scholarly journals Expression of Ki67 in Triple Negative Breast Carcinoma and Its Correlation with Clinicopathological Variables – A Study from a Tertiary Care Center in Thrissur, Kerala

2021 ◽  
Vol 8 (27) ◽  
pp. 2439-2443
Author(s):  
Reshma Gopalakrishnan ◽  
Freena Rose ◽  
Jisha Kalathil Thodiyil ◽  
Lovely Jose

BACKGROUND Breast cancer is the most common malignancy in females. Triple negative breast carcinomas (TNBC), one of the molecular subtypes of breast carcinoma, are not sensitive to hormonal therapy and are reported to have aggressive behaviour. The present study was done to evaluate the expression of Ki67 in triple negative breast cancer using immunohistochemistry (IHC) and correlate the Ki67 expression with other clinicopathological variables. METHODS Based on the IHC status (ER, PR, HER neu), 50 triple negative breast carcinoma cases were selected from January 2019 to June 2020 for a cross-sectional study in Department of Pathology, Government medical college Thrissur. Ki67 immunohistochemical staining was done on the tissue sections and the Ki67 score was correlated with clinicopathological variables. RESULTS Of the 50 cases, majority (74 % cases) had high Ki67 expression (score of more than 50 %). High Ki67 score was strongly associated with presence of lymphovascular emboli (LVE) (P value < 0.05). Even though most of the patients were above 50 years (72 %), no significant correlation was seen between age and Ki67 score. The association with tumour size, histopathological type, tumour grade and lymph node status were not statistically significant. CONCLUSIONS Ki67 expression was high in triple negative breast cancer with mean score of 62 %. High Ki67 score correlated with presence of LVE. High Ki67 would predict increased proliferation of breast cancer cells and could be considered as a prognostic marker. KEYWORDS TNBC- Triple Negative Breast Cancer, Ki 67 Score, Clinicopathological Variables

2018 ◽  
Vol 17 (5) ◽  
pp. 539-551 ◽  
Author(s):  
M. S. Eng ◽  
J. Kaur ◽  
L. Prasmickaite ◽  
B. Ø. Engesæter ◽  
A. Weyergang ◽  
...  

Light-controlled immunotargeting of CSPG4+ triple negative breast cancer and malignant melanoma.


2020 ◽  
Vol 5 (2) ◽  
pp. 101-105
Author(s):  
Suman Khanal ◽  
Yogendra P. Singh ◽  
Gita Sayami ◽  
Akihiko Ozaki

Background: TNBC (Triple negative breast cancer) subtype (ER-/PR-/HER2-) of breast cancers are known for aggressive tumor biology and poor survival prospects, with high early relapse rate. However, little is known about the prevalence and characteristics of TNBC breast cancer in Nepal. Objectives: To clarify the geographical distribution, clinical profile and outcome of TNBC patients when compared with non-TNBC patients managed in tertiary care university hospital in Nepal. Materials and Methods: This is a study on prospective observational analyses of TNBC and non-TNBC patients managed at Tribhuvan University Teaching Hospital, Kathmandu from October 2015-March 2018. We collected and analyzed data on clinical profile, pathological tumor features and outcome of the two patient groups. Results: A total of 108 breast cancer patients were included in our study, 38 (35.2%) of which were TNBCs. Mean age at diagnosis was 49±12 years. Majority of TNBCs (29%) were concentrated in Terai districts compared to non-TNBCs (18.6%). Among TNBCs, 15.2% had tumor size 5 cm or more while only 11.9% had such finding in non-TNBCs. Majority of TNBCs and non-TNBCs were of invasive ductal carcinoma of NST histology (76.3 vs 90%). TNBC tumors were significantly of grade 3 (P value=0.003). Perineural invasion was seen more (15.8%) in TNBCs compared to 8.96% in non-TNBCs. On average, 23.6% of total nodes retrieved from axilla were positive for tumor in TNBCs compared to 21% in non-TNBCs. Three patients developed metastases in TNBCs of which two were to brain while 5 had metastases in non-TNBC with none to brain. Higher percentage of patients died in TNBC group (13.2 vs 7.1%). Conclusions: TNBCs are quite common, higher grade tumors with brain metastasis without particular geographic distribution.


Biomedicine ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 75-81
Author(s):  
N. Priyathersini ◽  
J. Thanka ◽  
B Jayashree

Introduction and Aim: Breast cancer is the most common malignancy in females worldwide. Almost 1.4 million new cases have been diagnosed with breast cancer every year. This aims to study the clinicopathological profile and molecular subtypes of invasive breast carcinoma in resected mastectomy specimens over a period of 5 years. Materials and Methods:A retrospective study of 90 mastectomy and wide local resection specimens received during the period of January 2012 to June 2017 were analyzed. The clinical data of patients including age, gender, and stage of the diseasewere obtained from the medical records section. Immunohistochemical staining for Estrogen Receptor [ER], Progesterone Receptor[PR] and Human Epidermal Growth Factor Receptor 2HER2neu were done.The cases were classified according to the molecular classification based on the ER, PR and HER2 receptor status. Results: The peak incidence of breast carcinoma was in the age group 50 to 60 years. Invasive ductal carcinoma,Not otherwise specified[NOS] accounted for the most common histologic type. There was higher incidence of pT2 tumors in our study. The most common molecular subtype was luminal A, followed by triple negative tumors. These molecular subtypes associated well with Tumor grade and HGDCIS with a statistically significant p value of 0.001 and 0.015 respectively. An increased proportion of Grade 3 tumors were Triple Negative tumors. Conclusion:In breast carcinomas the routine histopathological features provide inexpensive method for understanding tumour biology and prognosis. It`s essential in areas with poor resources. ER, PR and HER2 assessment helps in identifying hormonal status and enables for hormone therapy and anti HER2 therapy.  


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Shadia M. Al-Bahlani ◽  
Ruqaya M. Al-Rashdi ◽  
Shiyam Kumar ◽  
Shadia S. Al-Sinawi ◽  
Maiya A. Al-Bahri ◽  
...  

Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer in which calpain system plays an important role in its cellular processes including apoptosis and proliferation. Although such roles have been assessed in tumor pathogenesis, the correlation of its expression to the proliferating/apoptotic index has not been studied yet. Immunohistochemical staining of calpain-1 was performed on paraffin-embedded tissues to correlate its expression with clinicopathological variables and outcome. The proliferation activity was determined by calculating the percentage of cells expressing the Ki-67 antigen. The apoptotic index was assessed morphologically and biochemically using Haematoxylin & Eosin method and Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, respectively. Calpain-1 was significantly expressed in TNBC tissues varying from low to high with a significant correlation to lymph node status but not with the other clinicopathological variables, suggesting its role as a prognostic factor. In addition, a positive correlation was found between both apoptotic counts assays (P<0.001, r=0.547) as well as with proliferation (P=0.045). Calpain-1 expression had no significant correlation with either proliferation (P=0.29) or apoptotic indices (P=0.071 and P=0.100). Determining calpain-1 expression may provide relevant prognostic value for TNBC cancer patients.


Author(s):  
Prasant Kumar Parida ◽  
Subrat Kumar Samantara ◽  
Sashibhusan Dash

Background: Because of its high-risk biological features and lack of effective treatment options, triple-negative breast cancer (TNBC) has received greater clinical and experimental interest. Aim and objectives: The aim of this study was to compare and analyze the clinicopathological features, recurrence, metastasis, and prognosis of patients with TNBC and non-triple negative breast cancer (non-TNBC). Material and methods: This single hospital-based retrospective study was conducted on patients who were histopathologically diagnosed with breast cancer and subsequently treated from 2017 to 2018 at the Acharya Harihar Postgraduate Institute of Cancer. The clinical features and prognosis of TNBC and non-TNBC were compared. Results: This study comprised a total of 111 patients, with 36 (32.43%) being TNBC and 75 (67.56%) being non-TNBC. TNBC has 22 patients under the age of 40 (61.1%). Grade III tumors were seen in 47% of TNBC patients and 21% of non-TNBC patients (p-value = 0.05). The disease free survival (DFS) was determined to be 58 % for TNBC and 82% for non-TNBC groups, respectively (p-value = 0.05). These two groups had an overall survival rate (OS) of 72% and 92%, respectively (p-value = 0.05). Conclusion: When compared to non-TNBC, TNBC was related to high-grade malignancies, worse disease-free survival , and overall survival (OS) rates. Understanding the molecular features of TNBC, clarifying its mechanism at the molecular level, interpreting the gene expression profiles of TNBC, and studying and creating new therapeutic targets should be the focus of future research. To enhance the prognosis of TNBC patients, try to find a focused and effective therapy. Keywords: Breast cancer; survival; triple-negative breast cancer.


Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 704 ◽  
Author(s):  
Parisa Lotfinejad ◽  
Mohammad Asghari Jafarabadi ◽  
Mahdi Abdoli Shadbad ◽  
Tohid Kazemi ◽  
Fariba Pashazadeh ◽  
...  

This meta-analysis aimed to evaluate the prognostic value of tumor-infiltrating lymphocytes (TILs) and programmed death-ligand 1 (PD-L1), their associations with the clinicopathological characteristics, and the association between their levels in patients with triple-negative breast cancer (TNBC). PubMed, EMBASE, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched to obtain the relevant papers. Seven studies with 1152 patients were included in this study. Like the level of TILs, there were no significant associations between PD-L1 expression and tumor size, tumor stage, lymph node metastasis, histological grade, and Ki67 (All p-values ≥ 0.05). Furthermore, there was no significant association between PD-L1 expression with overall survival (OS) and disease-free survival (DFS). In assessment of TILs and survival relationship, the results showed that a high level of TILs was associated with long-term OS (hazard ratios (HR) = 0.48, 95% CI: 0.30 to 0.77, p-value < 0.001) and DFS (HR = 0.53, 95% CI: 0.35 to 0.78, p-value < 0.001). The results displayed that tumoral PD-L1 expression was strongly associated with high levels of TILs in TNBC patients (OR = 8.34, 95% CI: 2.68 to 25.95, p-value < 0.001). In conclusion, the study has shown the prognostic value of TILs and a strong association between tumoral PD-L1 overexpression with TILs in TNBC patients.


2019 ◽  
Vol 13 ◽  
pp. 117822341983098
Author(s):  
Marcy C Purnell

Introduction: The Bio-Field Array (BFA) is a device that generates a dielectrophoretic electromagnetic field (DEP-EMF) when placed in a hypotonic saline solution and a direct current (dc) of ~3 amperes is applied. Human triple-negative breast cancer (MDA-MB-231 cells) is known to have a high percentage of apoptotic ( P53) deficient cells and some patients can have poor outcomes with current treatments. Objectives: Previously, we reported a strong upregulation of the apoptotic arm of the unfolded protein response, via reverse transcription–quantitative polymerase chain reaction (RT-qPCR), as well as positive annexin staining in this human breast carcinoma, when grown in media prepared with BFA’s dc DEP-EMF treated saline. Here we will examine and discuss cytoskeletal microtubule changes that were noted in the treated breast carcinoma that are strongly suggestive of apoptosis and the possible correlation of these microtubule changes to the upregulation of Junction Mediating and Regulatory Protein ( JMY, a P53/TP53 cofactor) that is known to drive cytoskeleton microfilaments (actin) function. Methods: In addition to microarray and RT-qPCR analyses, we conducted 7 days of fluorescent microscopic analyses of tubulin assays in these treated versus control MDA-MB-231 cells. Results: These data suggest 2 possible forms of apoptosis, rounded and irregular, may be occurring and possibly facilitated by the significant upregulation (via microarray and RT-qPCR) of an important but poorly understood Nucleation-Promoting Factor (NPF), JMY. Conclusions: The ability of the BFA dc DEP-EMF to significantly upregulate JMY and possibly influence the regulation of unbranched (nucleation-microtubule spikes) and branched forms (autophagy) of actin in the cytoplasmic domains may facilitate a “two coffins” or round and irregular necrosis-like apoptosis for this highly aggressive and often apoptotic-deficient breast cancer cell line.


2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 140-140
Author(s):  
Anna Kaminsky

140 Background: Metaplastic breast carcinoma (MBC) is a rare subtype that accounts for <1% of all breast carcinomas. MBC is frequently triple-negative and neoadjuvant chemotherapy (NAC) is often used in triple-negative breast cancer (TNBC). The objective of this analysis is to ascertain response rates of MBC to NAC as compared to non-metaplastic TNBC. Methods: We searched the Magee Women’s Cancer Center of UPMC IRB-approved neo-adjuvant treatment database which contains outcome data on 594 patients treated from 2004-2010. 116 patients with triple negative breast cancer (ER /PR negative or ER /PR weakly positive [H score of 10 or less] and HER2 negative or indeterminate [HER2 1+ or 2+ without amplification by FISH]), were identified. Nine of these TNBCs had metaplastic subtype and two groups were analyzed: metaplastic breast carcinoma (MBC) (N= 9) and non-metaplastic breast carcinoma (NMBC) (N = 107). Tumor volume reduction (TVR), pathologic complete response (pCR), recurrence and mortality were compared in both groups. Results: Average follow-up in MBC group was 43 months and no patients were lost to follow-up. Average tumor size on presentation in MBC group was 4.47 cm while in NMBC group it was 3.33 cm. pCR was noted in 0/9 MBC and 43/107 NMBC cases (p = 0.0253). 6/9 patients had mastectomy, 2/9 had breast conserving surgery (BCS) and 1/9 patients did not have a surgery yet. Average TVR was 28% in MBC cases compared to 74% in NMBCs when cases with pCR were included (p = 0.0001) and 56% when cases with pCR were excluded (p = 0.0202). Follow up on 9 MBC cases revealed 1 recurrence and subsequent death (11%). Follow-up on 64 NMBC patients who failed to achieve pCR revealed 22 recurrences (34%) and 18 of them subsequently died (28%). Follow-up on 43 NMBC cases that achieved pCR revealed 3 recurrences (7%) and 1 death (2%). Conclusions: MBC was characterized by larger size at baseline as compared to NMBC. There were no pCR’s seen in MBC, but some MBC did achieve response that allowed for breast conservation. Although the average tumor volume reduction was significantly less in MBC compared to NMBC, the NMBC that failed to achieve pCR fared much worse than MBC who did not achieve pCR. Therefore, the triple-negative paradox is likely not applicable to MBC.


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 ◽  
...  

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.


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