Abstract
In some cases of breast cancer, diagnosis of triple‐negative breast cancer (TNBC) requires further fluorescence in situ hybridization (FISH) for determining human epidermal growth factor receptor 2 (HER2) status. However, few cases undergo FISH in China, leading to difficulty regarding subsequent treatment decisions. Here, we used immunohistochemical analysis to explore expression of fascin‐1, an actin‐bundling protein, as a diagnostic marker of TNBC. A total of 457 cases of breast cancer were divided into four molecular subtypes, including 82 cases (17.9%) of TNBC, 81 (17.7%) of HER2‐enriched, 185 (40.5%) of luminal A, and 109 (23.9%) of luminal B. Positive fascin‐1 expression was seen in 144 cases (31.5%), including 77 (16.8%) strong positive cases. Rates of positive and strong positive expression of fascin‐1 were significantly higher in cases of TNBC than in the other molecular subtypes. In all cases of breast cancer, the sensitivities and specificities of positive and strong positive fascin‐1 expression for predicting TNBC were 87.8% and 80.8%, and 78.0% and 96.5%, respectively. In cases of hormone receptor–negative breast cancer, the sensitivities and specificities of positive and strong positive fascin‐1 expression for predicting TNBC were 87.8% and 61.7%, and 78.0% and 92.6%, respectively. In 24 cases with estrogen receptor (ER)‐, PR‐, and HER2 2 + equivocal status who underwent FISH, the sensitivity and specificity of strong positive fascin‐1 expression for predicting TNBC were 71.4% and 90.0%. These results suggest that strong positive fascin‐1 expression can be used as a diagnostic marker of TNBC.
Highlights
Breast cancer is the most common type of cancer and the second leading cause of cancer-related death among women in the United States [1]
Cases of Triple-negative breast cancer (TNBC) had a higher histologic grade and clinical stage compared with the other molecular subtypes (P < 0.01 and 0.05, respectively)
TNBC accounts for approximately 10–20% of all cases of breast cancer, and is associated with a more aggressive course and a poorer prognosis than other breast cancer subtypes [2, 3]
Summary
Breast cancer is the most common type of cancer and the second leading cause of cancer-related death among women in the United States [1]. TNBC is associated with an aggressive course and poor survival, and unlike patients with ER/PR-positive or HER2-overexpressing breast cancer, Fascin-1 in Triple-Negative Breast Cancer. Immunohistochemical (IHC) analysis can be used to assess ER, PR, and HER2 status, some cases of breast cancers are HER2 2+ equivocal. In those cases, fluorescence in situ hybridization (FISH) can be used to further determine HER2 status. Use of FISH is not universal in China, and the cost is higher than that of IHC analysis; in some cases of breast cancer, HER2 status remains unclear. In cases of hormone receptor–negative breast cancer, unclear HER2 status leads to uncertain classification as TNBC or HER2-enriched subtype, resulting in difficulty regarding subsequent targeted therapy decisions
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