Publications (16)

  • [Show abstract] [Hide abstract] ABSTRACT: Aims: Vascular invasion in breast cancer is associated with increased risk of recurrence, metastases and death from disease. However, there are few studies discriminating between blood vessel invasion (BVI) and lymphatic vessel involvement (LVI). Methods: A population-based series of 282 breast cancers was examined (200 screen-detected and 82 interval patients) with respect to BVI and LVI in addition to basic features and molecular subtypes, using CD31 and D2-40 antibodies. This series is part of the prospective Norwegian Breast Cancer Screening Program. Results: The frequency of LVI and BVI was 25% and 15%, respectively. BVI was associated with HER2-positive and basal-like tumours, and several features of aggressive breast cancer, whereas LVI showed weaker associations. BVI was the strongest factor to predict interval cancer presentation. BVI showed significant associations with recurrence-free survival and disease-specific survival in univariate and multivariate analyses, whereas LVI was not significant. Conclusions: Our findings indicate that BVI by tumour cells is strongly associated with aggressive tumour features including a basal-like phenotype, and BVI was an independent prognostic factor in contrast to what was found for LVI.
    Article · Sep 2016 · Journal of clinical pathology
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    Dataset: S3 Fig
    [Show abstract] [Hide abstract] ABSTRACT: High mitotic count and Ki-67 in PT and LN. High mitotic count (asterisk) in PT (A) and LN (B). High Ki-67 expression in PT (C) and LN (D) (Leica, x 400). (PDF)
    Full-text Dataset · Mar 2016
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    Dataset: S6 Fig
    [Show abstract] [Hide abstract] ABSTRACT: High mitotic count and Ki-67 expression in PT and low in LN. High mitotic count (asterisk) and high Ki-67 expression in PT (A, C, respectively), while low mitotic count (asterisk) and low Ki-67 expression in LN (B, D, respectively) (Leica, x 400). (PDF)
    Full-text Dataset · Mar 2016
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    Dataset: S2 Fig
    [Show abstract] [Hide abstract] ABSTRACT: The difference in Ki-67 expression and mitotic count between PT and LN. A parallel graphic illustration for the difference in ki-67 expression and mitotic count between PT and LN metastases. (PDF)
    Full-text Dataset · Mar 2016
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    Dataset: S4 Fig
    [Show abstract] [Hide abstract] ABSTRACT: Low mitotic count and Ki-67 in PT and LN. Low mitotic count (aterisk) in PT (A) and LN (B). Low Ki-67 expression in PT (C) and LN (D) (Leica, x 400). (PDF)
    Full-text Dataset · Mar 2016
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    Dataset: S7 Fig
    [Show abstract] [Hide abstract] ABSTRACT: Survival curves for Ki-67 and MC in matched pairs. Survival curves (Kaplan-Meier method) are shown for Ki-67 (a) and for MC (b) in PT and LN metastasis in matched pairs. Number of events / number of cases are given in parenthesis. (PDF)
    Full-text Dataset · Mar 2016
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    [Show abstract] [Hide abstract] ABSTRACT: Few studies have addressed the risk of recurrence by assessing proliferation markers in lymph node metastasis from breast cancer. Here, we aimed to examine Ki-67 expression and mitotic count in lymph nodes in comparison with primary tumors. A cohort of node positive breast cancer (n = 168) was studied as a part of the prospective Norwegian Breast Cancer Screening Program (1996-2009). The percentage of Ki-67 positivity was counted per\ 500 tumor cells in hot-spot areas (x630). Mitotic count was conducted in the most cellular and mitotic active areas in 10 high power fields (x400). Our results showed that Ki-67 and mitotic count were significantly correlated between primary tumor and lymph nodes (Spearman's correlation 0. 56 and 0.46, respectively) and were associated with most of the histologic features of the primary tumor. Univariate survival analysis (log-rank test) showed that high Ki-67 and mitotic count in the primary tumor and lymph node metastasis significantly predicted risk of recurrence. In multivariate analysis, mitotic count in the lymph node metastasis was an independent predictor of tumor recurrence. In conclusion, proliferation markers in lymph node metastases significantly predicted disease free survival in node positive breast cancer. © 2016 Aziz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Full-text Article · Mar 2016 · PLoS ONE
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    Dataset: S1 Fig
    [Show abstract] [Hide abstract] ABSTRACT: Flow diagram. Flow diagram for the cases included in this study. Abbreviations: SN; Sentinel node, AXLD; Axillary node dissection, FNAC; Fine Needle Aspiration Cytology, CNB; Core Needle Biopsy, n; number of cases. (PDF)
    Full-text Dataset · Mar 2016
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    Dataset: S5 Fig
    [Show abstract] [Hide abstract] ABSTRACT: Low mitotic count and Ki-67 in PT and high in LN. Low mitotic count (asterisk) and low Ki-67 expression in PT (A, C, respectively), while high mitotic count (asterisk) and high Ki-67 expression in LN (B, D, respectively) (Leica, x 400). (PDF)
    Full-text Dataset · Mar 2016
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    Dataset: S1 Table
    [Show abstract] [Hide abstract] ABSTRACT: Clinico-pathologic characteristics of primary tumors for the whole cohort. Clinico-pathologic characteristics of primary tumors for the whole cohort before exclusion of some cases (n = 231). (DOCX)
    Full-text Dataset · Mar 2016
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    Dataset: S2 Table
    [Show abstract] [Hide abstract] ABSTRACT: Clinico-pathologic characteristics of primary tumors for the study cohort. Clinico-pathologic characteristics of primary tumors for the cases which were finally included in this study (n = 168). (DOCX)
    Full-text Dataset · Mar 2016
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    Dataset: S3 Table
    [Show abstract] [Hide abstract] ABSTRACT: Data-sheet for cases used in this study. (XLSX)
    Full-text Dataset · Mar 2016
  • Y. Chen · T. A. Klingen · H. Aas · [...] · L. Akslen
    Article · Sep 2015 · Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin
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    [Show abstract] [Hide abstract] ABSTRACT: Background Mammography screen-detected breast cancers have a better prognosis than predicted from established prognostic markers. A search for additional features that are characteristic for these tumours and their prognosis is needed to reduce overtreatment, a recognized challenge in breast cancer patient management today. Here, we have investigated the occurrence and importance of tumour elastosis.Methods We performed a population based retrospective study of breast cancers detected in the Norwegian Breast Cancer Screening Programme in Vestfold County during 2004¿2009. In total, 197 invasive screen-detected cancers and 75 interval cancers in patients aged 50¿69 years were compared with regard to standard clinico-pathological parameters and tumour shape, as well as ER, PR, HER2 and Ki67 expression. In particular, the presence of elastotic material in tumours was graded on a 4-tiered scale (score 0¿3).ResultsScreen-detected cancers had a significantly higher content of stromal elastosis than interval cancers (p¿<¿0.001). High content of elastosis (score 3) correlated strongly with stellate tumour shape, low histological grade, and ER+/HER2- status. Further, high elastosis score was significantly associated with lower Ki67 expression. In survival analyses, cases with high elastosis demonstrated increased recurrence free (p¿=¿0.03) and disease-specific survival (p¿=¿0.11) compared to cases with low elastosis.Conclusion There is a strong correlation between the presence of tumour elastosis, stellate tumour shape and mammography detection of breast cancers. To our knowledge, this is the first time elastosis has been studied in relation to breast cancer detection method. Presence of elastosis is associated with low tumour cell proliferation (Ki67) and a good prognosis.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_230.
    Full-text Article · Dec 2014 · Diagnostic Pathology
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    [Show abstract] [Hide abstract] ABSTRACT: Abstract This case describes an infiltrating breast tumour with thyroid transcription factor-1 (TTF-1) positive staining and ductal differentiation in a 72-year-old woman. The presence of ductal carcinoma in situ with positive TTF-1 is a strong indication that this is a primary tumour and not a metastasis from lung. On PET scan and CT follow up there were no other tumours found in this patient. We are not aware of any previously reported TTF-1 positive primary breast carcinoma with ductal differentiation.
    Full-text Article · Jun 2010 · Diagnostic Pathology
  • Tor Audun Klingen · Herman Klaasen · Hans Aas · [...] · Lars A Akslen
    [Show abstract] [Hide abstract] ABSTRACT: Secondary tumours in the breast are rare. Based on literature, an incidence of 0.4-2% is reported. In this population-based study, secondary breast tumours from a 5-year period (2001-2005), not including metastasis from contralateral breast carcinoma, were reviewed (Vestfold County, Norway). A total of 722 patients with breast malignancies were found in this population (89.3% from Vestfold County Hospital). Ten of these, approximately 1.4%, were metastatic tumours, representing four cutaneous melanomas, three pulmonary carcinomas and three malignant lymphomas. The tumours were often solitary, palpable and close to the skin. Radiologically, the lesions mostly resembled primary carcinomas by mammography and ultrasound, which differs from other studies. Comparison with a known primary tumour and use of immunohistochemical profiling is of crucial importance. Melanoma markers (Melan-A, HMB-45, S-100 protein), lung cancer markers (Cytokeratins, TTF1, Chromogranin, Synapthophysin) and lymphoid markers (CD3, CD20) usually help to confirm a secondary breast tumour diagnosis. This approach is especially indicated in diffusely growing tumours with lack of glandular structure and high-grade cytological features, and staining for ER and GCDFP15 may be helpful. Thus, the diagnosis of a breast metastasis may be suspected by careful mammography and ultrasound imaging, although some cases have atypical radiological features, and histological examination might be necessary to ensure a correct diagnosis and appropriate treatment.
    Article · Oct 2009 · Apmis