Long-term prognosis of scar and non-scar cancers of the breast

The prognostic significance of histopathologic classification of ductal breast carcinoma as scar and non-scar types was studied among 311 patients with breast cancer, followed up for a minimum of 22 years after the diagnosis or until death. Ninety-six (31%) cancers were of scar type and they had a more favourable prognosis than the cancers of non-scar type (p = 0.0001). The scar cancers were more often well differentiated (p less than 0.0001), had more pronounced inflammatory cell reaction (p less than 0.0001), less nuclear pleomorphism (p less than 0.0001), less tumor necrosis (p less than 0.0001), and a lower mitotic rate (p less than 0.0001) than the non-scar cancers. It was less common for patients with scar cancer to have axillary lymph node metastases (p = 0.01) and their primary tumor was smaller (p = 0.006). In flow cytometric analysis the scar cancers were more often DNA diploid (p = 0.004) with S-phase fraction below the median (p = 0.0002). In a multivariate analysis the association of cancer with a scar did not appear as an independent prognostic factor, whereas histologic grade (p less than 0.001) and extent of tumor necrosis (p less than 0.001) did. We conclude that the classification of breast cancer as scar and non-scar types has less prognostic value than the conventional histopathologic grading.     

Indicators of prognosis in node-negative breast cancer

Measures of the proliferative activity of tumor cells have prognostic value in patients with node-negative breast cancer. We studied 367 women in southern Sweden who had undergone surgical resection for such cancer. Tumor specimens were analyzed with DNA flow cytometry in order to estimate both the DNA content (ploidy) and the fraction of cells in the synthetic phase of the cell cycle (S phase). The median duration of follow-up was four years; 28 percent of the patients received adjuvant therapy, usually with tamoxifen (n = 83). A multivariate analysis based on complete data on 250 patients included the following covariates: age (greater than or equal to 75, 50 to 74, and less than or equal to 49 years), tumor size (less than or equal to 20 vs. greater than 20 mm), concentration of estrogen and progesterone receptors (less than 10 vs. greater than or equal to 10 fmol per milligram of protein), ploidy (diploid vs. nondiploid), and S-phase category (fraction of cells in S phase: less than 7.0 percent, 7.0 to 11.9 percent, and greater than or equal to 12 percent). The S-phase fraction yielded the most prognostic information, followed by progesterone-receptor status and tumor size. A prognostic model based on these three variables identified 37 percent of the patients as constituting a high-risk group with a fourfold increased risk of distant recurrence. In the remaining 63 percent of the patients, the five-year overall survival rate (92 +/- 4 [+/- SE] percent) did not differ from the expected age-adjusted rate for Swedish women. We conclude that a prognostic index that includes indicators of the proliferative activity of tumor cells may be able to identify women with node-negative breast cancer in whom the risk of recurrence is sufficiently low that adjuvant chemotherapy can be avoided.     

Histomorphological criteria for prognosis in breast cancer

One hundred cases of carcinoma breast were analysed with regard to histological features and clinical follow-up. Bad prognostic factors included tumour size larger than 5cms; absent or minimal intraduct component in the tumour and absent or minimal periductal elastosis. Conversely significant intraduct component in the tumour and periductal elastosis were associated with better survival. Degree of lymph nodal involvement did not influence the outcome. One reason for this unexpected finding could be that patients with more than 3 lymph node involvement were given additional chemotherapy.     

Cathepsin D and prognosis in breast cancer

We investigated the possibility that cathepsin D, an estrogen-induced lysosomal protease, might have value as a prognostic factor in breast cancer by studying frozen tissue specimens from 397 patients. We measured the 34-kd mature form of the enzyme by Western blot assay and densitometry. Among 199 patients with node-negative disease, but not among 198 with node-positive disease, high levels of cathepsin D proved to be a significant predictor of reduced disease-free survival (median follow-up, 64 months), either as a continuous variable (log cathepsin D; P = 0.018) or as a dichotomous variable with an optimized cutoff point (P = 0.0001). Results were similar for overall survival (P = 0.009 and 0.0001, respectively). Relating the level of cathepsin D to other prognostic factors in the patients with node-negative disease, we found an association with aneuploidy but none with estrogen or progesterone receptors, tumor size, or the age of the patient. In multivariate analyses, a high level of cathepsin D was the most important independent factor in predicting shorter disease-free and overall survival in patients with node-negative disease. As compared with the risk in women with low levels of cathepsin D, the relative risk of tumor recurrence was 2.6 (95 percent confidence interval, 1.6 to 4.4) and the relative risk of death was 3.9 (95 percent confidence interval, 2.1 to 7.3) among those with high levels of cathepsin D. For disease-free survival, cathepsin D status was predictive of outcome primarily among those with aneuploid tumors; the actuarial five-year recurrence rates of aneuploid tumors were 60 percent among women with high levels of cathepsin D and 29 percent among those with low levels, as compared with 22 percent for all diploid tumors. We conclude that cathepsin D may be an independent predictor of early recurrence and death in node-negative breast cancer.     

乳腺癌患者长期留置中心静脉导管维护

乳腺癌是威胁人类健康和生命的主要恶性肿瘤之一,在我国乳腺癌居全身恶性肿瘤的第三位（7％～10％）,居女性恶性肿瘤第二位^[1]。绝大多数乳腺癌仍采取以手术为主的综合治疗,新辅助化疗的出现,使乳腺癌患者需在手术前后进行多个疗程化疗。针对乳腺癌患者化疗周期长、上肢静脉使用受限以及化疗药物刺激性大等特点,我科采用经颈内静脉置人中心静脉导管（CVC）输入化疗药,为保持导管通畅,预防导管感染,     

乳腺浸润性导管癌分子亚型与临床病理特征及预后的关系

目的 检测乳腺浸润性导管癌的临床病理特征及特定蛋白的表达情况,对其进行分型,探讨各哑型与预后的关系.方法 采用免疫组织化学EnVision法检测128例浸润性导管癌ER、PR、HER2和CK5/6的表达,参考文献报道的免疫分型方法 对其分型,并对HER2过表达型9例进行FISH检测.结果 ER、PR、HER2和CKS/6在本组128例浸润性导管癌中的阳性表达率分别为67%(86/128)、45%(58/128)、27%(34/128)和27%(34/128),并将128例分为5种免疫哑型,管腔A型55%(70/128),管腔B型20%(25/128),HER2过表达型7%(9/128),基底细胞样型10%(13/128),无法分类型8%(11/128).FISH检测HER2过表达型9例均为HER2基因扩增.各分子亚型间预后差异具有统计学意义,管腔A型预后最好,基底细胞型预后较差.多因素分析,乳腺癌临床分期和免疫分型是独立的预后因素.月经状态在乳腺癌各免疫亚型中的分布差异有统计学意义.结论 通过检测ER、PR、HER2和CK5/6的表达可以将乳腺浸润性导管癌分成具有不同生物学行为的5个免疫亚型,对于评估预后,指导治疗具有一定的意义.     

乳腺浸润性导管癌分子亚型与临床病理特征及预后的关系

目的 检测乳腺浸润性导管癌的临床病理特征及特定蛋白的表达情况,对其进行分型,探讨各哑型与预后的关系.方法 采用免疫组织化学EnVision法检测128例浸润性导管癌ER、PR、HER2和CK5/6的表达,参考文献报道的免疫分型方法 对其分型,并对HER2过表达型9例进行FISH检测.结果 ER、PR、HER2和CKS/6在本组128例浸润性导管癌中的阳性表达率分别为67%(86/128)、45%(58/128)、27%(34/128)和27%(34/128),并将128例分为5种免疫哑型,管腔A型55%(70/128),管腔B型20%(25/128),HER2过表达型7%(9/128),基底细胞样型10%(13/128),无法分类型8%(11/128).FISH检测HER2过表达型9例均为HER2基因扩增.各分子亚型间预后差异具有统计学意义,管腔A型预后最好,基底细胞型预后较差.多因素分析,乳腺癌临床分期和免疫分型是独立的预后因素.月经状态在乳腺癌各免疫亚型中的分布差异有统计学意义.结论 通过检测ER、PR、HER2和CK5/6的表达可以将乳腺浸润性导管癌分成具有不同生物学行为的5个免疫亚型,对于评估预后,指导治疗具有一定的意义.     

乳腺浸润性导管癌分子亚型与临床病理特征及预后的关系

目的 检测乳腺浸润性导管癌的临床病理特征及特定蛋白的表达情况,对其进行分型,探讨各哑型与预后的关系.方法 采用免疫组织化学EnVision法检测128例浸润性导管癌ER、PR、HER2和CK5/6的表达,参考文献报道的免疫分型方法 对其分型,并对HER2过表达型9例进行FISH检测.结果 ER、PR、HER2和CKS/6在本组128例浸润性导管癌中的阳性表达率分别为67%(86/128)、45%(58/128)、27%(34/128)和27%(34/128),并将128例分为5种免疫哑型,管腔A型55%(70/128),管腔B型20%(25/128),HER2过表达型7%(9/128),基底细胞样型10%(13/128),无法分类型8%(11/128).FISH检测HER2过表达型9例均为HER2基因扩增.各分子亚型间预后差异具有统计学意义,管腔A型预后最好,基底细胞型预后较差.多因素分析,乳腺癌临床分期和免疫分型是独立的预后因素.月经状态在乳腺癌各免疫亚型中的分布差异有统计学意义.结论 通过检测ER、PR、HER2和CK5/6的表达可以将乳腺浸润性导管癌分成具有不同生物学行为的5个免疫亚型,对于评估预后,指导治疗具有一定的意义.     

HPD overexpression predicts poor prognosis in breast cancer

BackgroundThe enzyme, 4-hydroxyphenylpyruvate dioxygenase (HPD), is critical to tyrosine metabolism; its deficiency can cause tyrosinemia. However, its precise contribution to tumorigenesis is unclear. Here, we investigated the correlation between HPD expression and prognosis in patients with breast cancer.Methods145 breast cancer specimens were selected to analyze HPD protein expression by immunohistochemistry and evaluate its relationship to patients’ clinicopathological features. HPD localization was confirmed in MCF-7 and MDA-MB-231 breast cancer cells, using immunofluorescence staining. The expression of HPD protein was detected in breast cancer and cancer-adjacent normal tissues using Western blot analysis. Survival rates were calculated by the Kaplan–Meier method.ResultsWe found that HPD protein was mainly located in the cytoplasm/nucleoli/perinucleus in breast cancer cells, as shown by immunofluorescence staining in MCF-7 and MDA-MB-231 cells, and immunohistochemistry in breast cancer and adjacent normal tissues (HPD protein expression—breast cancer: 46.9% [68/145], ductal carcinoma in situ [DCIS]: 22.6% [12/53], and normal tissues: only 4.8% [2/42]). Similarly, the Western blot results further confirmed the increased expression of HPD in breast cancer compared with cancer-adjacent normal tissues (P < 0.05). HPD expression level was positively correlated with histological grade and clinical stage, and inversely correlated with 10-year overall survival (OS) rates, in patients with breast cancer. Among patients with breast cancer, those with high HPD expression had worse OS rates than those with low HPD expression. Additionally, when patients were subgrouped by disease stage or grade, those with high HPD expression had worse OS rates than those with low HPD expression for each respective stage or grade.ConclusionsOur findings indicate that HPD may be a useful prognostic predictor, and a potential therapeutic target for patients with breast cancer.     

Long-term relapses of breast cancer: a working hypothesis

The study of long-term relapses that present 8 years or more after mastectomy in breast cancer patients indicates these cases are strictly related to the presence of hormone receptors and particularly to estrogen receptors. It is possible to infer that the presence of estrogen receptors indirectly conditions the formation of antimitotic factors more effective than those used for therapy, to the point of determining in some cases the phenomenon of long-term relapses.     

MFG-E8 overexpression is associated with poor prognosis in breast cancer patients

Background

MFG-E8(Milk fat globule-EGF factor 8), a secreted glycoprotein, plays an exceptional role in various diseases. MFG-E8 overexpression is found in a variety of cancers. However, it remains unclear whether MFG-E8 overexpression is associated with the clinicopathological characteristics and prognosis of human breast cancer.

RNA-seq analysis identified hormone-related genes associated with prognosis of triple negative breast cancer

Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer that currently lacks effective biomarkers and therapeutic targets required to investigate the diagnosis and treatment of TNBC. Here we performed a comprehensive differential analysis of 165 TNBC samples by integrating RNA-seq data of breast tumor tissues and adjacent normal tissues from both our cohort and The Cancer Genome Atlas (TCGA). Pathway enrichment analysis was conducted to evaluate the biological function of TNBC-specific expressed genes. Further multivariate Cox proportional hazard regression was performed to evaluate the effect of these genes on TNBC prognosis. In this report, we identified a total of 148 TNBC-specific expressed genes that were primarily enriched in mammary gland morphogenesis and hormone levels related pathways, suggesting that mammary gland morphogenesis might play a unique role in TNBC patients differing from other breast cancer types. Further survival analysis revealed that nine genes (FSIP1, ADCY5, FSD1, HMSD, CMTM5, AFF3, CYP2A7, ATP1A2, and C11orf86) were significantly associated with the prognosis of TNBC patients, while three of them (ADCY5, CYP2A7, and ATP1A2) were involved in the hormone-related pathways. These findings indicated the vital role of the hormone-related genes in TNBC tumorigenesis and may provide some independent prognostic markers as well as novel therapeutic targets for TNBC.     

乳腺癌肿瘤出芽与肿瘤浸润淋巴细胞及患者预后的关系研究

目的:研究肿瘤出芽与乳腺癌临床病理特征、肿瘤浸润淋巴细胞(TILs)以及患者预后的关系。方法:收集2012年1月～2016年12月于暨南大学附属第一医院行手术治疗的178例乳腺癌患者资料及肿瘤组织切片,显微镜下观察乳腺癌组织病理切片中肿瘤出芽和肿瘤浸润淋巴细胞水平,X~2检验分析肿瘤出芽水平与乳腺癌患者临床病理特征和TILs的关系,Log-rank检验分析肿瘤出芽水平与乳腺癌患者无病生存期和总生存期的关系。结果:高肿瘤出芽组患者淋巴结阳性数目多、组织性分级高、脉管癌栓更多;肿瘤出芽数较多的患者TILs的水平较低,而肿瘤出芽数较少的患者TILs水平较高;高肿瘤出芽患者比低肿瘤出芽患者预后较差。结论:乳腺癌肿瘤出芽水平与恶性程度高的临床病理指标密切相关,肿瘤出芽水平与TILs水平呈负相关,是影响乳腺癌预后的重要因素。     

Decreased expression of miR-204 is associated with poor prognosis in patients with breast cancer

The identification of biomarkers in breast cancer diagnosis and therapy is important in achieving early cancer diagnosis and improving patient outcomes. The aim of this study was to examine clinical significance of miR-204 expression in tissues from breast cancer patients. The relationship between miR-204 expression and clinicopathological characteristics was investigated. MiR-204 expression was significantly associated with TNM stage and metastasis. Patients with low miR-204 expression had poorer overall survival time and disease free survival time than those with high miR-204 expression. Furthermore, miR-204 expression was correlated with chemotherapeutic resistance of breast cancer patients. In conclusion, the miR-204 may be a potential diagnostic and prognostic biomarker of breast cancer.     

Value of clinico-pathological factors in prognosis of breast cancer patients

Two hundred and twenty nine cases of breast cancer diagnosed and treated in CMC, Ludhiana were studied for their clinical details, histological features and followed up. Various factors have an effect on the prognosis. The relationship between various clinicopathological features and prognosis were evaluated. The good prognostic factors in this study were middle age, small size of the tumour, low histological grade with marked lymphocytic infiltrate around the tumour, and sinus histiocytosis and no tumour metastasis in axillary lymph nodes. Pregnancy, lactation, younger age, large size, high grade tumour, skin invasion, and increased number of metastatic axillary lymph nodes were associated with significantly poor prognosis.