Histological Types Of Breast Cancer Research Articles

METAPLASTIC CARCINOMA BREAST: A CASE SERIES

Introduction: Metaplastic breast carcinoma is a distinct histological type of breast cancer and comprises of two components ofboth epithelial & mesenchymal type in a single tumor. It includes adenosquamous, squamous cell carcinoma (SCC), spindle cell carcinoma, metaplastic carcinoma with mesenchymal differentiation, mixed carcinoma and myoepithelial carcinoma. Materials and Methods: The study comprises of 5 cases of Metaplastic Breast carcinoma and was conducted in the Department of Pathology in Western part of India. Discussion: MBC is characterized by adenocarcinoma admixed with spindle cells, squamous cells and mesenchymal differentiation. Among the five cases in the present series, two cases showed lymph nodes metastasis. Commonlyimmunohistochemistry (IHC) markers in cases of MBC shows triple negative for estrogen receptor (ER), progesterone receptor (PR) and HER2-neu. Conclusion: The MBC has a poor prognosis and have a diverse clinical behavior, variable histology and different regime of treatment.

Meme Kanserine Bağlı Beyin Metastazlarında Difüzyon Ağırlıklı Görüntüleme ile Histopatolojik Tip Arasında Bir İlişki Var mı?

Aim: The aim of this study is to evaluate the relationship between diffusion-weighted imaging (DWI) properties and apparent diffusion coefficient (ADC) values of metastases with the histological type of breast cancer in patients with breast cancer-related brain metastasis.
 Material and Methods: Between May 2008 - April 2011, 57 female patients who had been previously diagnosed with breast cancer in the radiology clinic were included in the study. Cases with invasive ductal carcinoma were considered group 1 (46 patients, 89 lesions) and cases with invasive lobular, comedo carcinoma and papillary cribriform carcinoma were considered group 2 ( 11 patients, 25 lesions). ADC values in both groups were compared by statistical analysis methods.
 Results: In group 1; 37 lesions (41.57%) and in group 2; 13 lesions (52%) included cystic component. In the group of invasive ductal carcinoma 48 lesions (53.92%) and 18 lesions (72%) of second group included peritumoral edema. The mean ADC value of the solid component of metastases (group1: 1.105x10-3mm2/ s, group2: 1.099x10-3mm2/ s) was higher than the average ADC value of normal brain parenchyma (group1: 0.790x10-3mm2/s, group2: 0.801x10-3mm2/s), and was statistically significant (p

The accuracy of core needle biopsy in determining histological type and Scarf-Bloom-Richardson grade in invasive breast cancer

Core needle biopsy provides information not only on the histological diagnosis but also about tumor grade and different prognosis factors for breast cancer. This study was designed to determine the accuracy of percutaneous core needle biopsy (CNB) through comparative analysis of histological diagnosis and SBR tumor grade of invasive breast cancer between CNB and surgical excision specimen (SES). This was a retrospective cross-sectional study from January 2023 to July 2023. All patients with invasive breast cancer diagnosed by CNB and confirmed by surgical excision specimen (SES) examination were included in the study. Patients who received neoadjuvant chemotherapy were excluded. One twenty-three patients were assessed. All patients were female. The median age was 45 years (37 – 54). Invasive ductal carcinoma (IDC) was the major histological type of breast cancer (95.1%) followed by invasive lobular carcinoma (ILC) (4.9%). SBR grade 2 tumors accounted for 78.1% of cases. The majority of patients presented with locally advanced stage breast cancer (65.9%) or a metastatic disease (31.7%). Concordance for histological type was substantial (k= 0.79; p<0,001) whereas it was moderate (k= 0.45; p<0,001) for Scarf-Bloom-Richardson grade. Histological type on CNB correlates almost perfectly with that of the surgical excisional specimen in case of breast cancer. Nevertheless, the agreement of tumor grade between CNB and SES remains moderate, with a significant underestimation and overestimation rates.

Spindle Cell Carcinoma of the Breast in a Patient with Previous History of Rectal Cancer: A Case Report

Abstract Background Spindle cell carcinoma of the breast is a very rare subtype of metaplastic breast cancer with aggressive behaviour in comparison with invasive ductal carcinoma, which is the most common histological type of breast cancer. It has a poor prognosis and a controversial response to systemic therapy. Aim of this study The aim of this study is to shed light on this uncommon but aggressive type of breast cancer. Case Presentation In this case report, we present a 56-year-old woman with spindle cell carcinoma of the breast with a previous history of treated rectal cancer. She presented with a left breast mass. Ultrasound-guided fine needle aspiration gave results positive for malignancy. A left mastectomy with axillary clearance was done, and the histopathology was spindle cell carcinoma of the breast. The patient refused chemotherapy until five months post-operation when she presented with local recurrence of two small masses at the site of mastectomy. New imaging revealed bilateral pulmonary metastasis. She started on single agent Adriamycin and received a total of six cycles. A CT scan of the chest and abdomen with contrast revealed disease progression. Imaging of the brain showed brain metastasis. The patient refused any kind of further chemotherapy or radiotherapy treatment until she passed away one month later from aspiration pneumonia and its complications. Conclusion Metaplastic breast cancer is an aggressive subtype of breast cancer with rapid progression, a high tendency for distant metastases, a poor response to treatment, and a short survival time.

THU495 Glutamate Metabolic Enzymes GLUD1/2 And GPX4 Are Associated with Tumor Size In Black Women With Invasive Lobular Breast Cancer

Abstract Disclosure: T. Young: None. T.C. Abalum: None. N. Hodgins: None. S. Persaud: None. A.I. Fernandez: None. A.O. Olukoya: None. A.M. Rozeboom: None. R.B. Riggins: None. Background and Objective: Invasive Lobular Breast Cancer (ILC) is a special histologic type of breast cancer with unique genetic and biological features. ILC may be less dependent on glucose metabolism than the more common histologic type, invasive ductal breast cancer (IDC), instead relying more on lipid and amino acid metabolism. Our lab has previously published that expression of metabotropic glutamate receptors is increased in more rapidly growing and therapy-resistant cell line models of ILC. We hypothesized that increased expression of glutamate transporters and regulatory enzymes is associated with poor prognostic features. Methods and Analysis: We used multispectral immunohistochemical staining to measure the expression of four functionally related proteins: CD98, GLUD1/2, GPX4, and SLC7A11 in a cohort of 72 women with ILC (23.5% Black, 64.7% White, 11.8% Other). The cohort was in a two-fold redundant tissue microarray (TMA) format comprised of primary tumors collected by the Georgetown University Histopathology and Tissue Shared Resource. SLC7A11 and CD98 form a heterodimer that exports glutamate from, and imports cystine to, the cell. GLUD1/2 are two isoenzymes that convert glutamate into α-ketoglutarate to replenish the TCA cycle, or recycle ammonia to support amino acid synthesis. GPX4 is an enzyme that protects cells from lipid peroxidation-induced death. We compared expression of these proteins with clinical, pathological, and demographic variables (overall survival, hormone receptor expression, tumor size, race, age) using t test/ANOVA, Kaplan-Meier survival analysis, and linear regression. Results: In the 68 evaluable cases, the percentage of ILC tumor cells stained positive for GLUD1/2 and GPX4 was significantly higher than for CD98 or SLC7A11 (P<0.001), so further analyses focused on these. Women with a combination of high (above median) GLUD1/2+ (>49%) and GPX4+ (>54%) expression had a trend toward decreased survival (Hazard Ratio, HR 3.53, P=0.159). GPX4, GLUD1/2, and estrogen receptor (ER) expression were associated with tumor size in the entire cohort (R2 = 0.124, P = 0.041), but this relationship was markedly stronger in Black women (R2 = 0.487, P = 0.040). In univariate analyses, GLUD1/2 (R2 = 0.43, P<0.01) and GPX4 (R2 = 0.27, P<0.05) expression were each associated with tumor size in Black women, but not in the entire cohort. GPX4 expression and tumor size were both significantly higher (P<0.05) in Black women over 60 years of age, compared to those under 60. Conclusion: GLUD1/2 and GPX4 expression may be prognostic in ILC, as our results show that tumor size increases with higher expression of these proteins (especially among Black women). Limitations of this study include small sample size and lack of an independent cohort for validation. Future studies will include analysis of these proteins in a TMA comprised of tissue from women with IDC. Presentation: Thursday, June 15, 2023

Clinical significance of MMP-2 and MMP-9 levels as potential biomarkers in patients with breast cancer in Maiduguri – Nigeria

Breast cancer (BC) is a significant public health challenge globally, affecting women of all races and ages. In Nigeria and Sub-Saharan Africa, BC is the most common cancer among women, with high mortality rates. In BC, a number of MMPs are overexpressed thereby causing tissue disruption and making tumour cell’s capable of invasion and metastasis. IDCA, ILCA and MCA are histological types of BCs that were seen in this study, they are classified into grade 1, 2 and 3 tumours. This present study investigated the expression of Matrix Metalloproteinases -2 and -9 in formalin fixed tissues from BC patients and correlated with some clinico-pathological parameters. Thirty-four (34) BC samples were analysed for the expression of the MMP-2 and -9 genes using real-time qPCR. The data analyses were performed using SPSS. The real-time qPCR results indicated that there was downregulation of MMP-2 in grade -2 cancer samples and upregulation of MMP-9 in both grade-2 and -3 samples when compared to normal breast tissues. MMP-2 and -9 were expressed in all the histological types we found during this study (IDCA – 78.1%, ILCA – 12.5% and MCA – 9.4%). Therefore, this differential regulation of MMP – 2 found during our studies on BC tissues can be an indication of their roles in tumour invasion, also the overexpression of MMP-9 in higher grades might be an indicator in tumour invasion and metastasis. Thus, MMP-2 and -9 are of immense significance to be considered and used as drug targets and diagnostic markers.

Decoding the mystery of MMTV-like virus and its relationship with breast cancer metastasis

BackgroundMMTV causes mammary tumors in mice, and it is associated with invasive and aggressive forms of breast cancer in humans. However, the underlying mechanisms are yet unknown. We aimed to determine the MMTV-like virus (MMTV-LV) association with histological types of breast cancer, nodal involvement, and metastasis. MethodsFirst, 105 breast cancer biopsies and 15 disease-free biopsies were collected. Details of clinicopathological characteristics were retrieved from patients’ records. The status of MMTV-LV was already known for these biopsy samples. Associations of MMTV-LV prevalence with LNM status and metastatic history were determined. Next, quantitative PCR (qPCR) was used to quantify env gene mRNA in biopsies positive for MMTV-LV. Expression of the env gene was compared against different histopathological types of mammary tumor, LNM status, and metastasis by performing Ordinary One Way ANOVA followed by Tukey’s multiple comparisons test. ResultsMMTV-LV prevalence was found to have no significant association with LNM or metastatic history. As compared to normal control, expression of the env gene was significantly higher (>2.8 folds) in invasive samples (P-value: < 0.01). Expression was also higher (3.28 and 2.89 folds) in patient samples with LNM (P-value: 0.0006) or metastatic history (P-value: < 0.0001), respectively. ConclusionWe conclude that MMTV-LV prevalence is not associated with LNM status or breast cancer metastasis; samples with invasive phenotypes, nodal involvement, and metastasis exhibit significantly higher expression of the MMTV-like env gene.

Crowding phenomenon in breast cancer as a prognostic factor

Purpose: to evaluate the crowding-induced morphological changes in invasive breast carcinoma and compare the data obtained with the parameters of the tumor progression. Material and Methods. The study group included 107 patients (mean age: 57.2 ± 11.2 years) who did not receive neoadjuvant chemotherapy. Breast cancer morphological and immunohistochemical images were studied. The histological type of breast cancer was determined according to WHO recommendations (The WHO Classification of Breast Tumors, 5th Edition, 2019). The study included only cases with invasive breast carcinoma of no specific type. Clinical parameters were assessed using the patients' medical history. Statistical analysis was carried out using the Statistica 10.0 program. A p-value of 0.05 or lower was considered statistically significant. Results. The phenomenon of crowding in breast cancer was shown to be associated with lymph node metastases, with intratumoral heterogeneity of particular importance. The phenomenon of crowding was morphologically confirmed in all cases (n=40) with lymph node metastases in solid tumors. In these solid tumor structures, a decrease in the expression level of the proliferative index Ki67 was observed. In tumor sites with the evidence of crowding phenomenon in solid structures with lymph node metastasis, positive expression of integrin β1 was less frequently observed. Conclusion. Te results obtained suggest that the mechanism that initiates the process of tumor cell invasion may be based on crowding and basal cell extrusion, while the patterns found are a manifestation of changes in cell properties with the acquisition of a higher potential for mobility and cell migration.

Prospective evaluation of pathologic response with neoadjuvant chemo-immunotherapy in metaplastic breast cancer.

606 Background: Metaplastic breast cancer (MpBC) is a rare aggressive histologic type of breast cancer that is often resistant to standard chemotherapy with pathologic complete response (pCR) rates ranging between 2-23%. PDL1 expression has been reported in up to 95% of primary MpBCs suggesting that response rates may be improved with addition of immune checkpoint blockade (ICB). Here we evaluate pCR rates (ypT0/is ypN0) in stage I-III MpBCs receiving neoadjuvant chemo-immunotherapy (NAT). Methods: The Memorial Sloan Kettering Cancer Center Rare Breast Cancer Program (CARE-4-RARE) is a new clinical and translational program dedicated to the study of rare breast cancers. Since the start of the program, 15 patients (pts) with early-stage MpBC have completed treatment with the neoadjuvant KEYNOTE-522 regimen. Wilcoxon rank-sum and Fisher’s exact tests were used to compare characteristics according to pCR status. All statistical tests used a significance level of 5%. Results: Median age at diagnosis was 50 (range, 43-60). All pts were female, 13% self-identified as Asians, 33% as Black and 53% as White. All tumors were poorly differentiated and of triple-negative phenotype, median tumor size was 3.2cm, 80% had stage II disease and 20% were clinically node positive. Metaplastic subtypes included 5 matrix-producing (33%), 3 spindle (20%), 4 squamous (27%), 3 mixed (20%). Of the 15 pts, 4 (27%) achieved a pCR, which suggest the possibility of a higher than expected pCR rate in MpBC with the addition of ICB to chemotherapy. We did not observe a significant difference in clinicopathological features between pCR vs. non-pCR groups. We observed numerical differences in pCR between MpBC subtypes though the p-value was not significant due to limited sample size. Of these 4 pts, 2 had matrix-producing and 2 had mixed subtypes. Two pts with pCR only received Cb+P+Pem. Three pts (20%) experienced PD (squamous n = 2, spindle n = 1) necessitating discontinuation of NAT and expediting surgery. Conclusions: This is the first prospective study to evaluate neoadjuvant ICB in MpBC. These data suggest the possibility of a higher than expected pCR rate in MpBC with the addition of ICB to chemotherapy (27%). This work suggests that neoadjuvant ICB should be considered in MpBC with close monitoring. Notably, 50% of reported pCR in this cohort were in pts who only received Cb+P+Pem. In spite of improved pCR rates, 20% of pts progressed during NAT highlighting the need for better treatment strategies in this treatment-refractory subset of MpBC and close monitoring to allow resection before progression to inoperability. The dichotomy in responses to ICB (super-responsive vs. super-refractory) may suggest the presence of unique biomarkers for immune response in MpBC. By the 2023 ASCO Annual Meeting a total of 26 pts will have completed NAT; we will report updated outcomes along with correlative immune biomarkers (sTIL, PDL1, TMB).

Prevalence and influence of overweight and obesity on clinical and epidemiological profile of breast cancer patients in the North of Mato Grosso, Brazil: a retrospective cross-sectional study

Obesity is one of the main preventable risk factors in post-menopausal breast cancer. This retrospective cross-sectional study aimed to demonstrate the clinical and epidemiological profile of breast cancer patients diagnosed in the period from 2013 to 2018 in the North of Mato Grosso, Brazil and to verify the prevalence and influence of overweight and obesity in these patients. Data were collected from patient’s medical records who were diagnosed with breast carcinoma in the Department of Oncology of Santo Antônio’s Hospital, in Sinop-MT. 196 patients were included. 99.5% were women. The majority were married, ≥50 years old (57.7%) and overweight or obese. In the overweight and obesity group the percentage of patients with invasive breast carcinoma were significantly higher when compared with eutrophic group (p=0.03). In all groups the profile of estrogen and progesterone receptors positive and HER-2 negative were more prevalent, however, the frequency of triple negative profile was higher in the overweight (7.1%) and obesity (6.3%) group when compared with control (4.3%) group, as well as the presence of hypertension and diabetes. In conclusion, it was observed a high prevalence of overweight and obesity in breast cancer patients, which contributed to modify the histological type of breast cancer (high prevalence of invasive and lobular carcinomas), increase the frequency of patients in stages 3 and 4, the percentage of triple negative profile and the frequency of other comorbidities, as hypertension and diabetes. Furthermore, metformin, an antidiabetic drug, seems to be contributing to reduce tumor development and improve the clinical profile and prognosis in diabetic breast cancer patients.

FDG and Non-FDG Radiopharmaceuticals for PET Imaging in Invasive Lobular Breast Carcinoma.

Invasive lobular cancer (ILC) is the second most frequent histological type of breast cancer (BC) and includes a heterogeneous spectrum of diseases with unique characteristics, especially the infiltrative growth pattern and metastatic spread. [18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is extensively used in oncology and BC patient evaluation. Its role in ILCs is considered suboptimal due to its low FDG avidity. Therefore, ILCs could benefit from molecular imaging with non-FDG tracers that target other specific pathways, contributing to precision medicine. This narrative review aims to summarize the current literature on the use of FDG-PET/CT in ILC and to discuss future opportunities given by the development of innovative non-FDG radiotracers.

The Impact of Human Mammary Tumor Virus (HMTV) on the Expression of Epidermal Growth Factor Receptor (EGFR) and Death-Domain Associated Protein (DAXX) in Breast Carcinoma Tissues.

The presence and characteristics of HMTV in Iraqi breast cancer women are still unknown. Furthermore, the identification of HMTV in human breast carcinoma tissue of patients differs by country, and the factors that influence it are still unknown. In many epithelial tumor types, the EGFR and its signaling pathways outcomes are necessary for the behavior of cells and regulating their proliferation, and it has been discovered that DAXX has strong carcinogenic characteristics and could be a new treatment target. This case-control retrospective study investigated the presence of HMTV in paraffin-embedded blocks (FFPT) of tumor samples from 60 Iraqi women patients diagnosed with primary breast cancer and 20 cases of benign tumors as a control group. HMTV env sequences were identified by Real-time PCR. EGFR and DAXX expression were immun0-detected by the immuno-histochemistry technique. HMTV sequences were detected in 15 (25%) samples of malignant breast tumors and 8 (40%) samples of benign breast tumors. There was no statistically significant association between the detection of env sequences of HMTV and age, grade, hormone receptors, EGFR, or DAXX expression compared to clinicopathological characteristics. However, statistically, the data showed a highly significant difference in the Expression of EGFR between study groups, age, and histological types (P=0.0001), and a significant negative association was observed between EGFR and both Her2 and TNBC. There was a statistically significant difference between DAXX (+) and DAXX (-) in study groups (P=0.002), and it was significantly associated with age and histological types of breast cancer (P=0.031 and 0.007, respectively). No significant association was found between DAXX and EGFR, grade, Her2. TNBC of breast cancer. The current study found HMTV env sequences in breast tumors of Iraqi women, suggesting that a larger sample size is needed to illustrate the potential causative role of HMTV in the development of human breast malignancy. Moreover, a negative association was found between HMTV and DAXX and EGFR Expression.

Clinical Characteristics and Prognosis of Metaplastic Breast Cancer Compared with Invasive Ductal Carcinoma: A Propensity-Matched Analysis.

Metaplastic breast cancer (MpBC) is an aggressive histologic type of breast cancer. Although MpBC has a poor prognosis and is responsible for a large proportion of breast cancer mortalities, the clinical features of MpBC compared with invasive ductal carcinoma (IDC) are not well known, and the optimal treatment has not been identified. We retrospectively reviewed medical records of 155 MpBC patients and 16,251 IDC cases who underwent breast cancer surgery in a single institution between January 1994 and December 2019. The two groups were matched 1:4 by age, tumor size, nodal status, hormonal receptor status, and HER2 status using propensity-score matching (PSM). Finally, 120 MpBC patients were matched with 478 IDC patients. Disease-free survival and overall survival of MpBC and IDC patients both before and after PSM were analyzed by Kaplan-Meier survival, and multivariable Cox regression analysis was performed to identify variables affecting long-term prognosis. The most common subtype of MpBC was triple-negative breast cancer, and nuclear and histologic grades were higher than those of IDC. Pathologic nodal staging of the metaplastic group was significantly lower than that of the ductal group, and more frequent adjuvant chemotherapy was performed in the metaplastic group. Multivariable Cox regression analysis indicated that MpBC was an independent prognostic factor for disease-free survival (HR = 2.240; 95% CI, 1.476-3.399, p = 0.0002) and overall survival (HR = 1.969; 95% CI, 1.147-3.382, p = 0.0140). However, survival analysis revealed no significant difference between MpBC and IDC patients in disease-free survival (HR = 1.465; 95% CI, 0.882-2.432, p = 0.1398) or overall survival (hazard ratio (HR) = 1.542; 95% confidential interval (CI), 0.875-2.718, p = 0.1340) after PSM. Although the MpBC histologic type had poor prognostic factors compared with IDC, it can be treated according to the same principles as aggressive IDC.

Correlation of serum CA 15-3 with histological types of breast cancer

Background: The incidence of breast cancer and its fatal effects are constantly on a rise across the globe. Breast cancer is the most common cancer in Pakistan with approximately 1 in every 9 Pakistani women developing breast cancer at some stage of their life. There is a constant search for better screening methods which help in early detection and also reflect upon the prognosis of the tumor. CA 15-3 is a reliable serum marker that also helps in identifying patients who would benefit most from adjuvant therapy. Objective: To determine the correlation of serum CA 15-3 with histological types of breast cancer. Methodology: This prospective cross sectional study was conducted on 51 cases of female carcinoma breast from December 2015 to August 2016. The specimens were collected after mastectomy or lumpectomy and then transported to collection Shaukat Khanum Lab and city lab for chemical analysis and histopathological analysis. All the data was analyzed by using SPSS version 17. Results: In the current study, a total of 51 patients were included. Results of serum CA 15-3 level ranged from 3 to 743.2 U/ml (with mean of 40.62). 

Thr presence of PIK3CA gene mutations and possible implications in breast cancer

Breast cancer is one of the most common types of cancer worldwide, which predominantly affects women. Histology-based classification is one of the most used methods to identify it nowadays. Histologic subtypes include ductal, lobular,mucinous and medullary. The development of breast cancer may be driven by environmental and genetic factos. Mutations in the PIK3CA gene are one of the most common genetic risk factors. There are two main exons, 9 and 20, where the mutation predominantly takes place. To describe the presence of p.E545K, p.E542K and p.H1047R mutations in different histologic types of breast cancer, with the aim that future investigations might find some uses in the clinical setting. A recompilation of data was conducted by the research of specific keywords (PIK3CA mutation, PIKaCA breast cancer prognosis, presence of PIK3CA mutation in breast cancer and different histologic types of breast cancer) in clinical key, google scholar and PubMed databases. PIK3KCA expression is increased in breast cancer compared to notmal tissue. Mutations were more prevalent in lobular breast cancer than other subtypes. Mucinous show the less rate of mutations. Exon 9 mutation were related with early death and exon 20 with goog prognosis. Also, mutations in found between the presence of the mutations and cancer parameter like nodes metastasis but is was demonstrated the importance od the piK3CA mutations in the development of breast cancer, based on histological classification

Breast cancer histology and hormonal status characterization in Libyan patients; a sample from middle region

Background: Breast cancer, has increased in developed and developing countries among females, and in Libya, often diagnosed at advanced stage. This study conducted to evaluate histological features and hormonal status of breast carcinoma in Libyan females. Materials and Methods: This retrospective study was performed at Sirte Oncology Centre, Sirte, Libya. Demographic characteristics, such as age, sex, marital status recorded. Histopathology examination provided the histologic type, grade, tumor size, stage, lymph node status, site of metastasis and hormonal status. Data were obtained and analyzed using SPSS software version18.0. Results: A total of 74 breast cancer patients of which 72 (97.3%) were females and 2 (2.7%) were males. Majority of the cases occurred in the 5th decades. Invasive ductal carcinoma of no specific type was the most commonly diagnosed type of breast carcinoma accounting 95.9% of total cases, invasive lobular, ductal and lobular carcinoma and malignant phylloides were the second most common types. Majority of cases (57.4%) diagnosed with grade III tumors and 60 % of cases were found at advanced invasive and metastatic stage of breast cancer. Most of cases showed positive hormonal receptors (both ER and PR positive) (67.2%) while triple negative (ER, PR, and Her2Neu negative) cases were found to be the rarest group (1.6%). Conclusion: Invasive ductal carcinoma was the most common histological type of breast cancer in Libyan patients, commonly diagnosed with a higher grade and at advanced stage. As hormonal status carries a hope of benefit from hormonal treatment, so our study places the significance of early detection, histo-pathological informations and hormonal status in an appropriate treatment strategy.

Mucinous carcinoma of the breast: distinctive histopathologic and genetic characteristics

Mucinous carcinoma is a rare histologic type of breast cancer that, when classified with favorable histology, can be treated with different therapeutic options. This study reviews the histologic findings of mucinous carcinoma that support or exclude favorable histology and emphasizes the necessity of an appropriate gross examination with radiologic findings for an accurate diagnosis. In addition, unusual findings such as micropapillary arrangements and lobular differentiation in mucinous carcinoma and their implications for prognosis and treatment are reviewed. Mucinous carcinoma involves upregulation of MUC2, a mucus-associated gene common in mucinous carcinoma of the breast as well as various other organs. In mucinous carcinoma, the fraction of genome altered and tumor mutation burden are lower than those of invasive carcinoma of no special type, the most common histology of breast cancer. In addition, the genetic alterations found in mucinous carcinoma are diverse, unlike the pathognomonic genetic alterations observed in other histologic types of breast cancer. These genetic features support the importance of conventional microscopic evaluations for the pathologic differential diagnosis of mucinous carcinoma of the breast in routine practice. A variety of breast lesions, including mucinous cystadenocarcinoma and mucocele-like lesions, as well as mucinous carcinoma from other organs, can mimic mucinous carcinoma of the breast. In order to obtain an accurate pathologic diagnosis, careful evaluation of the overall histopathologic characteristics and ancillary testing are required to provide information on appropriate treatment and prognosis.

The association between serum lipid levels and histological type of breast cancer

BackgroundStudies have investigated the association between serum lipids level or apolipoprotein levels and breast cancer (BC) risk. However, the relationship between serum lipids level and apolipoprotein levels and histological type of breast cancer remains unclear. This study was aimed to explore the association between serum lipids level and the histological type of BC, particularly to estrogen receptor (ER) and progesterone receptor (PR) positive BC.Materials and methods220 cases of pathology-confirmed BC were retrospectively collected in this study. Patients’ demographic information, clinical data, and pathological features were obtained from medical records. Serum levels including high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), total cholesterol (TC), triglyceride (TG), apolipoprotein A (ApoA), ApoB, ApoE and lipoprotein a(LP(a)) were collected before treatment. Logistic regression analyses were used to show the association between serum lipids and subtypes of BC. Receiver operating characteristic (ROC) curves were generated to analyze the predictive performance.ResultsThere were 70 ER-negative and 73 PR-negative BC. Patients with ER-negative BC had higher HDL-c, higher LDL-c, and higher LP(a) than those in ER-positive one (p < 0.05). Patients with PR-negative BC were more likely to have high LDL-c and high LP(a) levels than patients with PR-positive one (p < 0.05). Multivariate logistic regression analysis showed that serum HDL-c (odds ratio (OR): 0.27, 95% confidence interval (CI) 0.10–0.76), LDL-c (OR: 0.19, 95%CI 0.04–0.93) and LP(a) (OR: 0.23,95%CI 0.07–0.80) levels were negatively associated with ER-positive BC, and serum HDL-c and LDL-c levels were significantly negatively associated with PR-positive BC (OR: 0.32, 95%CI 0.12–0.82; OR: 0.14, 95%CI 0.03–0.77). In addition, ER and PR positive BC was negatively associated with serum HDL-c and LDL-c levels (OR = 0.39, 95% CI 0.17–0.91; OR = 0.22, 95% CI 0.06–0.85) after adjusting with confounders. Serum HDL-c level (OR = 0.13, 95% CI 0.02–0.87) was still independently associated with ER and PR positive BC in postmenopausal women. The area under the curves (AUCs) of HDL-c to identify ER-positive BC, PR-positive BC, and ER and PR positive BC were 0.65 (95%CI 0.58–0.73, P < 0.01), 0.62 (95%CI 0.54–0.69, P < 0.01) and 0.64 (95%CI 0.56–0.72, P < 0.01), respectively.ConclusionsSerum HDL-c and LDL-c levels were related to ER or PR positive BC. Lipid levels may also have acceptable performance in identifying BC histological type.

Presence of Dendritic Cell Subsets in Sentinel Nodes of Breast Cancer Patients Is Related to Nodal Burden.

BACKGROUND: Sentinel lymph nodes (SLNs) are both the first site where breast cancer (BC) metastases form and where anti-tumoral immunity develops. Despite being the most potent antigen-presenting cells, dendritic cells (DCs) located in a nodal tissue can both promote or suppress immune response against cancer in SLNs. METHODS: In SLNs excisions obtained from 123 invasive BC patients, we performed immunohistochemistry (IHC) for CD1a, CD1c, DC-LAMP, and DC-SIGN to identify different DCs populations. Then we investigated the numbers of DCs subsets in tumor-free, micrometastatic, and macrometastatic SLNs with the use of a light microscope. RESULTS: We observed that CD1c+ and DC-SIGN+ DCs were more numerous in SLNs with a larger tumor size. More abundant intratumoral DC-LAMP+ population was related to a higher number of metastatic lymph nodes. Conversely, more abundant CD1a+ DCs were associated with a decreasing nodal burden in SLNs and a lower number of involved lymph nodes. Moreover, densities of the investigated DC populations differed with respect to tumor grade, HER2 overexpression, hormone receptor status, and histologic type of BC. CONCLUSIONS: According to their subtype, DCs are associated with either lower or higher nodal burden in SLNs from invasive BC patients. These relationships appear to be dependent not only on the maturation state of DCs but also on the histological and biological characteristics of the tumor.

Li\u2013Fraumeni syndrome in Tunisian carriers with different and rare tumor phenotype: genotype\u2013phenotype correlation

BackgroundLi–Fraumeni syndrome (LFS) is a rare autosomal hereditary predisposition to multiples cancers, mainly affecting young individuals. It is characterized by a broad tumor spectrum. To our best knowledge, only one Tunisian study with a confirmed LFS was published.MethodsOur study focused on the clinical, histopathological and genetic results of two patients with rare tumor phenotype and tried to establish genotype–phenotype correlation. The clinical diagnosis was based on Chompret-Bonaiti criteria relative to LFS. Molecular study was assessed using Sanger sequencing of the hotspot germline variants of TP53 gene.ResultsWe report 2 Tunisian families fulfilling the clinical criteria of Chompret-Bonaiti. The tumor phenotype was bilateral breast cancer (BC) in 27-year-old woman and multiple tumors for the second proband, with an onset age of 14, 35 and 36 yo for osteosarcoma, BC and esophageal cancer respectively. Each of them had a rare histological type of breast cancer associated with LFS, phyllode tumor and intralobular carcinoma. Both patients had cancer family history. The molecular study showed deleterious heterozygous germline TP53 variants in each index case: The first had a well-known hotspot missense variation c.742C>T p.(R248W) with a rare histological association, explaining genotype phenotype correlation. The second case had a nonsense variation c.159G>A p.(W53*), rare worldwide, extending the phenotype spectrum in LFS. Immunohistochemistry study in tumor samples confirmed the lack of p53 protein expression.ConclusionsConclusively, germline TP53 testing is primordial in patients with a family history suggestive of LFS for clinical practice avoiding genotoxic treatments and adapting the surveillance. National database in LFS listing clinical and mutational data is important to set, particularly for variants rarely reported worldwide. Experience from different countries must be integrated to harmonize global protocols for cancer surveillance in LFS.