Characteristics Of Invasive Breast Cancer Research Articles

Educational level and characteristics of invasive breast cancer: findings from a French prospective cohort.

Breast cancer (BC) characteristics are known to influence patients survival. Social differences have been reported by previous studies for those characteristics but questions persist because of inconsistent conclusions. We aimed to investigate the impact of education on BC stage, grade, and hormone receptor (HR) status, while adjusting for potential confounders including a broad set of health behaviors, anthropometric measures, and reproductive factors. In the French E3N cohort, 5236 women developed a primary invasive BC for which there was available information on stage, grade, and HR status. No multivariate analyses was performed for BC stage based on the lack of association in bivariate analyses. Odds ratios and confidence intervals were estimated using multinomial logistic regression models for BC grade or binomial logistic regression models for HR status of BC. Women with a lower education were diagnosed with higher grade BC compared to women with a higher education (1.32 [1.12; 1.57]). This association was slightly attenuated after adjustment for covariates independently and more strongly affected in the fully adjusted model (1.20 [0.99; 1.45]). A significant association was observed between lower education and HR- status of BC (1.20 [1.02; 1.42]) attenuated after adjustment for age at first childbirth (1.12 [0.95; 1.33]). In this cohort, education was associated with BC grade and HR status but not stage at diagnosis. The link between education and BC grade was not entirely explained by the different adjustments. A specific mechanism could be at play and deserves further investigations.

Epidemiological, clinical, and pathological characteristics of invasive breast cancer in Bedouin and Jewish women in southern Israel: a retrospective comparative study

BackgroundInvasive breast cancer (IBC) is a leading cause of cancer-related death among women in Israel, regardless of ethnicity. This study compared IBC epidemiological, clinical, and pathological characteristics in Bedouin and Jewish patients in southern Israel.MethodsMedical records of 1514 Jewish and 191 Bedouin women with IBC treated at Soroka University Medical Center between 2014 and 2021 were analyzed retrospectively. Baseline measures and tumor characteristics were compared between groups. Overall survival (OS) and disease-free survival (DFS) were analyzed using log-rank test. Multivariate analysis was performed using the Cox proportional hazard model.ResultsBedouin patients exhibited a significantly younger age at diagnosis (median 48 vs. 62 years, p < 0.001), larger tumor size (median 2.5 vs. 2.13 cm, p < 0.001), and higher metastasis rate (18.8% vs. 12.7%, p = 0.03) compared to Jewish patients. In early-stage (non-metastatic) disease, Jewish and Bedouin patients had comparable overall survival (OS) rates (127 vs. 126 months, p = 0.2), consistent across stages 1 to 3. However, among patients with metastatic disease, Bedouins exhibited significantly longer OS (76.6 vs. 37.8 months, p = 0.006). Disease-free survival (DFS) showed no ethnic differences (not reached vs. 122 months, p = 0.31). There were no significant differences in OS between Bedouin and Jewish patients undergoing various treatment modalities for early-stage disease: surgery, adjuvant radiotherapy, chemotherapy, and systemic neoadjuvant therapy.ConclusionBreast cancer among Bedouin women in southern Israel manifests at a younger age, with larger tumors and more advanced stages than in Jewish women. However, recent data indicate no differences in OS and DFS between the ethnic groups despite past disparities in prognosis.

Subtyping of Breast Carcinoma According to ER/PR and HER2/neu Expression: A Cross-Sectional Study from Southern Part of Assam, India

Introduction: Globally, breast carcinoma is the most prevalent and lethal form of cancer in women. Breast cancer is no longer considered a single disease but a complex heterogeneous disease with multiple genetic and epigenetic alterations. The prognosis and management of the disease depend on histological stage, type, grade, tumour size, lymph node status, and the status of hormonal receptors like ER, PR, and Her2/ neu. Recently, more attention has been given to the molecular classification of breast cancer. Aim: To analyse and compare the clinicopathological characteristics of invasive breast cancer in the four breast carcinoma subtypes defined by the immunohistochemical expression of Estrogen Receptor (ER), Progesterone Receptor (PR), and Human Epidermal Growth Factor Receptor 2 (Her2/neu). Materials and Methods: The cross-sectional study was conducted on 64 primary invasive breast carcinoma cases diagnosed on mastectomy specimens between February 1, 2018, and July 30, 2022, in the Department of Pathology at the histopathology section of Silchar Medical College and Hospital, Silchar, Assam, India. Age and tumour characteristics (morphology, grade, stage, and size) and nodal disease status were included in the data for analysis. Immunohistochemical markers were analysed on the sections of these diagnosed cases. IBM Statistical Packages for Social Sciences (SPSS) software was used for data analysis. Qualitative data was presented as frequency and percentage, while quantitative data was presented as mean ±{Standard Deviation (SD)}. The Chi- square test was used to determine the statistical significance of hormonal receptors with the various clinicopathological features. A p-value of &lt;0.05 was considered statistically significant. Results: In present study of 64 cases of invasive breast carcinoma, the mean age of patients was 51.95±12.72 years. Subtyping was performed based on hormonal receptors. Authors found that the Luminal A variety 33 (51.6%) was the most common hormonal subtype in present study, followed by the basal subtype 24 (37.5%). The Luminal A subtype was found to be predominant among others. The majority of the patients (59.4%) had stage-I tumours, and Ductal type carcinoma was the most common (57.8%). Histologically, most of the tumours were poorly differentiated (28, 43.8%), and most were sized ≤2 cm (41, 64.1%). Lymph nodes were not palpable in most of the patients (43, 67.2%). Subtype comparison with respect to age, stage, histological grade, type, size, and nodal status revealed statistically significant outcomes (p-value of &lt;0.05). Conclusion: Classification based on Immunohistochemistry (IHC) provides prognostic and therapeutic information that cannot be obtained from either ER/PR or Her2/Neu status alone. The present study provides the incidence of different molecular subtypes in the southern region of Assam, and comparison among them with statistical correlation offers improved and crucial treatment guidance. IHC classification as a clinical tool for ER/PR and Her2/Neu testing is widely accessible, reasonably priced, based on immunophenotype/biologic phenotype categorisation of breast cancer, and is prognostic as well as partly predictive and needs to be practiced invariably.

Clinicopathological Features of Invasive Breast Cancer: A Five-Year Retrospective Study in Southern and South-Western Ethiopia.

Background: Breast cancer (BC) is the most common type of cancer in Ethiopia. The incidence of BC is also rising, but the exact figure is still poorly known. Therefore, this study was conducted to address the gap in epidemiological data on BC in southern and southwestern Ethiopia. Materials and Methods: This is a five-year (2015-2019) retrospective study. The demographic and clinicopathological data were collected from biopsy reports of different kinds of breast carcinomas in the pathology department of Jimma University Specialized Hospital and Hawassa University Specialized Referral Hospital. Histopathological grades and stages were conducted using Nottingham grading and TNM staging system, respectively. Collected data were entered and analyzed using SPSS Version-20 software. Results: The mean age of patients at diagnosis was 42.27 (SD = 13.57) years. The pathological stage of most BC patients was stage III, and most of them had tumor sizes greater than 5 cm. Most patients had moderately differentiated tumor grade, and mastectomy was the most common type of surgery at the time of diagnosis. Invasive ductal carcinoma was the most common histological type of BC, followed by invasive lobular carcinoma. Lymph node involvement was seen in 60.5% of cases. Lymph node involvement was associated with tumor size (χ2 = 8.55, p = 0.033) and type of surgery (χ2 = 39.69, p < 0.001). Conclusions: This study showed that BC patients in southern and southwestern Ethiopia displayed advanced pathological stages, relatively young age at diagnosis, and predominant invasive ductal carcinoma histological patterns.

Intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI for preoperative prediction of intraductal component in invasive breast cancer.

To develop and validate radiomic models for preoperative prediction of intraductal component in invasive breast cancer (IBC-IC) using the intratumoral and peritumoral features derived from dynamic contrast-enhanced MRI (DCE-MRI). The prediction models were developed in a primary cohort of 183 consecutive patients from September 2017 to December 2018, consisting of 45 IBC-IC and 138 invasive breast cancers (IBC). The validation cohort of 111 patients (27 IBC-IC and 84 IBC) from February 2019 to January 2020 was enrolled to test the prediction models. A total of 208 radiomic features were extracted from the intratumoral and peritumoral regions of MRI-visible tumors. Then the radiomic features were selected and combined with clinical characteristics to construct predicting models using the least absolute shrinkage and selection operator. The area under the curve (AUC) of receiver operating characteristic, sensitivity, and specificity were used to evaluate the performance of radiomic models. Four radiomic models for prediction of IBC-IC were built including intratumoral radiomic signature, peritumoral radiomic signature, peritumoral radiomic nomogram, and combined intratumoral and peritumoral radiomic signature. The combined intratumoral and peritumoral radiomic signature had the optimal diagnostic performance, with the AUC, sensitivity, and specificity of 0.821 (0.758-0.874), 0.822 (0.680-0.920), and 0.739 (0.658-0.810) in the primary cohort and 0.815 (0.730-0.882), 0.778 (0.577-0.914), and 0.738 (0.631-0.828) in the validation cohort. The radiomic model based on the combined intratumoral and peritumoral features from DCE-MRI showed a good ability to preoperatively predict IBC-IC, which might facilitate the individualized surgical planning for patients with breast cancer before breast-conserving surgery. •·Preoperative prediction of intraductal component in invasive breast cancer is crucial for breast-conserving surgery planning. • Peritumoral radiomic features of invasive breast cancer contain useful information to predict intraductal components. •·Radiomics is a promising non-invasive method to facilitate individualized surgical planning for patients with breast cancer before breast-conserving surgery.

Is Digital Breast Tomosynthesis Superior to Digital Mammography? A Preclinical Evaluation of Tumor Histopathological Markers Using Digital Breast Tomosynthesis

Background: Digital mammography (DM) and digital breast tomosynthesis (DBT) are important radiological modalities, which increase the survival of breast cancer patients. Breast cancer is a morphologically heterogeneous disease with various histopathological parameters and multiple receptors in its biological profile. Objectives: This study aimed to analyze the morphological features of invasive breast cancer on DM and DBT, to investigate the contribution of DBT to DM, to examine the association of DBT findings with pathological molecular subtypes, Bloom-Richardson grade, and Ki-67 index, and to determine the effect of breast parenchyma density on the relationship between DBT findings and hormone receptors. Patients and Methods: A total of 36 patients with malignant lesions were evaluated in this study. According to the American College of Radiology (ACR) classification, the lesion features were divided into subgroups based on DM and DBT, and the findings were compared. The relationships between DBT findings and the hormone receptor status, molecular classification, and Bloom-Richardson grade were also investigated, and the effect of density on these relationships was assessed. Results: The mean age of the patients (n = 36) was 53 years. Based on the comparison of DM and DBT findings, spiculated margins, mass density, architectural distortion, and microcalcifications were significantly more frequent in DBT. Lesions with indistinct margins on DM were observed as mass lesions with spiculated margins on DBT (P &lt; 0.001). Regarding the relationship between DBT findings and hormone receptor status and Ki-67 proliferation index, in progesterone receptor (PR)-positive patients, an irregular tumor shape was more common (89.7%). In PR-negative patients, skin changes and nipple retraction were more frequently seen (P = 0.03 for skin changes, and P = 0.049 for nipple retraction). Regarding the association between Bloom-Richardson grade (BRG) and DBT findings, tumors with a higher grade were more likely to be associated with a high tumor density (P = 0.032). Also, considering the relationship between molecular classification and DBT findings, skin changes and nipple retraction were significantly more frequent in triple-negative masses compared to other subtypes (P = 0.011 for skin changes and P = 0.016 for nipple retraction). Conclusion: DBT is superior to DM, as it reveals the lesion margins, density, and architectural distortion more accurately. The majority of PR-positive tumors were irregular, while most PR-negative cases were round. The mass density also increased as the tumor grade increased. Skin change and nipple retraction were frequently seen in triple-negative tumors compared to other subtypes. Therefore, DBT is a promising diagnostic tool for showing molecular subtypes in dense breasts.

Breast Cancer in Jamaica: Stage, Grade and Molecular Subtype Distributions Across Age Blocks, the Implications for Screening and Treatment.

BackgroundBreast cancer is the most commonly diagnosed and leading cause of cancer-related morbidity and mortality in females worldwide. Significant disparities exist in breast cancer incidence and mortalities between low- to middle- and high-income countries. The purpose of this study was to analyze the distribution of prognostic and predictive clinicopathological features of invasive breast cancer at a single institution in Jamaica across three age groups.MethodsData from patients diagnosed with invasive breast cancer who underwent definitive surgery between August 2017 and September 2018 were identified. The patients were divided into three age groups (< 50, 50 - 59 and > 59 years) and the distribution of tumor size, grade, molecular subtype, nodal status and anatomic stage were determined and compared with the US population registry. Comparisons of the various characteristics were performed using the Fisher’s exact test.ResultsNinety-nine definitive operations were performed and met the criteria for analysis. Average age at the time of diagnosis was 54 years compared to 62 years reported in the US databases. Thirty-six percent of the patients presented below age 50 years, which was twice the corresponding rate reported for Caucasian females (18%) in the USA. Fifty percent of patients in our registry had axillary lymph node metastases at presentation and they were younger than patients with negative axillary nodes (95% confidence interval (CI) -12.06 to -1.93, P = 0.007). Patients in the age group less than age 50 years were more likely to have advanced stage, high histological grade cancers compared to the older age blocks (95% CI 0.039 - 0.902, P = 0.033).ConclusionInvasive breast cancer presents at an earlier age in Jamaican women and is associated with poor prognostic features such as high rates of axillary lymph node metastases, high histological grade, advanced stage, triple-negative subtypes and low luminal A subtypes.

Ethnicity and the tumour characteristics of invasive breast cancer in over 116,500 women in England

BackgroundEthnic minority women are commonly reported to have more aggressive breast cancer than White women, but there is little contemporary national evidence available.MethodsWe analysed data from the National Cancer Registration and Analysis Service on women diagnosed with invasive breast cancer during 2013–2018. Multivariable logistic regression yielded adjusted odds ratios (and 95% confidence intervals) of less favourable tumour characteristics (high stage, high grade, ER negative, Her2 positive) by ethnicity (black African, black Caribbean, Indian, Pakistani and white) in younger (30–46 years) and older (53–70 years) women.ResultsIn 24,022 women aged 30–46 at diagnosis, all ethnic minority groups apart from Indian women had a significantly greater odds of certain less favourable tumour characteristics compared to white women in fully adjusted models. In 92,555 women aged 53–70, all ethnic minorities had a significantly greater adjusted odds of several of the less favourable tumour characteristics. These differences were most marked in black African and black Caribbean women.ConclusionsEthnic minority women are at greater risk of breast cancers with less favourable characteristics, even after allowing for age and other potential confounders. These differences are greater in older than younger women, and in the Black rather than South Asian ethnic groups.

Molecular markers, pathology, and ultrasound features of invasive breast cancer

IntroductionUltrasound is commonly used in breast cancer screening and diagnosis. The use of ultrasound features to predict the subtypes of invasive breast cancer is of great clinical significance, since it facilitates a fast and early diagnosis and treatment. The correlation between breast lesion ultrasound features and the breast cancer subtypes requires further investigation. Methods388 patients with invasive breast cancer were retrospectively analyzed by two sonographers. The tumor size, shape, margin, echogenicity, echotexture, posterior echo attenuation microcalcification, and blood vessel density were recorded. The correlation between the tumor ER, PR, HER2, and Ki67 status, the molecular subtypes, and the ultrasound features was analyzed using the chi-square test, Fisher's exact test, and multiple logistic regression. ResultsER and PR positivity were correlated with a low histologic grade, lymph node metastasis, and smaller-sized tumors. A hyperechoic or a mixed echogenicity was rare in the tumors of all groups but was enriched in the ER and PR tumors (9.57% and 7.64%, respectively, p < 0.01). A high percentage of posterior echo attenuation was found in the Ki67 low (53.94%) and ER+ (51.28%) tumors. Furthermore, heterogeneous and microcalcifications were enriched in HER2-positive tumors. In terms of the molecular subtypes, the luminal A subtype group had the lowest lymph node positivity and the smallest primary tumor size. The luminal B subtype had the lowest percentage of hyperechoic or mixed tumors. The HER2 subtype was positively correlated with microcalcification. Finally, TNBC showed the highest percentage of hyperechoic or mixed tumors and the lowest percentage of posterior echo attenuation and microcalcification. ConclusionTumor pathologic and ultrasound features were correlated with invasive breast tumor molecular marker positivity and its molecular subtypes.

Mammographic breast density and characteristics of invasive breast cancer

IntroductionInconclusive data exist on the association between breast density and breast cancer characteristics. Materials and methodsWe conducted a case-only study on 667 invasive breast cancers, using data from the Piedmont Cancer Registry. We applied a multivariate logistic regression model to estimate odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of high breast density (Breast Imaging Reporting and Data System, BI-RADS 3−4) versus low (BI-RADS 1−2) in relation to histologic grade, pathological tumour size and lymph node status, histotype, estrogen and progesterone receptor, HER2 and Ki67 status. Histopathological data were assessed according to the American Joint Committee on Cancer (AJCC) Staging Manual guidelines. The model includes terms for age at diagnosis, education level, body mass index, reproductive factors, family history of breast cancer, smoking and diabetes. ResultsAs regards histologic grade, compared to well differentiated tumours, the OR of high (versus low) breast density cases was 0.61 (95% CI 0.38−0.98) for moderately-poorly differentiated tumours. No other associations with hormonal and histopathological characteristics were observed. DiscussionOur results indicate that low breast density is associated with moderately-poorly differentiated breast tumours.

Associations between the ultrasound features of invasive breast cancer and breast cancer specific survival

To assess whether ultrasound features of breast cancer are associated with breast cancer specific survival (BCSS). Within a single breast service, data was collected prospectively (April 2010-April 2012) from 319 consecutive women (mean age 63 years) with 335 ultrasound-visible invasive breast cancers. Ultrasound features were evaluated retrospectively from the recorded images according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon by a radiologist blinded to outcomes. Survival and cause of death were ascertained from local and national sources. Kaplan-Meier survival curves were generated, and statistical significance tested using the log-rank test. Mean follow-up in those alive was 80.9 months. Thirty breast cancer deaths and 45 non-breast cancer deaths occurred. Five-year BCSS in the presence of distal acoustic enhancement was 76% compared to 88%, 96%, and 100% for those with distal shadowing, no distal effect or combined effect respectively (p<0.0002). Patients with sonographic skin involvement had 73% 5-year BCSS compared to 92% for no skin involvement (p<0.0001). Focal oedema was associated with 56% 5-year BCSS compared to 89% for those without (p=0.0002). A significant association was demonstrated between ultrasound tumour size and BCSS (p<0.0001). At multivariate analysis, skin changes, distal enhancement, and focal oedema maintained prognostic significance. Distal enhancement, focal oedema, and skin involvement have strong associations with breast cancer death. These factors could be taken into account, along with lesion size and other commonly used preoperative prognostic features, when considering management of women with breast cancer.

Characterization and imaging of surgical specimens of invasive breast cancer and normal breast tissues with the application of Raman spectral mapping: A feasibility study and comparison with randomized single-point detection method.

A mapping technique was used in the present study to explore the biological and imaging characteristics of invasive breast cancer and normal breast tissues in Raman examination data and construct a diagnostic model for breast cancer. Raman examination data reflect the biochemical or molecular characteristics of the target tissues. A total of 45 specimens from patients with breast cancer who underwent surgery and 25 adjacent normal breast tissue specimens were included in the present study. Using the specimens, a total of 53 sets of mapping data and 2,597 pieces of Raman spectral data were obtained. The collected spectra were corrected and fitted, the Raman spectra were analyzed by robust statistical methods, and a diagnostic model was constructed using the k-Nearest Neighbor (KNN) method. The KNN classification method was applied to analyze the characteristics of the mapping test application. The percentage of outliers in the mapping data for malignant and normal breast tissues was 12.7 and 6.6%, respectively. The percentage of outlier data in the conventional single-point detection data for malignant and normal breast tissues was 24.5 and 26.0%, respectively. Analysis using a t-test identified a significant difference in the number of outliers between mapping and single-point detection for malignant (t=−6.169; P<0.001) and normal breast tissues (t=−8.873; P<0.001). Based on the mapping data, the accuracy, sensitivity and specificity for breast cancer detection by the diagnostic model constructed using the KNN method was 99.56, 96.6 and 98.48%, respectively. The positive and negative predictive value of this model was 99.56 and 89.04%, respectively. The data obtained by mapping technology demonstrated improved stability and contained less outliers compared with single-point detection. The diagnostic model constructed using the mapping data demonstrated excellent diagnostic performance and good correspondence with pathological results. The findings of the present study demonstrated the feasibility of the application of the diagnostic model for intraoperative real-time imaging for patients with breast cancer. This study provided the foundation of Raman spectroscopy-based diagnostic imaging at the molecular level.

Clinicopathologic features of invasive breast cancer (BC) diagnosed in carriers of germline PALB2, CHEK2 and ATM pathogenic variants.

1549 Background: While germline pathogenic variants (PVs) in BRCA1/2 account for a large proportion of hereditary breast cancer (BC), PVs in PALB2, CHEK2 and ATM are increasingly detected. However, the phenotype and clinical features of invasive BC with these PVs have not been fully described. Methods: We identified patients with a PV or likely PV in PALB2, CHEK2 or ATM tested clinically at Stanford between 2014 - 2019 who provided informed consent to be included in a prospective cancer genetics registry. Data on baseline demographics, genetic testing history, and clinicopathologic features of diagnosed BC were collected. For patients with a subsequent diagnosis of metastatic BC, we calculated disease-free interval (DFI). Results: 130 patients met inclusion criteria for analysis: ATM (N=39), CHEK2 (N=58), PALB2 (N=33). Nearly all (98.5%) were women, with 2 male BC in ATM carriers. Non-Hispanic White ethnicity was most common in ATM (64.1%, 95% CI 48.4%-77.3%) and CHEK2 carriers (69.0%, 95% CI 56.1%-79.4%), but comprised only 39.4% (95% CI 24.7%-56.4%) in PALB2 carriers. Asian/Pacific Islander (24.2%, 95% CI 12.6%-41.3%) and Hispanic (30.3%, 95% CI 17.3%-47.5%) ethnicities were enriched among PALB2 mutation carriers. In total, 97.7% learned of their PV status only after a preceding diagnosis of BC and 43.1% were diagnosed with BC at age ≤ 45. Data regarding invasive BC subtypes, incidence of subsequent primary BC, and metastatic recurrence are listed below in the table. Additional data on stage, grade and sites of metastatic spread will be presented. Conclusions: We observed clinically important differences in the spectrum of BC subtypes among carriers of ATM, CHEK2 and PALB2 PVs, in addition to racial/ethnic differences with Asian/Pacific Islander and Hispanic ethnicity enriched among carriers of PALB2 PVs. [Table: see text]

Characteristics of Invasive Breast Cancer Detected by Digital Breast Tomosynthesis on Screening and Diagnostic Mammograms.

To determine whether there is added benefit for 3D mammography in the context of screening and diagnostic imaging, particularly relating to known prognostic characteristics, including histopathology, receptor status, and axillary lymph node involvement. An institutional review board-approved retrospective review was performed of our mammography and pathology databases from October 2012 to May 2015 to identify biopsy-proven invasive breast carcinoma detected on screening and diagnostic mammograms by 2D plus 3D (2D + 3D) imaging. Percentages of cancer detection by 2D and 3D were compared. Correlation with histopathology and lymph node status was analyzed. Of 53 cancers diagnosed on 12 543 screening mammograms, 36 (67.9%) were better visualized on 3D (not visualized, equivocal, or only seen in retrospect on 2D). Of the 62 cancers diagnosed on 4090 diagnostic mammograms, 24 (38.7%) cancers were better detected on 3D. A statistically significant greater number of cancers were better detected on 3D in the screening compared to the diagnostic mammograms (67.9% vs 38.7%, P < .05). A significantly higher frequency of less aggressive tumors (grade I and grade II, positive estrogen/progesterone receptor, Her2 negative) was detected by 3D, with higher significance in the screening population. Additionally, there was a higher frequency of positive axillary lymph nodes in cancers detected by 3D in the screening group. Three-dimension increases invasive breast cancer detection, particularly pathologically less aggressive tumors, in both screening and diagnostic mammograms with more benefit for the screening population. Three-dimensional mammography detected more breast cancer associated with metastatic axillary lymph nodes in the screening population.

Pathology of Senegalese breast cancers.

IntroductionBreast cancer is among the most common cancers among women in most of Africa. However, features of histologically confirmed breast cancers presenting in specific regional populations is limited. Our study describes the clinic-pathologic features of invasive breast cancer diagnosed in women undergoing biopsy for a clinically apparent mass in Senegal, West Africa.MethodsA prospective cohort of 522 Senegalese women presenting consecutively to Dantec Hospital (University of Dakar Tumor Institute) with a breast mass were included in the study cohort. Demographic data was collected by survey and 197 (37.7%) core needle biopsy-confirmed invasive breast cancers available for review were subsequently centrally reviewed at the University of Washington in Seattle to further to characterize the pathologic features and to perform immunohistochemistry for ER/PR and HER2.ResultsSeventy six (76.1%) of the 522 Senegalese women presenting for biopsy of a clinically apparent breast mass were diagnosed with invasive breast cancer. The average age of a woman with invasive cancer was 46 years old, and most (83%) presented with Stage III or IV disease. The predominant histologic subtype among the 197 biopsy-confirmed cancers was invasive ductal carcinoma (98%), with few cases of invasive lobular carcinoma (2%). Cancers were classified into four clinically relevant treatment IHC groups by combined ER/PR status and HER2 status as follows: ER-/PR-, HER2- (n=92; 46.7%), ER-/PR-, HER2+ (n=20; 10.1%), ER+/PR+, HER2- (n=76; 38.6%) and ER+/PR+, HER2+ (n=9; 4.6%). Age at time of diagnosis was similar between these four subgroups although more HER2 positive cases were pre-menopausal (p=0.05). Stage of disease at presentation differed by IHC group (p=0.008), with HER2+ cancers significantly more likely to present with stage IV disease than other IHC groups, including ER-/PR-, HER2-. There were no significant differences between groups by age group, ethnicity, place of residence or birth, or parity.ConclusionOur analysis of breast cancer cases in Senegal shows a distribution of clinically relevant IHC groups like that seen in the few prior studies of breast cancer in West Africa, with higher frequencies of triple negative cancers than in most United States and European populations. Mean age at presentation, delayed presentation, and genetic/regional risk factors likely influence these differences. A better understanding of the frequencies of the pathologic features of breast cancers in the West African population may help guide future genetic studies as well as appropriate clinical management of breast cancer in these populations.

Kinetic Features of Invasive Breast Cancers on Computer-Aided Diagnosis Using 3T MRI Data: Correlation with Clinical and Pathologic Prognostic Factors.

ObjectiveTo investigate the correlation of kinetic features of breast cancers on computer-aided diagnosis (CAD) of preoperative 3T magnetic resonance imaging (MRI) data and clinical-pathologic factors in breast cancer patients.Materials and MethodsBetween July 2016 and March 2017, 85 patients (mean age, 54 years; age range, 35–81 years) with invasive breast cancers (mean, 1.8 cm; range, 0.8–4.8 cm) who had undergone MRI and surgery were retrospectively enrolled. All magnetic resonance images were processed using CAD, and kinetic features of tumors were acquired. The relationships between kinetic features and clinical-pathologic factors were assessed using Spearman correlation test and binary logistic regression analysis.ResultsPeak enhancement and angio-volume were significantly correlated with histologic grade, Ki-67 index, and tumor size: r = 0.355 (p = 0.001), r = 0.330 (p = 0.002), and r = 0.231 (p = 0.033) for peak enhancement, r = 0.410 (p = 0.005), r = 0.341 (p < 0.001), and r = 0.505 (p < 0.001) for angio-volume. Delayed-plateau component was correlated with Ki-67 (r = 0.255 [p = 0.019]). In regression analysis, higher peak enhancement was associated with higher histologic grade (odds ratio [OR] = 1.004; 95% confidence interval [CI]: 1.001–1.008; p = 0.024), and higher delayed-plateau component and angio-volume were associated with higher Ki-67 (OR = 1.051; 95% CI: 1.011–1.094; p = 0.013 for delayed-plateau component, OR = 1.178; 95% CI: 1.023–1.356; p = 0.023 for angio-volume).ConclusionOf the CAD-assessed kinetic features, higher peak enhancement may correlate with higher histologic grade, and higher delayed-plateau component and angio-volume correlate with higher Ki-67 index. These results support the clinical application of kinetic features in prognosis assessment.

Morphological MR features and quantitative ADC evaluation in invasive breast cancer: Correlation with prognostic factors

ObjectiveAssess the correlation between MRI characteristics of invasive breast cancer and tumor prognostic features. Materials and methods95 women with invasive breast cancer underwent pre-treatment MR. Morphological findings and quantitative ADC were retrospectively evaluated. ResultsSmaller size, round shape, spiculated margins and homogeneous internal enhancement pattern on dynamic MRI were independently associated with established predictors of good prognosis, while larger size and rim enhancement pattern were related to predictors of poor prognosis. A positive correlation was observed between ADC value and clinical stage. ConclusionsMRI may be a useful tool for breast cancer aggressiveness prediction and for guiding subsequent clinical-therapeutic management.

Characteristics of invasive breast cancer and overall survival of patients eligible for mass breast cancer screening in Guadeloupe compared to those of the preceding age group

BackgroundMass breast cancer screening is offered to French women between the ages of 50 and 74. In the French overseas department of Guadeloupe, where the population is of mostly African ancestry, a low age at diagnosis of breast cancer has been reported, as for African-Americans. This raises the question of whether breast cancer is more aggressive in the age group preceding that eligible for mass screening (40–49) in Guadeloupe. MethodsWe compared the tumor-related prognostic factors, first line therapy and overall survival rates of breast cancer cases diagnosed between the 40–49 and 50–74 age groups, based on reports of the cancer registry of Guadeloupe for the period 2008–2013. ResultsThe characteristics studied, risk of death after breast cancer (HR 0.84 [95% CI: 0.58-1.22] and overall survival, did not differ significantly between the two groups, except for higher tumor size (28.8 vs 24.0; p=0.004) in the younger group. ConclusionThese results do not show a pattern of more aggressive breast cancer in the age group preceding that eligible for mass screening in Guadeloupe.

Biologic Profiles of Invasive Breast Cancers Detected Only With Digital Breast Tomosynthesis.

The purpose of this study was to analyze the clinicopathologic and immunohistochemical features of invasive breast cancers detected only with digital breast tomosynthesis (DBT), compared with those of cancers detected with both DBT and full-field digital mammography (FFDM). The medical records of 261 women (108 without and 153 with symptoms) with invasive breast cancers who underwent FFDM and DBT between April 2015 and June 2016 were retrospectively reviewed. To assess detectability, all DBT and FFDM images were reviewed independently by three radiologists blinded to clinicopathologic information. The reference standard was established by an unblinded consensus review of all images. Clinicopathologic and immunohistochemical features were analyzed according to the detectability status. Of the 261 cancers, 223 (85.4%) were detected with both DBT and FFDM (both-detected group). Twenty-four cancers (9.2%) not detected with FFDM (DBT-only group) were classified by DBT as a mass (58.3%), architectural distortion (33.3%), or asymmetry (8.3%). The remaining 14 cancers (5.4%) were not detected with either DBT or FFDM (both-occult group). On multivariate analysis, a dense breast parenchyma (p = 0.007), small tumor size (≤ 2 cm; p = 0.027), and luminal A-like subtype (estrogen receptor positive or progesterone receptor positive or both, human epidermal growth factor receptor 2 negative, and Ki-67 expression < 14%; p = 0.008) were significantly associated with the DBT-only group. For 108 screening-detected cancers, a dense breast parenchyma (p = 0.007) and luminal A-like subtype (p = 0.008) also maintained significance. The addition of DBT to FFDM in screening would aid in the detection of less-aggressive subtypes of invasive breast cancers in women with dense breasts.

Relationship between peritumoral lymphatic microvessel density and the clinical and pathological characteristics of invasive breast cancer

Abstract Objective The aim of the study was to determine the morphological characteristics of lymphatic microvessels and the relationship between lymphatic microvessel density (LMVD) and clinical and pathological characteristics of invasive breast cancer. Methods Tissue specimens and clinical pathological data of 51 cases of female breast cancer were collected in the General Hospital of Shenyang Military Region (Shenyang, China) from January 2007 to October 2011. Another 20 breast fibroadenoma tissue samples were used as controls. All specimens were cut into 4-μm slices, and immunohistochemically stained using streptomycin-resistant avidin peroxidase antibody D2-40. SPSS 17.0 for Windows was used to perform all analyses. Results A total of 38 breast cancer tissue specimens showed varied staining with monoclonal antibody D2-40. The rate of positive staining was in these tissues was 74.5% (38/51), which is significantly higher than that observed in breast fibroadenoma tissues (chi-square = 35.197, P = 0.000). The average LMVD in 38 cases of breast cancer was (26.46 ± 10.06) microvessels/100× magnification field, which was higher than that in the control group (t = 10.74, P = 0.000). Microvessels in peritumoral tissues were abundant, with an average LMVD of (38.42 ± 11.38) microvessels/100× magnification field. Based on layered analysis, the expression level of peritumoral LMVD was correlated with metastasis of lymph nodes, tumor size, and the expression of C-erbB-2 (P &lt; 0.05); however, there was no correlation with age or expression of estrogen receptors or progesterone receptors (P &gt; 0.05). Conclusion Lymphatic microvessels detected using D2-40 antibody are mainly present in the peritumoral region of breast cancer tissues, and LMVD showed a correlation with lymph node metastasis and the expression of C-erbB-2. Positive lymphatic vessels, especially in the peritumoral region, may provide a path for lymphatic metastasis in breast cancer. Peritumoral LMVD may be used to estimate the prognosis of patients with breast cancer and may aid in research on treatment methods.