Comparison of TNF-α and TGF-β Expression in Breast Cancer Tissues-with and without Axillary Lymph Node Metastasis

Background: Breast carcinoma dynamics can be seen from the inflammatory mediator produced and some of expressed cytokine mediators mostly found in breast cancer tissues are TNF-α and TGF-β. This research analyzed TNF-α and TGF-β influence in axillary lymph nodes metastasis to prove the role of cytokines in breast cancer dynamics and to be taken as prognosis. Methods: This research used paraffin block of breast carcinoma in various stages of axillary lymph nodes metastasis and TNF-α and TGF-β antibody to observe the expressions. Result: There were significant differences in TNF-α expressions improvement with p < 0.05 in lymph nodes metastasis N1 (13.18%) and TNF-α expressions reduction in lymph nodes metastasis N2 (52.27%) and N3 (27.27%) compared with lymph nodes without metastasis (52.73%). There were no significant differences in TGF-β expressions of all N groups. Conclusion: The result stated that TNF-α cytokines can be used as biomarker independently predicting breast carcinoma prognosis and progressivity. ABSTRAKLatar Belakang: Dinamika karsinoma payudara tercermin dari mediator inflamasi yang dihasilkannya dan salah satu mediator sitokin yang terekspresi banyak pada jaringan tumor payudara adalah TNF-α and TGF-β. Kami menganalisis pengaruh TNF-α dan TGF-β pada metastasis kelenjar getah bening aksila untuk membuktikan peran sitokin dalam dinamika kanker payudara dan untuk dimanfaatkan sebagai alat prognosis. Metode: Penelitian ini menggunakan blok parafin karsinoma payudara pada berbagai stadium metastasis kelenjar getah bening aksila dan menggunakan antibodi TNF-α dan TGF-β untuk mendeteksi ekspresinya. Hasil: Hasil penelitian ini didapatkan perbedaan peningkatan ekspresi TNF-α yang signifikan dengan p < 0,05 pada metastasis kelenjar getah bening N1 (73,18%) dan penurunan ekspresi TNF-α pada metastasis kelenjar N2 (52,27%) dan N3 (27,27%) dibandingkan dengan tanpa metastasis (52,73%). Tidak ada perbedaan signifika n pada ekspresi TGF-β antar semua kelompok N. Kesimpulan: Hasil ini menyatakan sitokin TNF-α dapat dipakai sebagai biomarker untuk memprediksi progresifitas dan prognosis karsinoma payudara secara independen

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Factors Predicting Positive Axillary Lymph Nodes Metastasis in Primary Breast Cancer in Women

Al-Anbar Medical Journal ◽

10.33091/amj.0901022012 ◽

2012 ◽

Vol 10 (2) ◽

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Primary Breast Cancer ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Lymph Nodes Metastasis

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Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽

10.3390/cancers13040757 ◽

2021 ◽

Vol 13 (4) ◽

pp. 757

Author(s):

Sanaz Samiei ◽

Renée W. Y. Granzier ◽

Abdalla Ibrahim ◽

Sergey Primakov ◽

Marc B. I. Lobbes ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Mr Images ◽

Node Metastasis

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.

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

Mastology ◽

10.29289/259453942020v30s1004 ◽

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.

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Positron emission tomography/computed tomography (PET/CT) as a biomarker of pathologic response to neoadjuvant chemotherapy in breast carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e21147 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e21147-e21147

Author(s):

Catherine M. Kelly ◽

Clare Smith ◽

Susan Conlon ◽

Reem Salman ◽

John McCaffrey ◽

...

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Lymph Nodes ◽

Breast Cancer Subtype ◽

Standardized Uptake Value ◽

Predictive Biomarkers ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Pet Ct

e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.

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