Onitilo AA, Engel JM, Greenlee RT, Mukesh BNBreast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res 7: 4-13

ArticleinClinical Medicine & Research 7(1-2):4-13 · July 2009with43 Reads
DOI: 10.3121/cmr.2009.825 · Source: PubMed
Abstract
To compare the clinicopathologic features and survival in the four breast cancer subtypes defined by immunohistochemistry (IHC) expression of estrogen receptor (ER) or progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2): ER/PR+, Her2+; ER/PR+, Her2-; ER/PR-, Her2+; and ER/PR-, Her2-. A 7-year retrospective study of 1134 invasive breast cancer subjects. Clinical and pathologic features and survival of the four subtypes were compared. Using ER/PR+ and Her2- as a reference, ER/PR-, Her2- had the worst overall survival (hazard ratio, 1.8; 95% confidence interval [CI], 1.06-3.2) and the worst disease-free survival (hazard ratio, 1.5; 95% CI, 0.8-3.0). In ER/PR+, Her2-, chemotherapy conferred significant overall and disease-free survival advantages. Subtype comparison revealed statistically significant differences in outcomes. The triple negative subtype has the worst overall and disease free survival. Efforts should be directed at standardization of current testing methods and development of more reliable and reproducible testing.
    • "These papers give information about how pathologists examine these cancer images and take decisions. Adedayo A. Onitilo [1] describes the subtypes of breast cancer based on the receptors, Bhagat Vasudha M et al [2] presents a paper about how cancer types related on the histopathological features. Elsayed M Ali et al. [3] discussed about the area where correlation of cancer subtypes and auxiliary lymph node status connected. "
    [Show abstract] [Hide abstract] ABSTRACT: Breast cancer is one of the most common cancers among women. Early detection of cancer is the main challenging factor. This paper discusses about the study of breast cancer subtypes through Immunohistochemistry (IHC) images are used for the detection of Human Epidermal growth factor Receptor 2 (HER2). HER2/neu is a protein in human body which is encoded by erbb2 gene. In recent years, protein has become an important biomarker in the detection of breast cancer. HE2/neu over-expression or amplification is predictive of poor survival. Abundance of HER2/neu protein in the breast cells makes the cancer aggressive and fast growing. So the quantification of protein content is necessary for the proper treatment. In this work we used a method which includes Artificial Neural Network as the classification method. 1. Introduction Breast cancer is one of the most seen cancers in women. In the most cases, cancer is detected in the later stages and so the treatment is not that effective. If the cancer is detected in early stages, treatment becomes useful. The pathologists examine the cancer based on the breast cell images. Since cells are colorless, different types of stains are used. The severity of cancer can be measured by the presence of HER2 protein. Immunohistochemical stains are used for the detection of presence of HER2 and other growth hormones. Sometimes, these proteins help the growth of cancer cells. HER2 presence is based on the quantity of membrane staining which is based on the quantity, pathologist provide score to the expression. Breast cancer scoring based on the protein receptors like HER2 gives more information about the cancer cause condition and the probability of treatment. Most of the papers related HER2 scoring are medical based researches. These papers give information about how pathologists examine these cancer images and take decisions.
    Full-text · Article · Jan 2015
    • "The gene expression profile revealed that the levels of Estrogen (ER), Progesterone (PR) hormone receptors (HR) and HER2 overexpression characterize tumors of different subtypes, including Luminal A (ER + and/or PR + and HER2-), Luminal B (ER + and/or PR + and HER2+), HER2 overexpressed (ER- PR- HER2+) and triple negative (TN; ER- PR- HER2-) breast cancer [2-5]. Subtypes have different prognostic values, and Luminal A and triple negative tumors show the best and worst outcomes, respectively [6-9]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background The frequencies of molecular breast cancer subtypes vary among different human populations. The Northeastern region of Brazil has a mixed population of African, Indigenous and European ancestry. This retrospective study investigated breast cancer subtypes and applied therapies in a public hospital of Northeastern Brazil. Methods Data of 633 patients with invasive breast cancer from 2005 to 2011 were obtained from medical records. Status of hormone receptor (HR), HER2 and Ki67 expression index of 269 out of 633 patients were used to define subtypes of Luminal A and B, HER2 and triple negative (TN) breast cancer. Expression index of Ki67 ≥ 14% was applied to distinguish Luminal A from Luminal B subtypes. Results Overall, 185 (68.77%) and 132 (49.07%) patients showed positive hormone receptor (HR+) and positive HER2 (HER2+) tumors. The mean age ranged from 53.33 to 58.25 years for patients with tumors of Luminal B and Luminal A subtypes, respectively (p = 0.0182). In general, 67.39% of patients with TN tumors aged over 50 and 19.57% aged between 31 and 40 years (p = 0.0046). The rate of small tumors (T1: ≤ 2.0 cm) varied from 22.73% to 52.46% for TN and Luminal A subtypes (p = 0.0088). The rate of high graded (G3) tumors was increased for HER2 and TN subtypes (35.29% and 34.28%) compared to Luminal A and Luminal B subtypes (3.92% and 12.62%), respectively (p < 0.0001). The five-year survival rate ranged from 92.86% to 75.00%, for Luminal A, HER2 and TN subtypes, respectively (HR: 0.260 to 1.015; 95% CI: 0.043 to 3.594; p = 0.2589). Patients with HER2 positive (HER2+) breast tumors did not receive immunotherapy and chemotherapy application varied from 54.84% to 86.49% for Luminal A and HER2 subtypes, respectively (p = 0.0131). Conclusions The results of this study revealed a high percentage of HER2+ breast tumors and an increased rate of patients with TN tumors aged over 50 years. This emphasizes the need for establishing immunotherapy as an additional therapeutic option to improve clinical outcomes for patients with HER2+ tumors and to investigate the risk factors of TN breast cancer.
    Full-text · Article · Sep 2014
    • "Treatment of the basal-like class is currently based on cytotoxic drugs and have a worse overall and disease-free survival [2,4]. A small subclass, referred to as the special histological types (being medullary and adenoid cystic carcinomas) can still be eligible to endocrine treatment [2]. "
    [Show abstract] [Hide abstract] ABSTRACT: The most commonly used biomarkers to predict the response of breast cancer patients to therapy are the oestrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2). Patients positive for these biomarkers are eligible for specific therapies such as endocrine treatment in the event of ER and PgR positivity, and the monoclonal antibody, trastuzumab, in the case of HER2-positive patients. Patients who are negative for these three biomarkers, the so-called triple negatives, however, derive little benefit from such therapies and are associated with a worse prognosis. Deregulation of the protein serine/threonine phosphatase type 2A (PP2A) and its regulatory subunits is a common event in breast cancer, providing a possible target for therapy. The data portal, cBioPortal for Cancer Genomics was used to investigate the incidence of conditions that are associated with low phosphatase activity. Four (4) adherent human breast cancer cell lines, MDA-MB-468, MDA-MB-436, Hs578T and BT-20 were cultured to assess their viability when exposed to various dosages of rapamycin or FTY720. In addition, RNA was extracted and cDNA was synthesised to amplify the coding sequence of PPP2CA. Amplification was followed by high-resolution melting to identify variations.Results and conclusion: The sequence of PPP2CA was found to be conserved across a diverse panel of solid tumour and haematological cell lines, suggesting that low expression of PPP2CA and differential binding of inhibitory PPP2CA regulators are the main mechanisms of PP2A deregulation. Interestingly, the cBioPortal for Cancer Genomics shows that PP2A is deregulated in 59.6% of basal breast tumours. Viability assays performed to determine the sensitivity of a panel of breast cancer cell lines to FTY720, a PP2A activator, indicated that cell lines associated with ER loss are sensitive to lower doses of FTY720. The subset of patients with suppressed PP2A activity ispotentially eligible for treatment using therapies which target the PI3K/AKT/mTOR pathway, such as phosphatase activators. Full text Access: http://www.epmajournal.com/content/5/1/3/abstract
    Full-text · Article · Jan 2014
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