Pathological features and prognosis of different molecular subtypes of breast cancer
Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, PR China. Molecular Medicine Reports
(Impact Factor: 1.55).
07/2012; 6(4):779-82. DOI: 10.3892/mmr.2012.981
To examine the pathological features and prognosis of different molecular subtypes of breast cancer, the clinical data of 892 breast cancer patients were retrospectively analyzed and divided into four subtypes according to hormone receptor expression in breast cancer tissue: Her-2 overexpression, luminal A, luminal B and basal-like subtypes. The pathological data and prognosis of these subtypes were compared. Of the 892 breast cancer patients, there were 46 cases (5.2%) with Her-2 overexpression-type, 698 cases (78.3%) with luminal A-type, 38 cases (4.3%) with luminal B-type and 110 patients (12.2%) with basal-like-type. Immunohistochemistry was used to identify the progesterone and estrogen receptors in the tumor tissues. The χ2 test was used to verify the measurement data. The Cox proportional hazard regression model was used for the univariate and multivariate analyses. Results showed there was no statistical difference for lymphatic metastasis among the various molecular subtypes of breast cancer (P>0.05). The distant metastatic rate of patients with Her-2-type breast cancer was significantly higher compared to patients with the other three subtypes (P<0.05). The difference in local recurrence among molecular subtypes was not significantly significant (P>0.05). Lymph node metastasis, age and different molecular subtypes were found to have an impact on patient overall survival (OS) and disease-free survival (DFS). Her-2 overexpression-type breast cancer patients had the lowest 9-year DFS and 7-year OS compared to the other subtypes (P<0.05). Thus, Her-2-type was associated with the worst prognosis. In conlusion, the molecular typing of breast cancer has important clinical value in prognosis estimation and is expected to affect breast cancer treatment approaches.
Available from: Brian Czerniecki
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ABSTRACT: Patients with estrogen-independent (ER(neg)) human epidermal growth factor receptor-2 (HER-2)-positive ductal carcinoma in situ (DCIS) treated with lumpectomy alone or lumpectomy and radiation are at increased risk of developing subsequent breast cancer events.
Thirty-eight patients with HER-2 expressing DCIS received a HER-2 pulsed autologous dendritic cell (DC1) vaccine administered over 4-6 weeks before surgical resection. HER-2 and estrogen receptor (ER) expression were determined by immunohistochemistry. In 35 patients, CD4(pos) T-cell sensitization to HER-2 peptides was identified by ELISPOT. In 19 patients, CD8(pos) T-cell responses were identified by ELISA. Clinical and immune responses postvaccination were compared between intermediate-expressing HER-2 (2+) and high-expressing HER-2 (3+) patients, as well as ER(neg) and estrogen-dependent (ER(pos)) patients.
There was no significant difference in immune response after HER-2 vaccination in patients with HER-2 (2+) and (3+) tumors or ER(neg) and ER(pos) tumors. Complete tumor regression rates were similar in patients with HER-2 (2+) and (3+) DCIS. Overall, clinical response rates were similar in patients with ER(neg) and ER(pos) DCIS, but complete tumor regression was significantly more common in patients with ER(neg) DCIS.
Despite equivalent immune responses after vaccination in patients with HER-2 (2+), HER-2 (3+), ER(neg) and ER(pos) DCIS, HER-2 pulsed DC1 induces more complete responses in patients with ER(neg) DCIS. These data provide a rationale for developing vaccinations to reduce recurrence in patients with ER(neg) DCIS for whom there are currently limited adjuvant options.
Annals of Surgical Oncology 07/2013; 20(10). DOI:10.1245/s10434-013-3119-y · 3.93 Impact Factor
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ABSTRACT: To analyze the changing patterns of treatment and to explore the current treatment approaches for breast cancer in Southwest China, we conducted a population-based retrospective cohort study of early breast cancer cases. The data of patients who registered in the information management system for breast cancer in Huaxi Hospital, Sichuan University from 1989 to 2012 were extracted. Nearly all patients underwent surgery, among whom radical mastectomy was the predominant option. Chemotherapy (88.7 %) was the most predominant adjuvant therapy approach. The percentage of patients receiving radiation therapy displayed fluctuant increase, which was 37.1 % in 2001 and reached up to 67.6 % in 2011. Besides, the endocrinetherapy became more and more popular in the hormone-receptor positive patients and the percentage of endocrinetherapy was increased from 54.1 at 2001 to 85.6 % at 2011. However, more than 10 % of hormone-receptor positive patients still did not receive endocrinetherapy annually. The hormone-receptor positive patients who received endocrinetherapy had better 5-year disease free survival (DFS) and overall survival (OS) compared to those without endocrinetherapy (5-y DFS: 88.4 % vs. 75.1 %, P < 0.001; 5-y OS: 95.7 % vs. 88.4 %, P < 0.001). N stage appeared to have greater impact on the 5-year DFS and OS than molecular subtyping. The treatment for breast cancer in China has been significantly improved but more attentions should be paid to radiotherapy and endocrine therapy. In addition, the value of N stage in the prognosis of breast cancer should not be ignored when the molecular typing draws more and more attentions.
Pathology & Oncology Research 08/2014; 21(2). DOI:10.1007/s12253-014-9829-z · 1.86 Impact Factor
Available from: ncbi.nlm.nih.gov
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ABSTRACT: The aim of the current study was to investigate the expression of the proliferation antigen, Ki67, in triple-negative breast cancer (TNBC) and its correlation with clinicopathological factors. The expression of Ki67 and other biological indicators in 24 cases of TNBC tissues and 178 cases of non-TNBC tissues were detected using immunohistochemistry. Their correlation with the clinicopathological factors were also analyzed using the χ(2) test. The positive rate of Ki67 expression in TNBC tissues was 83.3%, exhibiting a statistically significant difference when compared with that in non-TNBC tissues (73.0%) (P<0.05). The expression of Ki67 in breast cancer tissue significantly correlated with the tumor size and lymph node metastases; however, no correlation was observed with the age and the clinical stage. Ki67 may be an indicator of poor prognosis in TNBC patients.
Oncology letters 01/2015; 9(1):149-152. DOI:10.3892/ol.2014.2618 · 1.55 Impact Factor
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