lack of targeted agents like endocrine or anti HER2 targets. Breast cancers which overexpress HER2 are usually treated by chemicals targeting HER2; either by blocking the extracellular domain through trastuzumab or the intracellular domain through the small molecule lapatinib. Both therapeutics lead to inhibition of downstream pathways like MAPK and PI3K, resulting in increased apoptosis as well as reduced proliferation. Methods: We hypothesize that downstream effects might be induced in TNBC cells when HER2 is artificially overexpressed and cells get treated as HER2 positive cells. Therefore, triple negative breast cancer cell lines were transfected with HER2. These cells were treated with anti-HER2 agents. Molecular analyses will demonstrate whether transfection with HER2 will yield a HER2 positive breast cancer phenotype in that all downstream signaling mechanisms act similarly to a priori HER2 positive cells. Results: Preliminary experiments suggest that proliferation of TNBC cells transfected with HER2 does not change significantly. Treatment with HER2-blocking antibody trastuzumab leads to significant decrease of proliferation in HER2 transfected, initially triple negative MDA-MB-231 breast cancer cells. Only a moderate decrease in proliferation was observed when lapatinib, a molecule directed against both EGFR and HER2, was used in both MDA-MB-231 wildtype and HER2-transfected cell lines. Conclusions: We surmise that firstly, conversion of cancer might become a clinical tool to treat cancer of poor prognosis and secondly that our results might shed light on future therapeutic approaches e.g. small molecule compound screening for endogenous HER2 reactivation / overexpression and subsequent targeted treatment of triple negative breast cancers.

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