Preferential HER‐2/neu overexpression and/or amplification in aggressive histological subtypes of invasive breast cancer
University of Zurich, Zürich, Zurich, Switzerland Histopathology
(Impact Factor: 3.45).
03/2004; 44(4):332 - 338. DOI: 10.1111/j.1365-2559.2004.01843.x
Aims: To investigate whether alterations of the HER2 gene occur more frequently in histologically unfavourable subtypes of invasive breast cancer.Methods: The study was composed of nine invasive apocrine, six lipid-rich, 12 glycogen-rich, 11 micropapillary and 33 pleomorphic lobular breast carcinomas. Lymph node involvement was represented in all subgroups. HER2 status was confirmed in all cases by using immunohistochemistry (CB11, Herceptest) and fluorescent in-situ hybridization (FISH) analysis (Vysis).Results: Micropapillary and apocrine carcinomas showed the highest rate of protein overexpression (72% and 66%) and gene amplification (45% and 44%). Protein overexpression was common in poorly differentiated pleomorphic lobular carcinomas (56%); however, this subgroup failed to show an increased number of gene copies by FISH (31%). The incidence of HER2 overexpression (33% and 50%, respectively) and gene amplification (25% and 33%, respectively) among glycogen-rich and lipid-rich carcinomas was not higher than that observed in breast cancer generally.Conclusion: Our data suggest that preferential involvement of the HER2 gene in micropapillary and apocrine breast carcinomas may contribute to their aggressive behaviour.
Available from: sciencedirect.com
- "Case series 100 100 475% (n =42), 50–75% (n =20), 25–50% (n =15), o25% (n =23) Varga et al.  "
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ABSTRACT: Background: Invasive micropapillary carcinoma (IMPC) of the breast is a rare and aggressive variant of invasive ductal carcinoma. IMPC has been reported to account for 3-6% of all breast cancers, and these tumors have been associated with a strong tendency to invade lymphatics with early spread to regional lymph nodes. Patients and methods: We present a case of this rare type of breast cancer diagnosed in a male patient and summarize the current literature to date. Results: Review of the literature on invasive micropapillary breast carcinoma revealed 27 retrospective cohort studies and case series. Significant heterogeneity of inclusion criteria and follow up data prevented meta-analysis. Tumors with an IMPC component demonstrated an early and high rate of lymphatic metastasis compared to invasive ductal carcinoma, however, no significant association was found between IMPC and decreased overall survival. Conclusions: The IMPC data currently available indicates a strong trend towards a higher initial stage at diagnosis and possibly an increased risk of loco-regional recurrence, but remains underpowered to elucidate the prognostic effect of IMPC phenotype on survival. Further studies are warranted to establish the potential of this unique histologic phenotype to serve as a prognostic indicator and guide tumor-specific oncologic therapy.
Available from: Semir Vranic
- "The primary mechanism of Her-2/neu activation is HER- 2/neu gene (located on 17q12) amplification. In apocrine carcinoma, the rate of Her-2/neu overexpression (HER- 2/neu gene amplification) is approximately 50% (between 44% and 54%) (Moinfar et al., 2003; Varga et al., 2004; Vranic et al., 2010) (Figs. 2D, 3B) although some studies, on the basis of a limited number of cases, reported a significantly lower rate of Her-2/neu positivity (~17%) (Weigelt et al., 2008; Banneau et al., 2010). "
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ABSTRACT: Apocrine carcinoma of the breast is a rare, special type of breast carcinoma showing distinct morphologic, immunohistochemical and molecular genetic features. Apocrine epithelium has a characteristic steroid receptor profile that is estrogen receptor and progesterone receptor negative and androgen receptor positive. This combination of morphologic and immunohistochemical characteristics is essential for the proper recognition of the apocrine carcinomas. Strictly defined, apocrine carcinomas express either Her-2/neu or EGFR, which along with androgen receptor positivity make patients with the apocrine carcinoma eligible for targeted therapies.
Available from: Ja Seung Koo
- "Based on IHC results, this case will require continued attention for future treatment. Presently, researchers agree that if GRCC is comparable to the conventional ductal carcinoma of the same TNM stage, the prognosis of the two types of carcinomas would be the same.7 "
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Glycogen rich clear cell carcinoma (GRCC) of the breast is a rare subtype of invasive ductal carcinoma and involves a poor prognosis. In the literature, less than 150 cases have been reported. Many researchers have attempted to characterize GRCC according to electron microscope, flow cytometry, or clinical data. However, an organized study of the immunophenotype of GRCC has yet to be reported.
Materials and Methods
Here, we present three cases of GRCC and their immunohistochemical profiles.
Histologically, all three cases contained periodic acid stain (PAS) positive and d-PAS labile granules in their clear cytoplasm. Case I showed positivity for only estrogen receptor (ER) and c-erbB2. Case II exhibited positivity for progesterone receptor and negativity for ER and c-erbB2. Case III presented with triple negative invasive carcinoma. The expression pattern of E-cadherin was concordant with epidermal growth factor receptor and c-kit, but discordant with ki-67. Among these three cases, p53-positive cases exhibited a low proliferative index (ki-67: 15%), while p53-negative cases showed a high proliferative index (ki-67: 50-60%).
In conclusion, the immunophenotype of GRCC is not uniform, but is similar to that of conventional ductal carcinoma.
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