Abstract
BackgroundImmune responses in a tumour microenvironment can be evaluated by analysing tumour-infiltrating lymphocyte (TIL) density; this has been verified in the clinical setting. Although there are many reports on TIL density in primary tumours, little is known about its density in recurrent tumours.MethodsOf 300 patients treated with neoadjuvant chemotherapy during the study period, 29 were considered for evaluation of TIL density in primary and recurrent tumours. We performed a retrospective analysis of the association between TIL density and prognosis.ResultsTIL density was significantly lower in recurrent tumours than in primary tumours (P = 0.007). There was no correlation between post-recurrence survival and TIL density in core-needle biopsy specimens obtained from primary tumours (P = 0.837). However, patients with high TIL density in recurrent tumours had significantly better post-recurrence survival than did the corresponding group with low TIL density (P = 0.041). Multivariate analysis revealed that high TIL density contributed significantly towards improving post-recurrence survival in all patients (P = 0.035; hazard ratio, 0.167).ConclusionsIn recurrent breast cancer, a decrease in TILs density was observed as compared to the primary tumour, and this affects the poor prognosis after relapse.
Highlights
An evaluation of the expression of various hormonal receptors is an important component of decision-making for the treatment of breast cancer
In one-third of the discordant group, the subtype transformed to triple-negative breast cancer (TNBC); postrecurrence survival (PRS) was poorer in all these cases
Two cases of hormone receptor-positive breast cancer (HRBC) transformed to TNBC: one from HER2-enriched breast cancer (HER2BC) to HRBC, and one from HRBC to HER2BC
Summary
An evaluation of the expression of various hormonal receptors is an important component of decision-making for the treatment of breast cancer. Expression of these receptors may change during treatment and during recurrence.[1,2,3,4] when recurrent tumours are diagnosed on histological examination of biopsy specimens, reconfirmation of oestrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor-2 (HER2) expression becomes critical. Multivariate analysis revealed that high TIL density contributed significantly towards improving post-recurrence survival in all patients (P = 0.035; hazard ratio, 0.167). CONCLUSIONS: In recurrent breast cancer, a decrease in TILs density was observed as compared to the primary tumour, and this affects the poor prognosis after relapse
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