Comparative Study of Clinicopathologic Features of Apocrine Carcinoma of Breast with Invasive Breast Carcinoma of No Special Type- A Tertiary Care Centre Experience

Introduction: Apocrine Carcinoma (AC) of breast is a rare breast cancer comprising only 0.3-1.0% of all breast cancers. Microscopically, Invasive Duct Carcinoma of No Special Type (IDC-NST) and AC have similar architecture, but they differ in cell morphology. Immunohistochemistry for both the tumour types is also different. Aim: This study was undertaken to know the incidence of AC and analyse them with respect to different clinicopathological features and compare them with that of IDC-NST. Materials and Methods: This was an observational study conducted in Department of Pathology, Veer Surendra Sai Institute of Medical Science and Research, Burla from March 2010 to February 2019. Patients diagnosed as invasive breast carcinoma were taken as study group. Breast cancer in male patients and female patients taking neoadjuvant chemotherapy were excluded from study group. Clinical features, pathological features and immunohistochemical findings of IDC-NST and AC were studied and statistical data were analysed by SPSS version 23.0 for windows. Comparison of data was done by using Pearson’s Chi-square test. Results having p-value <0.05 were accepted as significant. Results: During the 10 years, 05 cases of AC and 560 cases of IDC-NST were found. Mean age of presentation of AC was 59.5 years and that of IDC-NST was 50.4 years. Most cases of AC and IDC-NST presented with breast lump of size >5 cm. Low grade (grade 1) carcinoma was seen in 20% of AC. Immunohistochemistry showed 3 (60%) cases of AC as triple negative, whereas 213 (38.2%) of IDC-NST were triple negative. All the cases of AC were Gross Cystic Disease Fluid Protein (GCDFP-15) and CK-7 positive. Conclusion: AC is a rare category of breast cancer. Although prognosis of AC and IDC are almost similar, correct diagnosis of AC is important as antiandrogenic therapy can be given to Androgen Receptor (AR) positive AC cases.

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Molecular profiling of breast carcinoma with IHC surrogates in a tertiary care centre in South India

Biomedicine ◽

10.51248/.v41i1.537 ◽

2021 ◽

Vol 41 (1) ◽

pp. 75-81

Author(s):

N. Priyathersini ◽

J. Thanka ◽

B Jayashree

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Triple Negative ◽

Ductal Carcinoma ◽

Molecular Subtypes ◽

Molecular Subtype ◽

Tertiary Care ◽

P Value ◽

Her2 Receptor ◽

Luminal A

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.

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Immunohistochemical profile and its association with clinicopathological parameters in carcinoma breast: a prospective study in central India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191679 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1796

Author(s):

Vaishali Walke ◽

Gajanan Gunjkar

Keyword(s):

Lymph Node ◽

Breast Carcinoma ◽

Triple Negative ◽

Tumour Size ◽

Clinicopathological Parameters ◽

Low Grade ◽

Duct Carcinoma ◽

Carcinoma Breast ◽

Triple Negative Phenotype ◽

Negative Phenotype

Background: Carcinoma breast is one of the most common malignancies of women in India. The current study was conducted with the objective of assessing estrogen receptor (ER), progesterone receptor (PR), Her-2/neu (human epidermal growth factor receptor-2) expression and Ki67 index of breast carcinomas and its correlation with histological grade, tumour size and lymph node metastasis.Methods: Forty-seven lumpectomy or modified mastectomy specimens diagnosed as Infiltrating duct carcinoma (IDC): NOS, were selected for panel of imuno histochemistry (IHC) markers on tissue microarray blocks prepared from each case.Results: Maximum of our patients belonged to premenopausal 24/47 (51%) and 20% to younger age group (<30 year). Tumour size of 2-5 cm was observed in maximum females 29 (61%); while 13(27%) had size >5.0cm. The majority of cases diagnosed as grade I (40%) and lymph node involvement was seen in 31/47 (65%). Molecular classification revealed 10 (21%) luminal A, 4 (8%) luminal B, 9 (19%) Her2/neu positive, while triple negative phenotype comprised of maximum 24 (51%) patients. Most of the Luminal group tumours were low grade (14/15); while majority of Her2/neu positive 7/9(77%) and triple negative tumours 19/24 (80%) belonged to higher grades.Conclusions: Breast carcinoma among our patient is characterized by a large percentage of triple negative phenotype that is less susceptible to hormonal therapy. The empirical treatment with tamoxifen should therefore be reconsidered as it would be less effective. Assessment of prognostic markers in breast carcinoma is strongly advocated in order to provide the best therapeutic options.

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Association of CXCR4 mRNA Expression with Clinicopathological Aspects of Invasive Breast Carcinoma

Smart Medical Journal ◽

10.13057/smj.v4i1.46870 ◽

2021 ◽

Vol 4 (1) ◽

pp. 9

Author(s):

Novan Adi Setyawan ◽

Didik Setyo Heriyanto ◽

Naomi Yoshuantari ◽

Irianiwati Irianiwati

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Breast Carcinoma ◽

Lymph Node Metastasis ◽

Mrna Expression ◽

Ductal Carcinoma ◽

Invasive Breast Carcinoma ◽

Low Grade ◽

Node Metastasis ◽

Cxcr4 Mrna

ABSTRACT BackgroundBreast cancer is the most common malignancy in women of which majority histological type is Invasive (Ductal) Carcinoma of No Special Type (NST). The prognosis in breast carcinoma is influenced by many factors such as age, tumor size, degree of histology, and lymph node metastasis. Another factor in the development and metastasis of breast cancer is the chemokine receptor CXCR4 and its ligand, CXCL12. Studies state that the expression of CXCR4 in Breast Invasive Carcinoma associated with clinicopathologic aspects remain unclear. This study aims to determine differences in the level of CXCR4 mRNA expression between clinicopathologic aspects in breast carcinoma..MethodA total of 50 samples of formalin-fixed paraffin-embedded (FFPE) tissues diagnosed as invasive breast carcinoma (NST) are used in this study. Samples are divided into groups, namely with and without lymph node metastasis, age <45 years and> 45 years, small and large size, low grade and high grade. CXCR4 mRNA expression is quantitatively examined by qRT-PCR. CXCR4 mRNA expression differences between various clinicopathologic aspects were analyzed by One-Way ANOVAResultOf the 50 samples, 26 samples (52%) revealed increased expression of CXCR4 mRNA compared to normal tissue. There were no significant differences in mRNA expression of CXCR4 between various prognostic factors (p> 0.05) such as the status of lymph node metastasis, histologic grading, size, and age. However, the expression of CXCR4 mRNA is increased in breast carcinoma when compared to normal breast tissue. Nonetheless the level of CXCR4 expression alone is not associated to clinicopathologic aspects in invasive breast carcinoma.ConclusionCXCR4 mRNA expression did not differ significantly between the various clinicopathological aspects of invasive breast carcinoma. Keyword: invasive breast carcinoma, mRNA of CXCR4, Clinicopathologic aspects

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Correlation of histologic grade of breast carcinoma with hormone receptor status in a tertiary care hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181292 ◽

2018 ◽

Vol 6 (4) ◽

pp. 1331 ◽

Cited By ~ 1

Author(s):

Greeshma Ann George ◽

Archana Sachin Bembde ◽

Neha Borde ◽

Chandrashekhar Bhale

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Hormone Receptor ◽

Triple Negative ◽

Tertiary Care ◽

Radical Mastectomy ◽

Hormone Receptor Status ◽

Care Hospital ◽

Female Population ◽

Receptor Status

Background: Breast cancer is one of the most common malignancies affecting the female population worldwide. Prognosis and management of breast cancer are influenced by variables such as stage, grade, hormone receptor status of oestrogen(ER), progesterone(PR) and Human epidermal growth factor receptor2 (HER2/neu) overexpression. Aim to correlate grade of tumour with ER, PR and HER2/neu receptor status of breast carcinoma.Methods: A prospective study was done in Pathology department, MGM Medical College and Hospital, Aurangabad, Maharashtra for one year. Out of 65 cases studied, 28 cases were biopsy and 37 cases were modified radical mastectomy specimens. All samples were subjected for routine histological examination and immunohistochemical analysis.Results: Age of patients ranged from 30 to 82 years; 60% of tumours were right sided; 46% were involving upper outer quadrant; 58% were radiologically BI-RADS 4; 46% tumours were histopathologically grade 2 and 90% were invasive breast carcinoma, not otherwise specified. By immunohistochemistry, 60% were ER/PRpositive, 9% HER2/neu positive, 26% triple negative and 5% HER2/neu equivocal. In our study, out of 13 grade 1 tumours, 100% were ER/PRpositive and HER2/neu negative; thus an inverse relationship was found between HER2/neu and ER/PR receptors. Also 70% of triple negative tumours were grade 3 which have an aggressive behaviour compared to other subtypes and were common in premenopausal women.Conclusions: Assessment of hormone receptors for clinical management of breast cancer patients is strongly advocated to provide prognostic information and best therapeutic options. A significant correlation was observed between hormonal receptor status and the grade of tumour.

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/452 ◽

2021 ◽

Vol 8 (27) ◽

pp. 2439-2443

Author(s):

Reshma Gopalakrishnan ◽

Freena Rose ◽

Jisha Kalathil Thodiyil ◽

Lovely Jose

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Tertiary Care ◽

Lymph Node Status ◽

P Value ◽

Ki67 Expression ◽

Triple Negative Breast Carcinoma ◽

Clinicopathological Variables

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

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A study of Estrogen Receptor, Progestrone Receptor and hER2/NEU expressions in cases of breast cancer in a tertiary care hospital

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2795 ◽

2020 ◽

Vol 11 (3) ◽

pp. 4930-4936

Author(s):

Mamta Bharti ◽

Nanda J. Patil ◽

Kshirsagar A Y

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Breast Carcinoma ◽

Lymph Node Metastasis ◽

Tertiary Care ◽

Axillary Lymph Node Metastasis ◽

Invasive Breast Carcinoma ◽

Axillary Lymph ◽

Care Hospital ◽

Node Metastasis

The study of Estrogen receptor, Progesterone receptor and HER-2/neu expressions in cases of ca breast was carried out over a period of 2 years at tertiary care hospital karad which included 101 breast cancer cases. Maximum numbers of patients (34.65%) were in the 41 – 50 years group. All patients were female. Family history was seen in 10 (9.90%) cases. Out of 101 cases equal cases were in the category of invasive breast carcinoma grade -II (46.42%) and grade- III (46.42%).While grade- I tumors comprised of 7.41% cases. Invasive breast carcinoma - no special type accounted for maximum cases (77.22%). Other histological types were medullary carcinoma (7.92%), mucinous carcinoma (2.97%). Out of 101 cases, 56.43% of breast cancer cases were positive for estrogen and progesterone receptors. Maximum number of HER-2/neu over expression 5/10 (50%) was seen in 41-50 years of age group.A positive correlation was found between ER and PR expression. Maximum number of triple negative cases were seen in medullary carcinoma (100%), metaplastic carcinoma (100%) followed by invasive breast carcinoma .Out of 101 cases of breast cancer, 42 cases (41.58%) showed axillary lymph node metastasis. Axillary metastasis was divided as 0 lymph node (no metastasis) - 58.41% cases, 1-3 lymph node metastasis – 21.78% and >3 lymph node metastasis – 19.80%. Tumor emboli were noted in 31.68% of cases. Estrogen and Progesterone receptor expression correlate well with the established prognostic markers like- age, type of tumor, histological grade, axillary lymph node metastasis and tumor emboli.

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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

Breast Disease ◽

10.3233/bd-219002 ◽

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.

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EGCG Inhibits Adipose-Derived Mesenchymal Stem Cells Differentiation into Adipocytes and Prevents a STAT3-Mediated Paracrine Oncogenic Control of Triple-Negative Breast Cancer Cell Invasive Phenotype

Molecules ◽

10.3390/molecules26061506 ◽

2021 ◽

Vol 26 (6) ◽

pp. 1506

Author(s):

Narjara Gonzalez Suarez ◽

Sahily Rodriguez Torres ◽

Amira Ouanouki ◽

Layal El Cheikh-Hussein ◽

Borhane Annabi

Keyword(s):

Breast Cancer ◽

Fatty Acid ◽

Cell Differentiation ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Vasculogenic Mimicry ◽

Stem Cell Differentiation ◽

Low Grade ◽

Invasive Phenotype ◽

Fatty Acid Binding

Obese subjects have an increased risk of developing triple-negative breast cancer (TNBC), in part associated with the chronic low-grade inflammation state. On the other hand, epidemiological data indicates that increased consumption of polyphenol-rich fruits and vegetables plays a key role in reducing incidence of some cancer types. Here, we tested whether green tea-derived epigallocatechin-3-gallate (EGCG) could alter adipose-derived mesenchymal stem cell differentiation into adipocytes, and how this impacts the secretome profile and paracrine regulation of the TNBC invasive phenotype. Here, cell differentiation was performed and conditioned media (CM) from preadipocytes and mature adipocytes harvested. Human TNBC-derived MDA-MB-231 real-time cell migration was performed using the exCELLigence system. Differential gene arrays and RT-qPCR were used to assess gene expression levels. Western blotting was used to assess protein expression and phosphorylation status levels. In vitro vasculogenic mimicry (VM) was assessed with Matrigel. EGCG was found to inhibit the induction of key adipogenic biomarkers, including lipoprotein lipase, adiponectin, leptin, fatty acid synthase, and fatty acid binding protein 4. Increased TNBC-derived MDA-MB-231 cell chemotaxis and vasculogenic mimicry were observed in response to mature adipocytes secretome, and this was correlated with increased STAT3 phosphorylation status. This invasive phenotype was prevented by EGCG, the JAK/STAT inhibitors Tofacitinib and AG490, as well as upon STAT3 gene silencing. In conclusion, dietary catechin-mediated interventions could, in part through the inhibition of adipogenesis and modulation of adipocytes secretome profile, prevent the onset of an obesogenic environment that favors TNBC development.

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

Annals of Diagnostic Pathology ◽

10.1016/j.anndiagpath.2021.151814 ◽

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

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

Breast Disease ◽

10.3233/bd-201011 ◽

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.

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