scholarly journals Correlation between the features of β1 and β3 integrin expression and lymphangitic metastatic spread in nonspecific invasive breast carcinoma based on tumor morphological heterogeneity

2022 ◽  
Vol 36 (4) ◽  
pp. 78-85
Author(s):  
N. V. Krakhmal ◽  
N. S. Telegina ◽  
M. V. Zavyalova ◽  
S. V. Vtorushin ◽  
V. A. Krokhmal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Invasive Breast Carcinoma ◽  
Β1 Integrin ◽  
Integrin Expression ◽  
Morphological Heterogeneity ◽  
Positive Expression ◽  
Β3 Integrin

Objective. To study β1 and β3 integrin expression in nonspecific invasive breast carcinoma and to find the associations with parameters of tumor morphological heterogeneity and lymphatic dissemination.Material and Methods. Study group comprised 107 patients with breast cancer. Histological type of tumor corresponded to invasive carcinoma of a nonspecific type (invasive ductal carcinoma) in 100% of cases. Patients did not receive any preoperative treatment. In each case, we performed morphological examination of samples of primary tumor and axillary lymph nodes obtained at the surgical stage of treatment (radical mastectomy or sectoral resection of mammary gland with axillary lymphadenectomy). The parameters of β1 and β3 integrin expression in primary tumor tissue were assessed by immunohistochemistry.Results. The study demonstrated that an increase in the degree of malignancy of breast carcinoma was associated with a decrease in the incidence of positive expression of β1 integrin as well as with an increase in the incidence of positive expression of β3 integrin. Metastases in lymph nodes were significantly less frequently detected in the presence of positive expression of β1 integrin in the alveolar and solid structures compared with the cases of absent expression of the marker in similar structures (48%; χ2 = 3.5; p = 0.05 and 48%; χ2 = 4.8; p = 0.02, respectively). Lymphogenic metastasis were detected significantly more often in cases with positive expression of β3 integrin in discrete groups of cells compared with the cases where the expression of study marker in the described structures was absent (47 and 23%, respectively; χ2 = 5.1; p = 0.02).Conclusion. The results of work showed the presence of relationships between the morphological heterogeneity of the tumor and the parameters of β1 and β3 integrin expression in the parenchymal structures of the neoplasm. The study showed the association of described parameters with the frequency of lymphatic dissemination in patients with breast cancer. Obtained data expand and support previously known evidence and suggest the possibility of assessing the markers as potential prognostic factors predicting the course of cancer.

The value of tumor-infiltrating lymphocytes and CD8 expression as a predictor of response to anthracycline-based neoadjuvant chemotherapy in invasive breast carcinoma of no special type

2021 ◽  
pp. 1-6
Author(s):  
Upik A. Miskad ◽  
Rizki A. Rifai ◽  
Rina Masadah ◽  
Berti Nelwan ◽  
Djumadi Ahmad ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Immune System ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Predictive Value ◽  
Disease Free Survival ◽  
Tumor Infiltrating Lymphocytes ◽  
Invasive Breast Carcinoma ◽  
Study Results ◽  
Infiltrating Lymphocytes

BACKGROUND: The immune system is known to play an important role in tumor cell eradication. Although cancer cells were able to escape from the immune system, many studies showed mononuclear inflammatory cell infiltrates known as tumor-infiltrating lymphocytes (TILs) on breast cancer histopathology specimens showed better prognosis, including in disease-free survival (DFS) and chemotherapy responses. OBJECTIVE: This study aimed to reveal the predictive value of tumor-infiltrating lymphocytes (TILs) levels and CD8 expression in invasive breast carcinoma of no special type patients’ samples on response to anthracycline-based neoadjuvant chemotherapy. METHODS: 75 pre-treatment biopsy samples that were diagnosed as invasive breast carcinoma of no special type were evaluated. TILs level determined following recommendations of International TILs Working Group 2014, CD8 expression assessed semiquantitatively after immunohistochemistry staining. Response to anthracycline-based neoadjuvant chemotherapy evaluated clinically using Response Evaluation Criteria in Solid Tumours (RECIST) criteria and pathologically by evaluating hematoxylin and eosin (H&E)-stained slides from mastectomy specimens after 3 or 4 cycles of neoadjuvant chemotherapy. RESULTS: Chi-squared analysis showed a significant relationship between TILs level and CD8 expression with chemotherapy responses clinically (p = 0.011 and p = 0.017 respectively) but not pathologically. Furthermore, the logistic regression test exhibit the predictive value of TILs level was 66.7% and CD8 expression was 64%. CONCLUSIONS: This study results suggest that TILs level and CD8 expression may be added as predictive factors to the response of anthracycline-based neoadjuvant chemotherapy, and oncologists may take benefit in breast cancer patient’s management.

Gene expression analysis of invasive breast carcinoma yields differential patterns in luminal subtypes of breast cancer

2021 ◽  
pp. 151814
Author(s):  
Ahmed S. Abdelhafiz ◽  
Merhan A. Fouda ◽  
Nahla A. Elzefzafy ◽  
Iman I. Taha ◽  
Omar M. Mohemmed ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Breast Carcinoma ◽  
Expression Analysis ◽  
Gene Expression Analysis ◽  
Invasive Breast Carcinoma

Correlation of manual semi-quantitative and automated quantitative Ki-67 proliferative index with OncotypeDXTM recurrence score in invasive breast carcinoma

2021 ◽  
pp. 1-11
Author(s):  
Brian S. Finkelman ◽  
Amanda Meindl ◽  
Carissa LaBoy ◽  
Brannan Griffin ◽  
Suguna Narayan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Hot Spot ◽  
Recurrence Score ◽  
Invasive Breast Carcinoma ◽  
Chemotherapy Response ◽  
Scoring Method ◽  
Cancer Proliferation ◽  
Ki 67 ◽  
Breast Cancer Chemotherapy

BACKGROUND: Ki-67 immunohistochemistry (IHC) staining is a widely used cancer proliferation assay; however, its limitations could be improved with automated scoring. The OncotypeDXTM Recurrence Score (ORS), which primarily evaluates cancer proliferation genes, is a prognostic indicator for breast cancer chemotherapy response; however, it is more expensive and slower than Ki-67. OBJECTIVE: To compare manual Ki-67 (mKi-67) with automated Ki-67 (aKi-67) algorithm results based on manually selected Ki-67 “hot spots” in breast cancer, and correlate both with ORS. METHODS: 105 invasive breast carcinoma cases from 100 patients at our institution (2011–2013) with available ORS were evaluated. Concordance was assessed via Cohen’s Kappa (κ). RESULTS: 57/105 cases showed agreement between mKi-67 and aKi-67 (κ 0.31, 95% CI 0.18–0.45), with 41 cases overestimated by aKi-67. Concordance was higher when estimated on the same image (κ 0.53, 95% CI 0.37–0.69). Concordance between mKi-67 score and ORS was fair (κ 0.27, 95% CI 0.11–0.42), and concordance between aKi-67 and ORS was poor (κ 0.10, 95% CI −0.03–0.23). CONCLUSIONS: These results highlight the limits of Ki-67 algorithms that use manual “hot spot” selection. Due to suboptimal concordance, Ki-67 is likely most useful as a complement to, rather than a surrogate for ORS, regardless of scoring method.

scholarly journals Atypical axillary lymphadenopathy mimicking an occult breast carcinoma in a patient diagnosed with sarcoidosis: case report

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Paula Clarke ◽  
Carolina Nazareth Valadares ◽  
Douglas de Miranda Pires ◽  
Nayara Carvalho de Sá
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Breast Lesions ◽  
Axillary Lymph ◽  
Axillary Lymphadenopathy ◽  
Granulomatous Lymphadenitis ◽  
Occult Breast Carcinoma

Introduction: Occult breast carcinoma is a rare presentation of breast cancer, with histological evidence of axillary lymph node involvement and clinical and radiological absence of malignant breast lesions. Its survival is similar to that of the usual presentation. The treatment consists of modified radical mastectomy or axillary drainage with breast irradiation, resulting in similar survival, associated with systemic therapy according to the staging. Neoadjuvant therapy should be considered in N2-3 axillary cases. Differential diagnoses of axillary lymphadenopathies include: non-granulomatous causes (reactive, lymphoma, metastatic carcinoma) and granulomatous causes (infectious – toxoplasmosis, tuberculosis, sarcoidosis, atypical mycobacteria). Objectives: To report the case of a patient who needed a differential diagnosis among the various causes of axillary lymphadenopathy. Methods: This is a literature review conducted in the PubMed database, using the keywords "granulomatous lymphadenitis", "breast sarcoidosis", "occult breast cancer". Inclusion and exclusion criteria were applied. Case report: V.F.S., female, 51 years old, was referred to an evaluation of axillary lymphadenopathy in May 2019. She was followed by the department of pulmonology due to mediastinal sarcoidosis since 2017. Physical examination indicated breasts without changes. Axillary lymph nodes had increased volume and were mobile and fibroelastic. Mammography revealed only axillary lymph nodes with bilaterally increased density, and the ultrasound showed the presence of atypical bilateral lymph nodes. Neither presented breast lesions. Axillary lymph node core biopsy was compatible with granulomatous lymphadenitis. This result corroborates the diagnosis of sarcoidosis affecting peripheral lymph nodes. The patient was referred back to the department of pulmonology, with no specific treatment since she is oligosymptomatic. Discussion: Despite the context of benign granulomatous disease, malignancy overlying the condition of sarcoidosis must be ruled out. The biopsy provided a safe and definitive diagnosis, excluding the possibility of occult breast carcinoma. The patient will continue to undergo breast cancer screening as indicated for her age and usual risk. Conclusion: In the presentation of axillary lymphadenopathy, the mastologist must know the various diagnoses to be considered. The most feared include lymphoma and carcinoma metastasis with occult primary site. A proper workup can determine the diagnosis and guide the appropriate treatment.

CLINICAL AND HISTOPATHOLOGICAL REVIEW OF INVASIVE BREAST CARCINOMA IN A TERITARY CARE CENTRE.

2021 ◽  
pp. 18-21
Author(s):  
A. Gomathy ◽  
Muruganantham Arunagirinathan ◽  
I. Nithya
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Survival ◽  
Histological Grade ◽  
Lymph Node Involvement ◽  
Left Breast ◽  
Invasive Breast Carcinoma ◽  
Indian Women ◽  
Node Involvement ◽  
Grade Ii

BACKGROUND: Breast cancer accounts for 14% of all cancers in Indian women, that can occur at any age. Cancer survival becomes more difcult in higher stages of tumour, hence in order to improve the survival of affected persons, early diagnosis of breast cancer is critical. METHODS: Retrospective study of 48 mastectomy specimens with relevant clinical details and respective H&E stained slides were reviewed. CONCLUSION: This review showed that occurrence of Invasive Breast Carcinoma(IBC) peaks in the age group of 41-50years (35.4% ) with right and left breast being affected equally in the ratio of R:L – 1 : 1. Most of the IBC (91.6%) were of No Special Type (NST), with 75% of tumours were of Histological Grade II. 58.3% of tumours were of tumour stage T along with lymph node involvement in equal number of cases.

Predictors of Local-Regional Recurrence After Neoadjuvant Chemotherapy and Mastectomy Without Radiation

2002 ◽  
Vol 20 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Thomas A. Buchholz ◽  
Susan L. Tucker ◽  
Lawrence Masullo ◽  
Henry M. Kuerer ◽  
Jessica Erwin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Clinical Stage ◽  
Pathologic Complete Response ◽  
Hazard Ratio ◽  
Regional Recurrence ◽  
Postmastectomy Radiation ◽  
Local Regional Recurrence

PURPOSE: To define clinical and pathologic predictors of local-regional recurrence (LRR) for patients treated with neoadjuvant chemotherapy and mastectomy without radiation. PATIENTS AND METHODS: We analyzed the outcome of the 150 breast cancer cases treated on prospective institutional trials with neoadjuvant chemotherapy and mastectomy without postmastectomy radiation. Clinical stage at diagnosis was I in 1%, II in 43%, IIIA in 23%, IIIB in 25%, and IV in 7%. No patient had inflammatory breast cancer. RESULTS: The median follow-up period of surviving patients was 4.1 years. The 5- and 10-year actuarial rates of LRR were both 27%. Pretreatment factors that positively correlated with LRR were increasing T stage (P < .0001) and increasing combined clinical stage (P < .0001). Pathologic and treatment factors that positively correlated with LRR were size of the residual primary tumor (P = .0048), increasing number of involved lymph nodes (P < .0001), and no use of tamoxifen (P = .0013). The LRR rate for the 18 patients with a pathologic complete response of both the primary tumor and lymph nodes (pCR) was 19% (95% confidence interval, 6% to 48%). In a forward stepwise Cox logistic regression analysis, clinical stage IIIB or greater (hazard ratio of 4.5, P < .001), pathologic involvement of four or more lymph nodes (hazard ratio of 2.7, P = .008), and no use of tamoxifen (hazard ratio of 3.9, P = .027) independently predicted for LRR. CONCLUSION: Advanced disease at presentation and positive lymph nodes after chemotherapy predict for clinically significant rates of LRR. Achievement of pCR does not preclude the need for postmastectomy radiation if warranted by the pretreatment stage of the disease.

Distribution of Estrogen and Progesterone Receptors in Primary Tumor and Lymph Nodes in Individual Patients with Breast Cancer

1984 ◽  
Vol 70 (2) ◽  
pp. 165-168 ◽  
Author(s):  
Danila Coradini ◽  
Vera Cappelletti ◽  
Patrizia Miodini ◽  
Enrico Ronchi ◽  
Gianfranco Scavone ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Progesterone Receptors ◽  
Cancer Tissue ◽  
Primary Tumors ◽  
Er Positive ◽  
Malignant Lymph Nodes ◽  
Negative Lymph Nodes ◽  
Primary Breast Cancer Tissue

Primary breast cancer tissue and lymph nodes were obtained from 48 patients. Estrogen receptors (ER) and progesterone receptors (PgR) were determined by a dextran-coated charcoal assay. ER were present in 72.9 % of the primary tumors and in 62.4 % of the malignant lymph nodes, whereas PgR were present in 73.0 % and 50.0 % of the cases, respectively. The primary tumor and the corresponding malignant lymph nodes showed an identical ER and PgR status, i.e., both tumor sites were receptor positive or both receptor negative in 89.6 % and 77.1 %, respectively. However, 10.4 % of the patients had ER-positive tumors but ER-negative lymph nodes and 22.9 % had PgR-positive primaries with PgR-negative lymph nodes. No receptor-positive lymph nodes showed a combination with receptor-negative primary tumor. This preliminary data shows that receptor-positive malignant lymph nodes mostly display the same receptor status as the corresponding primary tumor, whereas receptor-negative lymph nodes may have a receptor-positive primary tumor.

Clinical Significance of Subtype Classification in Metastatic Lymph Nodes of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

2015 ◽  
Vol 30 (2) ◽  
pp. 174-183 ◽  
Author(s):  
Noriko Nemoto ◽  
Yukiko Shibahara ◽  
Hiroshi Tada ◽  
Keiko Uchida ◽  
Keely M. McNamara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Primary Tumor ◽  
Breast Cancer Patients ◽  
Ki 67 ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph

Background Neoadjuvant chemotherapy has been increasingly utilized in the treatment of breast cancer patients. However, there are no established surrogate markers predicting the response to subsequent adjuvant therapy and clinical outcome of patients. In particular, whether primary or lymph nodes metastasis should be evaluated for these analyses has remained unknown. Therefore, in this study, we first evaluated the differences in biomarkers between primary and metastatic cancer tissues in the patients undergoing neoadjuvant chemotherapy. We then correlated the findings with the clinical outcomes of these patients. Methods We examined 49 patients receiving neoadjuvant chemotherapy and subsequent surgery with lymph node metastasis. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2) and Ki-67 were all immunohistochemically evaluated in core needle biopsy samples from primary and metastatic tumors following chemotherapy. Results No statistically significant differences in these markers were detected between the primary tumor and metastatic lymph nodes following therapy, but the Ki-67 labeling index was significantly higher in metastatic lymph nodes than in primary tumor (p = 0.017). The patients associated with luminal A type carcinoma in their lymph nodes following chemotherapy demonstrated significantly better clinical outcomes (disease-free survival: p = 0.0045, overall survival: p = 0.0006) than those who were not. Conclusion These data indicate that subtype classification following chemotherapy, in the metastatic lymph nodes rather than primary tumor could predict long-term outcomes of patients undergoing neoadjuvant chemotherapy.

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