Multifocal breast cancer documented in large‐format histology sections |
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| Authors: | Gyula Pekar MD Syster Hofmeyer MD László Tabár MD PhD Miklós Tarján MD Tony Hsiu‐Hsi Chen PhD Amy Ming‐Fang Yen PhD Sherry Yueh‐Hsia Chiu PhD Dan Hellberg MD PhD Mária Gere MD Tibor Tot MD PhD |
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| Institution: | 1. Department of Pathology and Clinical Cytology, Falun Central Hospital, Falun, SwedenFax: (011) 4623492389;2. Department of Pathology and Clinical Cytology, Falun Central Hospital, Falun, Sweden;3. Department of Mammography, Falun Central Hospital, Falun, Sweden;4. Division of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan;5. School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan;6. Department and Graduate Institute of Health Care Management, Chang Gung University, Kwei‐Shan Tao‐Yuan, Taiwan;7. Center for Clinical Research Dalarna, Falun, Sweden |
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| Abstract: | BACKGROUND: The prognostic significance of molecular phenotype in breast cancer is well established in the literature. Recent studies have demonstrated that subgross lesion distribution (unifocal, multifocal, and diffuse) and disease extent also carry prognostic significance in this disease. However, the correlation of molecular phenotypes with subgross parameters has not yet been investigated in detail. METHODS: In total, 444 consecutive invasive breast cancers that were documented in large‐format histology slides and worked up with detailed radiologic‐pathologic correlation were sampled into tissue microarray blocks and stained immunohistochemically to delineate the molecular subtypes. RESULTS: Diffuse or multifocal distribution of the invasive component of breast carcinomas in this series was associated with a 4.14‐fold respectively 2.75‐fold risk of cancer‐related death compared with unifocal tumors irrespective of molecular phenotype. Patients who had human epidermal growth factor receptor 2 (HER2)‐positive cancers; estrogen receptor‐negative, progesterone receptor‐negative, and HER2‐negative (triple‐negative) cancers; or basal‐like cancers had a 2.18‐fold, 2.33‐fold, and 4.07‐fold risk of dying of disease, respectively, compared with patients who had luminal A carcinomas. Unifocal luminal A, HER2‐positive, and basal‐like cancers were associated with significantly better long‐term survival outcomes than their multifocal or diffuse counterparts; luminal B and triple‐negative tumors also had the same tendency. In multivariate analysis, patient age, tumor size category, lymph node status, lesion distribution, and molecular phenotypes remained significant. CONCLUSIONS: Multifocality and diffuse distribution of the invasive component were associated with significantly poorer survival in women with breast carcinomas compared with unifocal disease in patients with luminal A, HER2 type, and basal‐like cancers. Molecular classification of breast cancer is a powerful tool but gains in power when combined with conventional and subgross morphologic parameters. Cancer 2013. © 2013 American Cancer Society. |
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| Keywords: | breast breast cancer multifocality diffuse molecular phenotypes survival |
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