scholarly journals Synchronous thyroid gland metastases from breast cancer. Case reports

2021 ◽  
Vol 23 (2) ◽  
pp. 280-286
Author(s):  
Nikolai A. Ognerubov ◽  
Tatyana S. Antipova ◽  
Elena E. Palkina
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Thyroid Gland ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Metastatic Breast ◽  
Distant Metastases ◽  
Luminal A ◽  
Cervical Lymph Nodes ◽  
Pet Ct

Background. Breast cancer is the leading cause of death in women. Distant metastases in different organs, including the thyroid gland, are still an urgent problem. Distant metastases are very rare in clinical practice. Nevertheless, the accumulated clinical and surgical experience in treatment has shown that breast cancer is the second most common primary tumor, leading to thyroid gland metastases, after kidney cancer. Aim. Present the clinical observations of synchronous thyroid gland metastases from breast cancer. Materials and methods. We observed two patients, aged 55 and 72 years, suffering from metastatic breast cancer with simultaneous metastases to the thyroid gland, to the cervical and mediastinal lymph nodes, to the lungs, to the ovaries and to the bones. Results. A 55-year-old woman with a left sided neck mass and hoarseness has been suffering from the metastatic breast cancer with simultaneous metastases to the thyroid gland, to the cervical lymph nodes, to the lungs, to the ovaries and to the bones. The biopsy of the primary tumor has been performed. The tumor has the structure of invasive ductal carcinoma, G2, luminal A subtype, HER2-negative type in histological and immunohistochemical analysis. The spread of the tumor has been determined by positron emission tomography/computed tomography (PET/CT). Metastases from breast cancer have been cytologically proven during thin needle biopsy. A 72-year-old woman with a mass in the region of thyroid gland has been suffering from breast cancer with metastases to the thyroid gland, to the mediastinal and cervical lymph nodes, to the bones, and to determine this process PET/CT, the thyroid fine needle aspiration biopsy and core biopsy of primary tumor have been applied. The histological variant was represented by invasive ductal cancer, G2, luminal A subtype, HER-2 negative type. Taking into account the spread of the process, the patients were given polychemotherapy, targeted therapy and hormone therapy. There is no disease progression for 6 months. Conclusion. Synchronous thyroid gland metastases in case of primary breast tumors are rare. In such cases, PET/CT is the important diagnostic method. The main therapeutic option in this case is systemic therapy, including chemotherapy, targeted and hormone therapy, the nature of the agent depends on the biological variant of the tumor.

scholarly journals Circulating Tumor Cell Transcriptomics as Biopsy Surrogates in Metastatic Breast Cancer

2022 ◽  
Author(s):  
Alexander Ring ◽  
Daniel Campo ◽  
Tania B. Porras ◽  
Pushpinder Kaur ◽  
Victoria A. Forte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Tumor Cells ◽  
Peripheral Blood ◽  
Primary Tumor ◽  
Metastatic Breast ◽  
Distant Metastases ◽  
Predictive Biomarker ◽  
Observation Data ◽  
Rna Seq

Abstract Background Metastatic breast cancer (MBC) and the circulating tumor cells (CTCs) leading to macrometastases are inherently different than primary breast cancer. We evaluated whether whole transcriptome RNA-Seq of CTCs isolated via an epitope-independent approach may serve as a surrogate for biopsies of macrometastases. Methods We performed RNA-Seq on fresh metastatic tumor biopsies, CTCs, and peripheral blood (PB) from 19 newly diagnosed MBC patients. CTCs were harvested using the ANGLE Parsortix microfluidics system to isolate cells based on size and deformability, independent of a priori knowledge of cell surface marker expression. Results Gene expression separated CTCs, metastatic biopsies, and PB into distinct groups despite heterogeneity between patients and sample types. CTCs showed higher expression of immune oncology targets compared with corresponding metastases and PB. Predictive biomarker (n = 64) expression was highly concordant for CTCs and metastases. Repeat observation data post-treatment demonstrated changes in the activation of different biological pathways. Somatic single nucleotide variant analysis showed increasing mutational complexity over time. Conclusion We demonstrate that RNA-Seq of CTCs could serve as a surrogate biomarker for breast cancer macrometastasis and yield clinically relevant insights into disease biology and clinically actionable targets. Visual Abstract Primary tumor cells (left side) disseminate via the blood stream to seed distant metastases (right side). Peripheral blood can be used for enrichment of CTCs (potentially representative of the full heterogeneity of a patient’s cancer) as a liquid biopsy. RNA-Seq can identify predictive biomarker expression in enriched CTCs as a surrogate for macrometastatic tissue biopsies. Different colored circles represent different cancer cell clones, representing heterogeneity in the primary tumor, and increased heterogeneity in metastatic tumors.

Correlate effects of local therapy for the primary tumor in metastatic breast cancer at diagnosis with molecular subtypes.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11502-e11502
Author(s):  
Fatima Zahra Hijri ◽  
Samia Arifi ◽  
Sami Aziz Brahmi ◽  
Nezar Bouyahia ◽  
Zineb Benbrahim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Primary Tumor ◽  
Molecular Subtypes ◽  
Metastatic Breast ◽  
Local Therapy ◽  
Axillary Lymph ◽  
Luminal A ◽  
Her2 Positive ◽  
Luminal B

e11502 Background: Few studies demonstrated that surgical resection of the primary tumor in patients with metastatic breast cancer at diagnosis is associated with significant improvement of survival. The aim of this study is to evaluate the correlation impact of local surgery in metastatic breast cancer at diagnosis with molecular subtypes. Methods: A retrospective study was conducted from 2007 to 2011 in our institution, of all stage IV breast cancer patients; who undergo breast surgery. Clinical , tumor characteristics, molecular subtypes, prognostic factors, therapeutic results data were analyzed. Results: We selected 59 cases. The mean age was 36 years (range: 22-44). 55 % women presented with locally advanced breast cancer with 13% T4 d . All patients underwent mastectomy except 4 who underwent conservative surgery .41 patients had axillary lymph node dissection. 63% were luminal A, 17% were luminal B, 7% were Her2-positive and 13% were basal-like . All patients received anthracycline based regimen and only 33% received taxanes. Loco regional radiotherapy (RT) was given to 6 women. Average follow-up was 13 months: - 20 patients represented partial response : 15 patients in luminal A , 3 patients in luminal B ,1 patients in basal-like and 1 patient in HER2-positive. - 11 patients (19%) were stable : 9 patients in luminal A and 2 patient in luminal B . -24 patients represented a progressive disease including 11 patients presented locoregional recurrence : 75 % in HER-positive, 40 % in basal-like, 50% in luminal B and 30% in luminal A (p=0.4). - 4 patients died in basal-like. The median local recurrence-free survival was 19 months and the median progression-free survival was 20 months. The local relapse is less observed in patients who: have a small tumor size (p = 0.003), had axillary lymph node dissection (p = 0.02) and loco regional radiotherapy (p = 0.03). The metastatic progression is less observed in patients with small tumor size (p = 0.01). Conclusions: Local Therapy of the primary tumor improves local control of disease, particularly in women with Small tumors. However, no significant correlation between impact of locale therapy and Molecular Subtypes was observed.

scholarly journals Invasive Micropapillary Carcinoma of Mixed Breast Cancer Metastasizing Faster Into Thyroid: A Rare Case Report

2021 ◽  
Author(s):  
Yupei Yu ◽  
Ruifeng Wang ◽  
Junqi Deng ◽  
Jiayu Zhou ◽  
Haiyan Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Thyroid Gland ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Metastatic Breast ◽  
Thyroid Tumor ◽  
Axillary Lymph ◽  
Invasive Micropapillary Carcinoma ◽  
Micropapillary Carcinoma ◽  
Cervical Lymph Nodes

Abstract Background: The incidence of metastatic breast cancer tumors in the thyroid gland is very rare, however, invasive micropapillary carcinoma of breast metastasizes to thyroid gland is rarer. As far as we know, there has never been reported that both invasive ductal carcinoma– no special type (IDC-NST) and invasive micropapillary carcinoma (IMPC) exist in breast whereas only the latter metastasizes into the thyroid gland.Case presentation: we report a case of a 59-year-old Chinese woman first diagnosed as IDC-NST of breast with involvement of axillary lymph node, grade 2 in 2015. However, five years later, blood tests revealed increased tumor markers. Multiple solid nodules were found in both side of thyroid gland by imaging. Total thyroidectomy and bilateral cervical lymph nodes dissection were presentation: the findings showed both IDC-NST and IMPC in lymph nodes but only the later in thyroid gland. Immunohistochemically, these tumor cells were positive for ER, PR, GATA3 and Mammaglobin, but negative for TG and TTF-1. Ultimately, the patient was diagnosed as mixed breast cancer with metastatic IMPC in thyroid and radiation therapy was still continued.Conclusion: Apart from the possibility of metastatic no special type of breast cancer to thyroid tumor, IMPC of breast metastasis must be taken into consideration, especially when the patient has a history of breast cancer and thyroid nodes. Accurate diagnose of metastatic breast carcinoma is vital for precise treatment and can improve the prognosis for patients.

scholarly journals CD3E is differentially expressed in metastatic breast cancer, both in metastases to the brain and to the lymph nodes.

2020 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Immune Cell ◽  
Metastatic Breast ◽  
Metastatic Tumor ◽  
Down Regulation ◽  
Primary Tumors ◽  
The Brain

Metastasis to the brain is a clinical problem in patients with breast cancer (1-3). We mined published microarray data (4, 5) to compare primary and metastatic tumor transcriptomes to discover genes associated with brain metastasis in patients with metastatic breast cancer. We found that the CD3 epsilon chain, a subunit of the T-cell receptor, encoded by CD3E was among the genes whose expression was most different in the metastatic tumor tissues of patients with metastatic breast cancer, both in metastases to brain and to the lymph nodes when compared to primary tumors of the breast or normal breast tissue, respectively. We observed significant down-regulation of CD3E in metastasis to the brain. If not attributable to immune cell contamination of primary tumor tissue sampled, molecular functions and down-regulation of CD3E may be important for metastasis of primary tumor-derived cancer cells to the lymph nodes and to the brain in humans with metastatic breast cancer and these data suggest some level of common origin for metastases that reside in the lymph nodes and colonize the brain.

scholarly journals Regulatory T lymphocyte infiltration in metastatic breast cancer—an independent prognostic factor that changes with tumor progression

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Jenny Stenström ◽  
Ingrid Hedenfalk ◽  
Catharina Hagerling
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
T Lymphocytes ◽  
T Lymphocyte ◽  
Metastatic Breast ◽  
Distant Metastases ◽  
Independent Prognostic Factor ◽  
Primary Tumors

Abstract Background Patients diagnosed with metastatic breast cancer have poor outcome with a median survival of approximately 2 years. While novel therapeutic options are urgently needed, the great majority of breast cancer research has focused on the primary tumor and less is known about metastatic breast cancer and the prognostic impact of the metastatic tumor microenvironment. Here we investigate the immune landscape in unique clinical material. We explore how the immune landscape changes with metastatic progression and elucidate the prognostic role of immune cells infiltrating primary tumors and corresponding lymph node and more importantly distant metastases. Methods Immunohistochemical staining was performed on human breast cancer tissue microarrays from primary tumors (n = 231), lymph node metastases (n = 129), and distant metastases (n = 43). Infiltration levels of T lymphocytes (CD3+), regulatory T lymphocytes (Tregs, FOXP3+), macrophages (CD68+), and neutrophils (NE+) were assessed in primary tumors. T lymphocytes and Tregs were further investigated in lymph node and distant metastases. Results T lymphocyte and Treg infiltration were the most clinically important immune cell populations in primary tumors. Infiltration of T lymphocytes and Tregs in primary tumors correlated with proliferation (P = 0.007, P = 0.000) and estrogen receptor negativity (P = 0.046, P = 0.026). While both T lymphocyte and Treg infiltration had a negative correlation to luminal A subtype (P = 0.031, P = 0.000), only Treg infiltration correlated to luminal B (P = 0.034) and triple-negative subtype (P = 0.019). In primary tumors, infiltration of T lymphocytes was an independent prognostic factor for recurrence-free survival (HR = 1.77, CI = 1.01–3.13, P = 0.048), while Treg infiltration was an independent prognostic factor for breast cancer-specific survival (HR = 1.72, CI = 1.14–2.59, P = 0.01). Moreover, breast cancer patients with Treg infiltration in their distant metastases had poor post-recurrence survival (P = 0.039). Treg infiltration levels changed with metastatic tumor progression in 50% of the patients, but there was no significant trend toward neither lower nor higher infiltration. Conclusion Treg infiltration could have clinical applicability as a prognostic biomarker, deciphering metastatic breast cancer patients with worse prognosis, and accordingly, could be a suitable immunotherapeutic target for patients with metastatic breast cancer. Importantly, half of the patients had changes in Treg infiltration during the course of metastatic progression emphasizing the need to characterize the metastatic immune landscape.

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