Risk factors of local relapses in patients with breast cancer depending on the properties of the primary tumor

2021 ◽  
Vol 43 (3-4) ◽  
pp. 67-73
Author(s):  
O. V. Movchan ◽  
◽  
I. Yu. Bagmut ◽  
I. V. Dosenko ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Primary Tumor ◽  
Main Group ◽  
Control Group ◽  
Histological Structure ◽  
Luminal A ◽  
Luminal B ◽  
Subtype B ◽  
Her 2

Of all a spread of disorders after mastectomy, most frequently we expect about the event of local relapse. The aim – to research the frequency of local relapses in patients with breast carcinoma, considering the subtype properties of the primary tumor. Materials. 6136 patients with breast carcinoma, including 146 patients with LR – main group, and 455 patients without LR – control group. They distributed betting on age, the state of the menstrual function, stage of the disease, histological type of cancer, grade, tumor subtype. Results. In step with the histological structure, ductal carcinoma was commonest. Established the 10-year non-relapse period in main group is longer with Luminal A and Triple-negative subtypes (61 vs 41%) compared to Luminal B and Her-2 / neu type with (3+) amplification (39 % vs 32 % respectively). Conclusions. The stage, histological structure, grade of the tumor does not significantly affect the frequency of local relapses breast cancer patients. The LR is more likely to occur in patients with luminal subtype B, while the littlest frequency of LR occurs with subtype A. Study of the menstrual status of the patient providing local relapses more often arise in women of pre-menopause. Established that the 10-year non-relapse period is that the best in patients with luminal A subtype and TNBC compared to luminal B and HER 2 type with (3+) amplification.

Molecular classification of breast cancer. Treatment and prognosis implications.

2021 ◽  
Vol 32 (2) ◽  
pp. 155-159
Author(s):  
M Alcaide Lucena ◽  
CJ Rodríguez González ◽  
S de Reyes Lartategui ◽  
R Gallart Aragón ◽  
MT Sánchez Barrón ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Molecular Classification ◽  
Breast Cancer Treatment ◽  
Cáncer De Mama ◽  
Luminal A ◽  
Luminal B ◽  
Her 2

Resumen Los avances recientes en el campo de la biología molecular y la secuenciación del genoma se han traducido en una nueva clasificación del cáncer de mama, que busca mayor precisión y se correlaciona mejor con el riesgo de recaída de la enfermedad y la respuesta al tratamiento. Establece cuatro subtipos de cáncer de mama: luminal A, luminal B, HER 2 positivo y triple negativo, siendo el subtipo luminal A el de mejor pronóstico, y el triple negativo, el de peor pronóstico. Si combinamos la clasificación clásica histológica con la nueva molecular, nos permite encuadrar a estas pacientes de una forma más precisa en función del riesgo, definiendo así un manejo terapéutico adaptado.

scholarly journals Survival of Spinal Metastasis Disease based on Immunohistochemistry Subtype of Breast Cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (F) ◽  
pp. 101-105
Author(s):  
Ivan Hugo Hadisaputra ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Putu Eka Mardhika
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Survival Time ◽  
Spinal Metastasis ◽  
Meta Analysis ◽  
Spinal Metastases ◽  
Luminal A ◽  
Luminal B ◽  
Moderate Growth ◽  
Her 2

BACKGROUND: Breast cancer is categorized as a slow-growth tumor in the spinal metastases disease (SMD) scoring system. Based on immunohistochemistry, breast cancer has four subtypes: Luminal A (LumA), luminal B (LumB), human epidermal growth factor 2 (Her-2) type, and triple-negative breast cancer (TNBC). TNBC has the poorest prognosis. AIM: This study aimed to describe the survival time of breast cancer with SMD based on immunohistochemistry subtypes through systematic review and meta-analysis. METHODS: This is a systematic review and meta-analysis study. This study used electronic articles published in PubMed and CENTRAL online database. We used keywords ([breast] AND [cancer] AND [spine] AND [metastasis]) to find eligible studies. Articles included were full-text studies in English. Survival time as the outcome was pooled according to the immunohistochemistry subtype of breast cancer. Statistical analysis was performed using software Stata. RESULTS: Five articles met our inclusion and exclusion criteria. LumA, LumB, Her-2 type, and TNBC have a survival time of 32.84 months, 35.20 months, 60.8 months, and 14.27 months, respectively. CONCLUSION: TNBC has the lowest survival time in the pooled analysis. We proposed TNBC be categorized as a moderate growth primary tumor.

Expression of BCRP/ABCG2 Protein in Invasive Breast Cancer and Response to Neoadjuvant Chemotherapy

2021 ◽  
Author(s):  
Yan Shou Zhang ◽  
Chao Yang ◽  
Lei Han ◽  
Lei Liu ◽  
Yun Jiang Liu
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Size ◽  
Hormone Receptor ◽  
Molecular Subtypes ◽  
Therapy Response ◽  
Luminal A ◽  
Luminal B ◽  
Response To Neoadjuvant Chemotherapy

Background: Breast cancer resistance protein (BCRP), or ABCG2 (ATP-binding cassette sub-family G member 2), is an ATP-binding cassette (ABC) transporter that mediates energy-dependent transport of substrate drugs out of the cell. Its overexpression may contribute to intrinsic drug resistance in vitro. However, the current literature has not yet clarified the clinical significance of BCRP/ABCG2 in invasive breast carcinoma. Objectives: The purpose of this study was to validate the expression of BCRP/ABCG2 in invasive breast carcinoma and its role in response to neoadjuvant chemotherapy. Methods: In this study, a pretherapeutic core biopsy was performed in 222 patients. BCRP/ABCG2 expression in carcinoma tissue was measured by immunohistochemistry. BCRP/ABCG2 expression correlations with clinicopathological features, molecular subtypes, and therapy response after neoadjuvant chemotherapy were investigated. Results: The results showed that BCRP/ABCG2 was expressed in different molecular subtypes. The proportions of patients with high BCRP/ABCG2 expression were similar in luminal A and luminal B tumors (Luminal B, 80%; Luminal A, 78%), compared with other molecular subtypes (Triple-negative, 63%; HER-2+, 58%. P=0.05). BCRP/ABCG2 expression and the number of lymphatic metastases (𝑃=0.001) and tumor size (𝑃=0.011) demonstrated a statistically significant correlation. Low BCRP/ABCG2 expression was associated with an increased pathological complete response (pCR) rate of 38%, higher than the 19% in tumors with high BCRP/ABCG2 expression (P=0.002). In multivariable analysis, BCRP/ABCG2 and hormone receptor (HR) expression were identified as independent risk factors of pCR (P=0.003, P=0.013. respectively). Conclusions: BCRP/ABCG2 is highly expressed in hormone receptor-positive breast cancer. High BCRP/ABCG2 expression is associated with lymphatic metastasis, tumor size, and poor pCR. BCRP/ABCG2 may be a novel potential biomarker that can predict clinical progression and therapy response after neoadjuvant chemotherapy.

scholarly journals Apparent diffusion coefficient cannot predict molecular subtype and lymph node metastases in invasive breast cancer: a multicenter analysis

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexey Surov ◽  
Yun-Woo Chang ◽  
Lihua Li ◽  
Laura Martincich ◽  
Savannah C. Partridge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diffusion Coefficient ◽  
Triple Negative ◽  
Molecular Subtype ◽  
Luminal A ◽  
Ki 67 ◽  
Luminal B ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Her 2

Abstract Background Radiological imaging plays a central role in the diagnosis of breast cancer (BC). Some studies suggest MRI techniques like diffusion weighted imaging (DWI) may provide further prognostic value by discriminating between tumors with different biologic characteristics including receptor status and molecular subtype. However, there is much contradictory reported data regarding such associations in the literature. The purpose of the present study was to provide evident data regarding relationships between quantitative apparent diffusion coefficient (ADC) values on DWI and pathologic prognostic factors in BC. Methods Data from 5 centers (661 female patients, mean age, 51.4 ± 10.5 years) were acquired. Invasive ductal carcinoma (IDC) was diagnosed in 625 patients (94.6%) and invasive lobular carcinoma in 36 cases (5.4%). Luminal A carcinomas were diagnosed in 177 patients (28.0%), luminal B carcinomas in 279 patients (44.1%), HER 2+ carcinomas in 66 cases (10.4%), and triple negative carcinomas in 111 patients (17.5%). The identified lesions were staged as T1 in 51.3%, T2 in 43.0%, T3 in 4.2%, and as T4 in 1.5% of the cases. N0 was found in 61.3%, N1 in 33.1%, N2 in 2.9%, and N3 in 2.7%. ADC values between different groups were compared using the Mann–Whitney U test and by the Kruskal-Wallis H test. The association between ADC and Ki 67 values was calculated by Spearman’s rank correlation coefficient. Results ADC values of different tumor subtypes overlapped significantly. Luminal B carcinomas had statistically significant lower ADC values compared with luminal A (p = 0.003) and HER 2+ (p = 0.007) lesions. No significant differences of ADC values were observed between luminal A, HER 2+ and triple negative tumors. There were no statistically significant differences of ADC values between different T or N stages of the tumors. Weak statistically significant correlation between ADC and Ki 67 was observed in luminal B carcinoma (r = − 0.130, p = 0.03). In luminal A, HER 2+ and triple negative tumors there were no significant correlations between ADC and Ki 67. Conclusion ADC was not able to discriminate molecular subtypes of BC, and cannot be used as a surrogate marker for disease stage or proliferation activity.

Response to neoadjuvant chemotherapy and outcome based on breast cancer subtype

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11516-e11516
Author(s):  
A. Guerrero-Zotano ◽  
J. Gavila ◽  
M. A. Climent ◽  
M. J. Juan ◽  
V. Guillem ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Breast Cancer Subtypes ◽  
Nuclear Staining ◽  
Luminal A ◽  
Long Term Outcome ◽  
Cancer Subtypes ◽  
Luminal B ◽  
Her 2

e11516 Background: Gene expression profiling identifies several breast cancer subtypes with different chemosensitivity and outcome. We used immunohistochemistry surrogate markers to classify tumors according to known breast cancer subtypes and examined the relationship between neoadjuvant chemotherapy (NAC) response and long-term end points, including distant disease-free survival (DDFS) and overall survival (OS). Methods: Review of clinical and pathological data from 271 breast cancer patients treated in our institution with NAC between 1991–2008. Breast cancer subtypes were defined as follows: Luminal A: Estrogen receptor positive (ER+) and/or progesterone peceptor positive (PR+), human epidermal growth factor receptor 2-positive (Her-2+); Luminal B: ER+ and/or PR+,Her-2+; Basal: ER-,PR-,Her-2-;HER2: ER-,PR-,Her-2 +. ER and PR positive scored as positive if tumor cell nuclear staining was at least 2+. Her-2 scored as positive if test DAKO scored 3+ or FISH ratio Her-2/CEP-17>2.2. Results: 121 (45.8%) patients were classifed as Luminal A; 22 (8.1%) as Luminal B; 75 (27.7%) as Basal, and 50 (18.5%) as HER2. Most patients (63%) received NAC based on anthracyclines and taxanes. 36% Her-2+ patients were treated with NAC based on trastuzumab, and 43% received trastuzumab as adjuvant treatment. Response and outcome results are shown below (Table). Independently from subtype, only four patients out of 58 with pCR relapsed. Among patients who didn´t achieved pathologic complete response (pCR), basal and HER2 subtypes have the worst outcome (4 years SG 80% and 72% respectevely) compared with Luminal A (4 years SG: 94.7%), (log-rank p=0.009). Conclusions: Basal and HER2 tumor despite high chemosensitivity have worst long term outcome, particularly if pCR is not achieved after NAC. [Table: see text] No significant financial relationships to disclose.

scholarly journals Diffusion Weighted Imaging of Different Breast Cancer Molecular Subtypes. A Systematic Review and Meta Analysis.

2020 ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Andreas Wienke ◽  
Alexey Surov
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Diffusion Weighted Imaging ◽  
Triple Negative ◽  
Molecular Subtypes ◽  
Luminal A ◽  
Adc Value ◽  
Luminal B ◽  
Adc Values ◽  
Her 2

Abstract Background: Magnetic resonance imaging can be used to diagnose breast cancer (BC)s. Diffusion weighted imaging and the apparent diffusion coefficient (ADC) can be used to reflect tumor microstructure. The present analysis sought to compare ADC values between molecular subtypes of BC based upon a large patient sample.Methods: MEDLINE library and SCOPUS databases were screened for the associations between ADC and molecular suptype of BC to April 2020. Primary endpoint of the systematic review was the ADC value in different BC. Overall, 28 studies were suitable for the analysis and included into the present study.Results: The included studies comprised a total of 2990 tumors. Luminal A type was diagnosed in 865 cases (28.9%), Luminal B in 899 cases (30.1%), Her-2 enriched in 597 cases (20.0%) and triple negative in 629 cases (21.0%). The mean ADC value of the Luminal A type was 0.99 × 10− 3 mm2/s [95% CI 0.94-1.04], of the Luminal B type was 0.99 × 10− 3 mm2/s [95% CI 0.89-1.05], of Her 2-enriched type was 1.02 × 10− 3 mm2/s [95% CI 0.95-1.08] and of the triple negative type was 0.99 × 10− 3 mm2/s [95% CI 0.91-1.07].Conclusions: ADC values cannot be used to discriminate between molecular subtypes of BC.

scholarly journals Immunohistochemical tests for diagnostics of infiltrative forms of breast cancer and identification of molecular subtype in women of different ages in Dnipro city

2017 ◽  
Vol 8 (2) ◽  
pp. 204-209
Author(s):  
T. M. Shevchenko ◽  
P. V. Gazdyuk ◽  
A. M. Bondar ◽  
O. Y. Govoruha
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Molecular Subtype ◽  
Luminal A ◽  
Luminal B ◽  
Different Ages ◽  
Her 2 ◽  
Duct Cancer ◽  
High Level ◽  
Immunohistochemical Testing

The article presents the results of histological and immunohistochemical testing of women of different ages who are suffering from infiltrative forms of breast cancer in Dnipro. The study presents the distribution of receptors of estrogens and progesterone (ER, PR), HER-2/neu (necessary for prescribing treatment) and Кi-67 (reveals additional features of a tumour). Considering that luminal types of breast cancer include tumours whose receptors express to ER and PR, depending on the kind of expression HER2/neu, they are classified into A (do not express HER2/neu) and B (express HER2/neu). Tumours with hyperexpression of HER2/neu and lack of ER and PR are called HER2+. The research conducted has shown that duct cancer is by far the commonest form, at 81%. In duct cancer, undifferentiated stage and moderately-differentiated stage cancer prevails, whereas with nodule cancer the majority (80%) have moderately-differentiated stage cancer. We discovered a correlative link between the stage of differentiation and the percentage of metastasis both in duct and nodule breast cancer. But nodule breast cancer is more aggressive: with metastasis occurring in 31.2% of women even in cases of moderately-differentiated stage cancer. Only duct cancer is able to produce slime, which distinguishes it from other forms. Combined forms of cancer are rare, but they lead to metastases in all cases. Most women with infiltrative cancer in Dnipro are aged between 51 and 60. There has been observed the increase in cases of breast cancer among young women; the most widespread among infiltrated forms of breast cancer is subtype Luminal A, which has the best prognosis. As the research shows, women under 60 tend to have less aggressive subtypes, which are easy to treat, whereas in older patients their aggressiveness increases substantially, which means an unfavourable prognosis and lower effectiveness of treatment. Кі-67 marker increases substantially in the absence of ER and PR, which means a high level of tumour aggressiveness. Luminal A subtype in not aggressive in most cases, which means the most favourable prognosis. Luminal B is partly aggressive which leads to a high percentage of metastasis, but thanks to ER+ or PR+, it is successfully treated by hormone therapy, which can lead to a positive prognosis. Overall, HER2+ and triple negative are the most aggressive. 

scholarly journals LDHA is differential expressed in luminal A and luminal B breast cancer

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
F Q Vieira ◽  
A R Cardoso ◽  
D Gigliano ◽  
I Carneiro ◽  
R Henrique ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Molecular Subtype ◽  
Therapy Resistance ◽  
Molecular Signature ◽  
Clinicopathological Parameters ◽  
Cancer Drug ◽  
Luminal A ◽  
Tissue Samples ◽  
Luminal B ◽  
Subtype B

Abstract Background Breast cancer (BrCa) is the most incident cancer in women worldwide, with more than 2 200 000 new cases and 600 000 deaths in 2020. Concerning BrCa molecular signature, tumors expressing estrogen receptor (luminal A and B) normally respond to hormonal therapy, but some cases develop resistance. We recently showed that LDHA expression is reduced upon treatment with [C16Pyr][Amp], a new proposed anti-cancer drug. LDHA has been implicated in Warburg effect regulation and has been associated with BrCa patients’ worse outcome. So, the mail goal of this study was to evaluate LDHA expression in BrCa tissues and correlate it with several clinical and pathological parameters. Methods A total of 40 BrCa tissue samples were selected to assess LDHA expression by immunohistochemistry. Percentage of positive tumor cells, intensity of immunostaining, and immunoexpression pattern were blinded evaluated. Correlations between clinicopathological parameters and LDHA expression were assessed using the Chi square test (P < 0.05 was indicated of the statistically significance). Results Higher LDHA expression intensity significantly is associated with luminal B molecular subtype (P = 0.003). Conversely, no association is found between LDHA expression and tumor stage or therapy resistance. Conclusions The intensity of LDHA immunoexpression is related with luminal molecular subtype B. Since LDHA is associated with the production of lactate, leading to a greater energy obtaining by cancer cells, these cells may have an increased capacity for proliferation. In fact, this subtype was previously reported to express high Ki67 levels, a proliferative marker.

scholarly journals Stage iv breast cancer surgery. Case serie

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
María Liz Bareiro Paniagua
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
De Novo ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Luminal B ◽  
Group A ◽  
Her 2 ◽  
Group B

Introduction: Distant site tumor implantation implies a severe condition, stimulated by an additional genome evolution that compromises the survival (6 months in the visceral metastasis). The literature is still controversial, and the guidelines recommend surgery only as palliative care. New results are conflicting, however, the initial modern systemic therapy, followed by the resection of the primary tumor, seems to improve the global survival (GS). “De Novo Metastasis (MT)” is that found in the diagnostic investigation. Objective: To assess the results of the primary metastatic breast cancer (BC) surgery. Method: retrospective review of medical records in a cohort of patients with metastatic BC treated between 2011 and 2018 in the state of Rio de Janeiro. Result: Eleven patients were included. (Group A= 6 patients with De Novo MT, and Group B= 5 patients with MT in the follow-up). In both cases, invasive ductal carcinoma was prevalent, frequently of grade 3 and with high Ki-67, Luminal B and Her-2. There was a mutation (BRCA2), and the PET CT was correlated to the complete pathological response. In group A, the patients were younger (50% <40 years old), 5/6 initiated neoadjuvant chemotherapy (NACT), all underwent mastectomy (multicentricity or size), 33% presented with imaging and pathological complete response (pCR). Of the MT, 50% were in the bone; 1/6 had negative and operated liver and pulmonary MT (HER-2), with disease-free survival (DFS) superior to 12 months. In group B, all MTs came after local recurrence (LR) (between 3 and 11 months); 40% had high initial axillary compromise (pN= mean of 25), and Luminal B, being treated according to the guidelines. In 2/5 (40%) of visceral MT, 18 months of DFS were observed after pCR and primary tumor resection. Finally, in the follow-up (mean of 42 months), there were two casualties (TN) in group A, and 4/6 presented DFS between 17 and 72 months. In group B, 3/5 presented DFS between 12 and 24 months. Conclusion: In this sample, the pathological complete response suggested better prognosis before surgery. There was benefit in the survival of visceral MT (including multiple ones) with pCR and breast surgery in comparison to the literature; further studies are required, considering the limitations of this analysis.

scholarly journals Metabolic syndrome and obesity as factors of good procnostic oncology in women in post-menopause with recent diagnosis of breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Andre Hideo Motoki ◽  
Daniel de Araújo Brito Buttros ◽  
Heloisa Maria de Luca Vespoli ◽  
Eduardo Carvalho Pessoa ◽  
Eliana Aguiar Petri Nahas
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Postmenopausal Women ◽  
Fat Deposition ◽  
University Hospital ◽  
Control Group ◽  
Ki 67 ◽  
Luminal B ◽  
Central Fat ◽  
Her 2

Objective: To evaluate the association between metabolic syndrome (MS), obesity, and central fat deposition with the immunohistochemical profile (IHC) of breast cancer (BC) in postmenopausal women. Methods: A comparative cross-sectional clinical study was carried out with 63 women with recent BC and MS, compared to 126 women with recent BC, without MS (control group). Inclusion criteria were: women aged 45-75 years, amenorrhea >12 months, without previous cancer treatment, attended at a University Hospital. The groups were matched for age, time since menopause, and body mass index (BMI), in the proportion of 1 case for 2 controls, according to the sample calculation of at least 186 women in their entirety. Clinical and anthropometric data were collected; tumor size and grade and the IHC profile (ER, PR, HER2, and Ki67). By IHC convention, tumors were grouped into five subtypes: Luminal A (ER+, PR+, HER-2 -, and Ki-67 <14%); Luminal B HER-2 - (ER+, PR+ or -, HER-2 -, and Ki-67≥14%); Luminal B HER-2+ (ER+, PR+ or -, HER-2+, and any Ki-67); Non-luminal HER-2 (ER-, PR-, HER2+, and any Ki-67); and Triple-negative (ER-, PR-, HER2-, and any Ki-67). Women with three or more diagnostic criteria were considered with MS: waist circumference (WC)>88 cm; TG≥150 mg/dL; HDL cholesterol<50 mg/dL; blood pressure ≥130/85 mmHg; glucose ≥100 mg/dL. For statistical analysis, the Student’s t-test, Gamma Distribution, χ2 test and logistic regression (odds ratio–OR) were used. Results: Among the participating women, the mean age, time since menopause and BMI were: 59.0±10.6 years, 11.4±9.6 years, and 28.5±5.5 kg/m2, respectively; there was no statistical difference in the comparison between the groups. Women with MS had a higher occurrence of tumors ≤2cm when compared to those without MS (49.2 vs. 31.8%, respectively) (p=0.038). Women with MS had a higher incidence of tumors with PR-positive (p=0.046), HER2-negative (p=0.038), when compared to women without MS (79.4 vs. 65.8% and 44.5 vs. 27.8%, respectively). In obese patients (BMI≥30 kg/m2), a higher proportion of HER2 negative tumors (p=0.047) was observed when compared to non-obese women (43.9 vs. 27.7%, respectively). In the multivariate analysis, a higher risk for tumors of the Luminal B HER-2 negative subtype was observed among women with MS (OR 2.00, 95%CI 1.03‒3.89), obese (OR 2.03, 95%CI 1.06‒3.90), and with central deposition of fat (OR 1.96, 95%CI 1.01‒4.03). Conclusion: Metabolic syndrome, obesity, and central fat deposition correlate with factors of good prognosis for breast cancer, such as tumors ≤2 cm, PR+ and HER2-, in postmenopausal women.

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