Association between the degree of fibrosis in fibrotic focus and the unfavorable clinicopathological prognostic features of breast cancer.

Yuhan Wei,Jingru Luo,Qin Li,Yuling Ma,Wenjun Tang,Yongfu Li,Minghua Wang,Hong Guo,Jun Zhang,Haifeng Lin

doi:10.7717/peerj.8067

Abstract

ObjectiveTo explore the association between the degree of fibrosis in fibrotic focus (FF) and the unfavorable clinicopathological prognostic features of breast cancer.MethodsA total of 169 cases of breast invasive ductal carcinoma (IDC) were included in the study. Hematoxylin and eosin (H&E) staining was performed in the primary lesion of breast IDC and the degree of fibrosis in tumor-stromal FF was assessed. The association between the degree of fibrosis in FF and the well-known clinicopathologic features of breast cancer was investigated and the influence of the degree of fibrosis in FF on the survival was analyzed.ResultsTumor size >2 cm (P = 0.023), vascular invasion (P = 0.011), lymphatic vessel invasion (P < 0.001) and HER-2+ (P = 0.032) were positively correlated with the degree of fibrosis in FF in breast IDC. The result of multivariate analysis showed that lymphatic vessel invasion was the only independent correlation factor of high fibrosis in FF in breast IDC (OR = 3.82, 95% CI[1.13 ∼ 12.82], P = 0.031). The Nottingham prognostic index (NPI) of high fibrosis in FF was significantly higher than that of mild and moderate fibrosis in FF in the no vascular infiltration subgroup, the no nerve infiltration subgroup, and the Luminal A subgroup (P = 0.014, 0.039, and 0.018; respectively).ConclusionsThe high fibrosis in FF is closely associated with the strong invasiveness and the high malignancy of breast IDC. The degree of fibrosis in FF might be considered as a very practical and meaningful pathological feature of breast cancer.

Highlights

Breast cancer is the most common malignant tumor in women across the world (DeSantis et al, 2017)
Inclusion criteria: (1) female diagnosed with primary breast invasive ductal carcinoma (IDC); (2) IDC must be the principal component (>50%) in mixed pathological type; (3) no distant metastasis; (4) no neoadjuvant therapy before surgery; (5) fibrotic focus (FF) stained with Hematoxylin and eosin (H&E) was present in the primary lesion of breast cancer
According to the proportion of fibroblasts and collagen fibers, FF was classified into three semi-quantitative categories (Van den Eynden et al, 2007): (1) mild fibrosis meant that FF consisted of a large number of fibroblasts and small amount of collagen fibers; (2) moderate fibrosis intermediated mild fibrosis and high fibrosis; (3) high fibrosis meant that FF was mainly composed of collagen fibers

Summary

Introduction

Breast cancer is the most common malignant tumor in women across the world (DeSantis et al, 2017). The prognosis of breast cancer is closely associated with various clinicopathological characteristics, such as age, tumor size, pathological type, lymph node metastasis status, histological grade, lymphovascular invasion, Ki-67 index, hormone receptor (HR) status, human epidermal growth factor receptor-2 (HER-2) expression, etc. These well-known pathological features have been widely used to make clinical treatment plans and predict the prognosis of breast cancer. FF is a pathological change in the tumor microenvironment of breast cancer, with an incidence of 18.7–53.0% (Colpaert et al, 2001; Hasebe et al, 1996; Kornegoor et al, 2012; Mujtaba et al, 2013; Van den Eynden et al, 2008). A retrospective study was conducted to explore the association between the degree of fibrosis in FF and the unfavorable clinicopathological prognostic features of breast cancer

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Results

Conclusion