Abstract
Breast cancer (BC) has varied morphological and biological features and is classified based on molecular and morphological examinations. Molecular classification of BC is based on biological gene-expression profiling. In this study, biomarker modulation was assessed during BC treatment in 30 previously untreated patients. Heterogeneity among patients was pathologically diagnosed and classified into luminal and basal-like immunohistochemical profiles based on estrogen, progesterone, and human epidermal growth factor receptor (ER/PR/HER2) status. Marker heterogeneity was compared with mRNA biomarker expression in patients with BC before and after therapy. Reverse transcription-polymerase chain reaction was performed for molecular characterization. Expression and modulation of biological markers, CK19, hMAM, CEA, MUC, Myc, Ki-67, HER2/neu, ErbB2, and ER, were assessed after treatment, where the expression of the biomarkers CK19, Ki-67, Myc, and CEA was noted to be significantly decreased. Marker expression modulation was determined according to different stages and pathological characteristics of patients; coexpression of three markers (CK19, Ki-67, and Myc) was specifically modulated after therapy. In the histopathologically classified basal-like group, two markers (CK19 and Ki-67) were downregulated and could be considered as diagnostic biomarkers. In conclusion, pathological characteristics and marker variation levels can be evaluated to decide a personalized treatment for patients.
Highlights
Breast cancer (BC) is the most common cancer in women worldwide and is reported to be the second most common cancer in Iranian women [1]
Most of our patients were diagnosed with invasive ductal carcinoma (IDC) and classified into luminal and basal-like immunohistochemical profile, based on ER/PR/HER2 molecular status
Expression of Myc, MUC, ER, carcinoembryonic antigen (CEA), Ki-67, CK19, hMAM, ErbB2, and HER2 mRNA markers was detected in patients with BC and compared with that in 30 healthy women using reverse transcription-polymerase chain reaction (RT-PCR) (Figure 1)
Summary
Breast cancer (BC) is the most common cancer in women worldwide and is reported to be the second most common cancer in Iranian women [1]. ER/PR/HER2 receptor expression, lymph node metastases, and vascular or perineural tumor invasion are pathological categories generally used for defining the prognosis of BC [3]. Numerous other parameters, such as the proliferating index and P53, CK, HER1, or carcinoembryonic antigen (CEA) molecular markers, are used for evaluating the prognosis and predicting therapeutic outcomes. Infiltrating DC has been classified based on the molecular subtypes designated as luminal (ER/PR), HER2 overexpressing, basal-like (CK5/6+, EGFR+), and normal breast-like; each group has a different clinical outcome [7]. Multigene genomic classification has been suggested to complement traditional pathological methods [8]
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