Type Of Invasive Ductal Carcinoma Research Articles

Age and Luminal Type Play Important Role as Therapeutic Policies in the Management of Breast Cancer at Prof. Dr. Margono Soekarjo Regional Hospital Purwokerto

Introduction: Breast cancer (carcinoma mammae) is a malignancy originating from breast tissue, either from its ductal or lobular epithelium. Objective: This study aims to find out the characteristics of Breast Cancer at Margono Soekarjo Hospital in Purwokerto to determine the breast cancer therapy policies. Methods : This study utilized a descriptive retrospective design with the research subjects being patients with carcinoma mammae who underwent anatomical pathology and immunohistochemistry examinations at Prof. Dr. Margono Soekarjo Regional General Hospital from 2020 to 2023. Result: The characteristics age of patients with Carcinoma Mammae are divided into 76 patients (30,9%) between 50-59 years old, followed by the 40-49 age group with 68 patients (27,6%). A total of 178 (72.4%) patients are ductal type, followed by 35 patients (14,2%) are lobular type. A total of 92 patients (37,4%) are grade 2 of Ca Mammae, followed by 83 patients (33,7%) are grade 3. A total of 95 patients (38,6%) are Luminal B sub type, followed by 69 patients (28%) are Her2 Enriched. Conclusion: The majority of breast cancer patient are aged 50 – 59 years with Invasive Ductal Carcinoma type, grade 2 and Luminal B Subtype.

Abstract PO4-05-12: High expression of SLC9A2 is correlation with lymphatic metastasis and poor survival in breast cancer

Abstract Background: SLC9A2 encodes Na+/H+ exchanger 2 which is an essential solute carrier protein on the surface of multiple cells. The prediction potentials of SLC9A2 in lymphatic metastasis and survival were unknow but explored in this study of breast cancer. Methods: Expression of SLC9A2 was determined in breast cancers (n=127) using real time quantitative polymerase chain reaction. Transcript levels of this gene was analysed in the breast cancers for the implication in lymph node involvement and survival using Mann-Whitney test with SPSS (Version 27). The relation of prognosis was also analysed by Kaplan Meier plotter in breast cancer. Results: In lymph node positive breast cancer, the expression of SLC9A2 shown an increase trend than no metastasis (n=43, median=25.9, interquartile range [IQR] [0.9-215.4] vs. n=44, median=4.9, IQR [0.2-31.8], p=0.1213). SLC9A2 expression in TNM stage Ⅱ was significantly higher than stage Ⅰ (n=31, median=42, IQR [0-195] vs. n=47, median=3.3, IQR [0.2- 31.6], p=0.0267) and also showed in the pathological type of invasive ductal carcinoma (n=27, median=42, IQR [3- 550] vs. n=35, median=3.3, IQR [0.2-31.8], p=0.0223). Kaplan Meier plotter showed over survival of SLC9A2 high expression was significantly worse than SLC9A2 low expression (66 months vs. 123.6 months, Hazard Ratio [HR]=1.57 [1.3-1.9], p=0.000), also found in estrogen receptor (ER) positive (63.8 months vs. 173.7 months, HR=2.19 [1.6-3.01], p=0.000). In patients with tamoxifen therapy, SLC9A2 high expression also had poor survival comparing to low expression (HR=2.86 [1.4-5.86], p=0.0026). Conclusions: High expression of SLC9A2 is correlation with lymph node metastasis and poor survival in breast cancer. SLC9A2 could be as a predictor for lymphatic involvement and survival and might be an indicator for detection of resistance to endocrine therapy. Citation Format: Binbin Cong, Xiaoshan Cao, Wen Jiang, Lin Ye. High expression of SLC9A2 is correlation with lymphatic metastasis and poor survival in breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-05-12.

Construction and Validation of a Novel Nomogram for Predicting the Risk of Metastasis in a Luminal B Type Invasive Ductal Carcinoma Population.

Postoperative distant metastasis is the main cause of death in breast cancer patients. We aimed to construct a nomogram to predict the risk of metastasis of luminal B type invasive ductal carcinoma. We applied the data of 364 luminal B type breast cancer patients between 2008 and 2013. Patients were categorized into modeling group and validation group randomly (1:1). The breast cancer metastasis nomogram was developed from the logistic regression model using clinicopathological variables. The area under the receiver-operating characteristic curve (AUC) was calculated in modeling group and validation group to evaluate the predictive accuracy of the nomogram. The multivariate logistic regression analysis showed that tumor size, No. of the positive level 1 axillary lymph nodes, human epidermal growth factor receptor 2 (HER2) status and Ki67 index were the independent predictors of the breast cancer metastasis. The AUC values of the modeling group and the validation group were 0.855 and 0.818, respectively. The nomogram had a well-fitted calibration curve. The positive and negative predictive values were 49.3% and 92.7% in the modeling group, and 47.9% and 91.0% in the validation group. Patients who had a score of 60 or more were thought to have a high risk of breast cancer metastasis. The nomogram has a great predictive accuracy of predicting the risk of breast cancer metastasis. If patients had a score of 60 or more, necessary measures, like more standard treatment methods and higher treatment adherence of patients, are needed to take to lower the risk of metastasis and improve the prognosis.

Clinicopathological features and prognoses of very young patients (≤35 years) with breast cancer: a retrospective population-based study in China.

Clinicopathological features and prognoses of very young patients (≤35 years) with breast cancer: a retrospective population-based study in China.

The impact of chemo-induced menopause on the quality of life of young women with non-metastatic breast cancer in Algeria

Background: Breast cancer is the most common cancer in females worldwide. Young women with breast cancer are treated with chemotherapy, which may exhibit gonadotoxicity thus inducing chemo- induced menopause with a risk of deterioration in their quality of life.
 Method: A prospective study first of its kind in Algeria was carried out on 57 patients aged between 30 and 49 years that went for consultation at the oncology department of Pierre and Marie Curie Medical Centre Algiers. The medical files obtained and criteria of questionnaires: Quality of Life Questionnaire for Breast Cancer (QLQ-BR23) and the Quality of Life Questionnaire-Core 30 (QLQ-C30) were used to assess the quality of life in patients.
 Results: From the medical files, patients had a dominant histological type of invasive ductal carcinoma at 96% and Scarff-Bloom-Richardson (SBR) II grade and luminal B profile were the most frequent. The (QLQ-C30) having averages of global health status, symptom score, and functional score with 56.34, 63.7, and 45.75 respectively. QLQ-BR23 having averages for symptom, functional score of 61.6 and 49.71 respectively.
 Conclusion: Chemotherapy induces gonadotoxicity, which results in chemo-induced menopause that has a negative impact on the quality of life of young women. QLQ-BR23 is more suitable than QLQ-C30 to access the context of this study.

Association of neutrophil-lymphocyte ratio (NLR) with the anthracycline-based neoadjuvant chemotherapy (NAC) clinical response in locally advanced breast cancer (LABC) in young women

Background: Breast cancer in young women is one of the leading causes of cancer death in young women worldwide, including in Indonesia. Most patients come to the hospital at the advanced stage. Neoadjuvant chemotherapy (NAC) is the standard treatment for locally advanced breast cancer. However, half of breast cancer patients had a negative response to therapy. 
 Methods: A retrospective cohort, analytic observational study to determine the association between NLR and anthracycline-based NAC clinical response in locally advanced young age breast cancer in Dr. Soetomo General Hospital, Surabaya.
 Results: We analyze a total of 44 patients. 81.8% had stage IIIB, 93.2% >50 mm tumor size. Most of the cases had invasive ductal carcinoma type (86.4%), grade 3 (52.3%), and Luminal B HER2-negative type (34.1%). 52.3% of patients had a negative clinical response. The mean NLR was 3.07 ± 1.69, with a cut-off value of 2.805. There was no significant association between age, tumor size, histopathological type, grade, and subtype with neoadjuvant chemotherapy clinical response. There was a significant relationship between NLR with anthracycline-based NAC clinical response in locally advanced young age breast cancer (p < 0.001).
 Conclusion: There was a significant relationship between NLR with the anthracycline-based neoadjuvant chemotherapy clinical response in young women with LABC.

Comparison of Estrogen and Progesterone Receptors Status between Cell-Blocks of Fine Needle Aspiration and Tissue-Blocks of Corresponding Mastectomy Specimen in Invasive Ductal Breast Cancer

Background: Breast cancer is one of the common causes of mortality in female population, world-wide. Pakistan has highest incidence among Asian countries. Majority of breast cancers belong to invasive ductal carcinoma type. Estrogen and Progesterone nuclear receptors are important expression tools for molecular categorization of invasive breast carcinoma. Aim: To correlate status of estrogen and progesterone receptor expression between FNA cell-blocks and tissue blocks from mastectomy specimen in invasive ductal carcinoma of female breast. Methods: In current study, carried out at Pathology Department of Niazi Medical and Dental College, Sargodha from August, 2018 to July,2020, 125 cell blocks of FNA and tissue blocks of corresponding mastectomy specimens of invasive ductal breast carcinoma were included. Routine H & E staining protocol was adopted for microscopic diagnosis.24 Estrogen and Progesterone receptor expression was evaluated by immunohistochemistry25. Data was analyzed by using SPSS-20 version. Results: Spearman’s correlation showed a strong positive relationship between status of ER (rs = .959, p<.001) and PR expression (rs = .958, p < .001) observed in fine needle aspirate cell-blocks and in corresponding tissue blocks of mastectomy specimen. Conclusion: The study concluded that as there is concordance in ER and PR expression status, hence, FNA cell-blocks are reliable for planning hormonal treatment strategies instead of tissue blocks in invasive ductal breast carcinoma. Keywords: Estrogen receptor, Progesterone receptor, FNA cell block.

Consommations de tabac et d’alcool chez des femmes traitées pour un cancer du sein dans un service de chirurgie oncologique : des comportements fréquents à considérer

Tobacco and alcohol represent the two most important risk factors increasing cancer incidence and mortality, particularly among women with breast cancer. However, few researches have focused on the consumption of psychoactive substances in women treated for breast cancer. The present study describes the prevalence of tobacco and alcohol consumption and their relationships with the sociodemographic, medical and psychological variables in a population of women receiving surgery treatment for breast cancer. Between October 2014 and August 2015, a group of women receiving breast cancer treatment were recruited to participate to a screening and brief intervention program (SBI) for the consumption of tobacco and alcohol, adapted to the oncology context. Data on tobacco and alcohol consumption were collected using two questionnaires: the smoking status identification (NIDA) and alcohol consumption (AUDIT-C). A questionnaire for socio- demographic data and two for psychological data (Thermometer of psychological distress; ESAS), have been used. The medical data were reported by participants and verified on medical records. In a total of 11 months, 120 women with breast cancer were included in this study. A large majority of patients were hospitalized for a first-time cancer (80.8%), type invasive ductal carcinoma (70.8%) and were receiving surgery as primary treatment (45%). Furthermore, 30.8% of the women reported tobacco consumption and 38.4% high-risk alcohol consumption. Regarding mental health, 40.8% presented moderate to intense levels of psychological distress. No significant relationships were found between consumption scores and sociodemographic, medical or psychological characteristics. Only the patient's age was negatively associated with tobacco consumption. Tobacco and at-risk alcohol consumption are frequently reported behaviors during breast cancer treatment. Intervention strategies targeting risk behaviors related to addictive consumption should be implemented during the full treatment of breast cancer patients.

Concurrent Down-regulation of the EAF1 and the EAF2 Genes in the Invasive Ductal Carcinoma Type of Breast Cancer

In mammals, the EAF1 and EAF2 genes build an active transcription module with other components. These genes code for factors acting as potent inhibitor of the Wnt-β catenin pathway, which might be due to their function as tumor suppressor gene. Recently, the involvement of both above-mentioned factors was described in some human tumors, but not yet in breast cancer. Breast cancer is one of the most cancer cases in Iran after colon and stomach carcinoma. We aimed therefore to investigate for the first time a possible correlation between breast cancer and the EAF1 and the EAF2 gene expression. We collected invasive ductal carcinoma tumor grading (grade 1 to 3) with marginal normal tissue from forty women diagnosed with breast cancer with the average age of 50 years old. All patients underwent triple marker test (ER/PR and Her2/neu), indeed the most of them were triple positive with few triple negative individuals. After RNA extraction, cDNA was synthesized for subsequent real-time polymerase chain reaction. The humanRPL27 gene wasusedas endogenous control. Analysis of real-time PCR results showeda significant down-regulation of EAF1 (p-value: 0.028), and of EAF2 (p-value: 0.0134) in tumor tissue samples in comparison to normal one.There was no correlation between clinical parameters and the target genes. We could find significant connection between both tumor suppressor genes in triple positive and triple negative breast cancer patients, which deserves more attention.

Neoadjuvant targeted therapy for apocrine carcinoma of the breast: A case report

BACKGROUNDApocrine carcinoma of the breast is a special type of invasive ductal carcinoma of the breast that is rare in clinical practice. Neoadjuvant therapy, especially neoadjuvant targeted therapy, has rarely been reported for apocrine carcinoma of the breast.CASE SUMMARYA 63-year-old woman presented with apocrine carcinoma of the left breast underwent core needle biopsy. The patient was diagnosed with apocrine carcinoma by immunohistochemical staining and negative hormone status (estrogen receptor and progesterone receptor) but showed overexpression of human epidermal factor receptor 2 (HER-2). Moreover, positive expression of androgen receptor (approximately 60%) and gross cystic disease fluid protein 15 was observed. The patient was treated with neoadjuvant targeted therapy consisting of the TCH regimen (docetaxel, carboplatin area under curve 6 and trastuzumab) every 21 d. The mass in the left breast was significantly reduced, and pain in the breast and left upper arm also improved.CONCLUSIONHER-2 positive apocrine carcinoma of the breast can be improved by neoadjuvant chemotherapy combined with targeted therapy.

Main Phenotypes and Histological Types of Breast Cancer in Young Women Attended at a Reference Hospital in Women’s Health in the City of São Paulo

It is estimated that there were 198,840 new cases of breast cancer (BC) in Brazil between 2020 and 2022. Young women who are affected by invasive BC with a triple-negative phenotype generally present more aggressive tumors that are intrinsically resistant to targeted therapies. This study evaluated the phenotypic and histological profile of BC in women up to the age of 40 years. Between 2015 and 2017, we identified 255 women with positive biopsy for carcinoma and with immunohistochemical panel, 51.76% who had a profile for luminal B (n = 132); 22.74% for triple-negative (n = 58). Of the samples, 65.88% presented histology as invasive ductal carcinoma – nonspecial type (n = 168). The results are in accordance with the literature regarding the high prevalence of triple-negative BC in young women and histological type invasive ductal carcinoma – nonspecial type.

The Vascular Index of Superb Microvascular Imaging Can Improve the Diagnostic Accuracy for Breast Imaging Reporting and Data System Category 4 Breast Lesions.

PurposeTo investigate whether the vascular index (VI) of superb microvascular imaging (SMI) could improve the diagnostic efficiency for BI-RADS 4 breast lesions and reduce the number of unnecessary biopsies.Patients and MethodsFor this study, we selected 222 consecutive BI-RADS 4 breast lesions detected by ultrasound and confirmed by pathology from January 2016 to October 2018. A VI of 4.0 was set as the cutoff value to degrade BI-RADS classification. We calculated the accuracy, sensitivity and PPV of a BI-RADS diagnosis alone and the combination of BI-RADS and the VI.ResultsPathologically, of the 222 lesions, 129 were confirmed to be benign, and 93 were found to be malignant. A VI of 4.0 was set as the cutoff value; when the VI≤4.0, those BI-RADS 4 masses were downgraded one level (4C-4B, 4B-4A, 4A-3) to an integral BI-RADS grade, while the others maintained the conventional grade. A total of 54 BI-RADS 4 lesions were degraded to BI-RADS 3, including 53 benign lesions and 1 malignant lesion. The diagnostic accuracy (65.3% vs 41.9%) and PPV (54.8% vs 41.9%) were significantly improved. The sensitivity decreased slightly (98.9% vs 100%) because 1 of the 54 downgraded BI-RADS 4 lesions, which had a pathological type of invasive ductal carcinoma, was incorrectly downgraded.ConclusionSMI is a noninvasive tool for visualizing the vascular structure with high-resolution microvascular images. As a quantitative index, the VI can be used to appropriately downgrade benign lesions classified as BI-RADS 4, which can improve the diagnostic accuracy and PPV and reduce unnecessary biopsies.

Histological and molecular classification of breast cancer: what do we know?

Breast cancer is the neoplasm most diagnosed malignancy and the leading cause of mortality among women on a global scale. A profound increase in the understanding and clinical management of breast cancer has occurred over the past two decades, which has led to significant progress in prevention, early detection, and personalized breast cancer therapy. However, the biggest obstacle still faced in clinical practice is the complete understanding of intertumoral and intratumoral heterogeneity, in addition to the mechanisms of multiple drug resistance in the systemic treatment of the disease. In view of this, many studies focus on analyzing morphological and, mainly, molecular patterns of breast cancer, with the purpose of grouping these tumors into classes or entities to assist in clinical management, in the elaboration of epidemiological and functional studies, and in the performance of clinical trials. The most common special histological types of breast cancer include: medullary carcinoma, metaplastic carcinoma, apocrine carcinoma, mucinous carcinoma, cribriform carcinoma, tubular carcinoma, neuroendocrine carcinoma, classic lobular carcinoma, and pleomorphic lobular carcinoma, in addition to the non-specific type of invasive ductal carcinoma, which constitutes the majority of newly diagnosed cases. As to their molecular aspect, intrinsic subtypes were identified based on global studies of gene expression profiles. Today, four molecular subgroups are widely reproduced and well established in the clinical routine, namely: Luminal A, Luminal B, HER2 +, and Triple Negative. Thus, the present article aims to briefly address the histological and molecular classification of breast cancer.

Colonic Metastases from a Luminal A Type Invasive Ductal Carcinoma Breast: A Rare Case Report

AbstractMetastatic carcinoma breast involving hepatobiliary system and peritoneum is a common and well-described entity. However, colonic luminal involvement by breast metastases is rare and its early recognition is important for accurate management planning. We report a case of an elderly woman with luminal A type invasive ductal carcinoma (IDC) breast, initially controlled/stabilized on hormonal treatment and later progressed to involve colon presenting with intestinal obstructive symptoms. Lobular carcinoma breast which constitutes around 10% of breast cancers is more likely to have gastrointestinal tract (GIT) involvement. On the other hand, GIT metastasis from IDC breast is quite rare. Given the progressively increasing survival with current and forthcoming novel treatment modalities, it is very important to recognize and understand unusual presentation of metastatic breast cancer, such as colonic metastasis, for timely treatment planning and implementation.

HER2 Type Male Breast Cancer Successfully Treated with Pertuzumab, Trastuzumab, and Eribulin Therapy: A Case Report

Background: Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases; hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-negative and human epithelial growth factor Receptor type 2-positive breast cancer is extremely low among male breast cancer. A patient with advanced HER2 type breast cancer, a rare male breast cancer, was successfully treated with pertuzumab, trastuzumab, and eribulin therapy. Case Presentation: A 75- year-old man presented to our hospital with induration of the right anterior chest and lymphoedema of the right upper limb. Based on the results of core needle biopsy, he was diagnosed with HER2 type invasive ductal carcinoma associated with bone metastasis (stage IV). Chemotherapy with pertuzumab, trastuzumab, and eribulin was started. The drugs were remarkably effective, and his lymphoedema tended to improve. Conclusion: We reported a successful case of chemotherapy and targeted therapy for a rare male breast cancer of HER2 positive and hormone negative type.

Association Between Delayed Diagnosis Of Breast Cancer And Its Degree Of Invasiveness Among The Patients In Tertiary Care Hospital Of Karachi

Objective: To find the association between delayed diagnosis of breast cancer over the degree of invasiveness for each of the immune-histochmically defined molecular type of invasive ductal carcinoma among the patient in tertiary care hospital of Karachi. Study Design and Setting: A cross sectional study was conducted on 153 post mastectomy patients in a time frame of two years at Bait-ul-Sukoon Hospital who had their immunohistochemistry workup. Methodology: The patients included in the research were diagnosed cases of breast cancer; had post-mastectomy with their histopathological and immunochemistry status work up reports. In addition to demographic variables; the histopathological report of specimen, histological tumor type and grade, invasive tumor size, axillary lymph node status, Paget’s disease and stage of the disease were recorded from the histopathological report however ER, PR and Her 2 neu receptor statuses were confirmed via immunochemistry report. Volume of the tumor was calculated using the following formula V = (W2 × L)/2 Convenient sampling was applied and the data was analyzed on SPSS 20.0 with CI-95% and P=0.05. Results- All 153 patients reported because of unpleasant symptoms.47.1% of the participants presented with LT while the remaining 52.9% were grouped as NLT. The association of molecular type with stage at mastectomy was statistically significant (P=0.015) in the ERG. Her-2 enriched variant shows that there was a moderate positive statistically significant relationship between log of total delay and log of tumor volume +2. Conclusion: Delay in diagnosis due to lack of screening modalities, lesser awareness among low socioeconomic groups and inaccessibility to tertiary care were not the major causes of aggressive tumors at diagnosis in developing countries, instead all the major known risk factors influence to the tumor burden collectively

Gambaran Histopatologi Tumor Ganas Payudara di Laboratorium Patologi Anatomi RSUP M. Djamil Padang Tahun 2017

Background: Malignant breast tumors are a disease where there is overgrowth or uncontrolled development of breast tissue cells. The method of mediating malignant breast tumors up to now which is the gold standard is histopathological examination, which in this examination can determine the type of malignant or benign breast tumors. Histopathological examination of breast tissue is needed as a definitive diagnosis in determining the type of breast malignant tumor and the degree of histopathology. Objective: To determine the histopathological picture of malignant breast tumors at the Pathology Anatomy Laboratory of RSUP. M. Djamil Padang in 2017.Method: This research is a descriptive study with cross sectional design. The sample of this study were 47 people with breast malignant tumors at the Anatomy Pathology Laboratory of Dr. M. Djamil Hospital in 2017 which met the inclusion and exclusion criteria. The research data was obtained from the status of the Pathology Anatomy Laboratory at RSUP.DR.M.Djamil Padang in 2017. Results: The highest frequency of malignant breast tumors in the age group 26-65 years (95.7%), female gender (100%), histopathology type invasive ductal carcinoma (63.8%), histopathological degree (68.1%). Conclusion: The description of the incidence of malignant breast tumors in the laboratory of Dr. M.Djamil Hospital Padang in 2017 mostly occurs at the age of 26-65 years, female, histopathological type of invasive ductal carcinoma, degree II.

Clinical analysis of 21-gene recurrence score test in hormone receptor-positive early-stage breast cancer.

The 21-gene recurrence score (RS) predicts the prognosis of patients with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer and the effectiveness of adding adjuvant chemotherapy on the basis of endocrine therapy to avoid excessive chemotherapy. The present study aimed to analyze clinicopathological characteristics and chemotherapeutic efficacy-related target genes with the 21-gene RS in hormone receptor-positive early-stage breast cancer in China. The prognostic value of chemotherapeutic efficacy-related target genes was also examined. In addition, this study investigated the postoperative adjuvant therapeutic decision-oriented role of 21-gene RS in hormone receptor-positive and lymph node-negative early-stage breast cancer. In the present retrospective study, 110 ER+/HER2− early-stage breast cancer patients were tested with the 21-gene RS. The analyses of clinicopathological characteristics and chemotherapeutic efficacy-related target genes with the 21-gene RS were performed using the χ2 test, the Wilcoxon rank-sum test and binary logistic regression. Kaplan-Meier survival plots were drawn in www.kmplot.com. Furthermore, the McNemar χ2 test was used to compare the changes of treatment decisions before and after the 21-gene test. The median RS of 110 patients was 16 (range, 2–47), and patients were categorized as low (59.1%), intermediate (34.5%) or high risk (6.4%). The results revealed that higher body mass index, invasive ductal carcinoma type, higher histological grade, luminal B molecular type and higher thymidylate synthetase (TYMS) and DNA topoisomerase IIα (TOP2A) gene expression levels were more likely to have a higher RS. Kaplan-Meier plots suggested that expression of TYMS, tubulin β3 class III (TUBB3) and TOP2A genes was significantly associated with relapse-free survival for ER+ breast cancer. Additionally, prior to 21-gene RS testing, 61 patients (55%) were recommended adjuvant chemotherapy and endocrine therapy; however, following 21-gene test, 32 patients (29%) were treated with only adjuvant endocrine therapy. TYMS, TUBB3 and TOP2A gene expression may have prognostic value for ER+ breast cancer. In addition, 21-gene RS testing may aid to avoid excessive postoperative adjuvant chemotherapy.

Correlation of Maximum Standardized Uptake Values in 18F-Fluorodeoxyglucose Positron Emission Tomography-computed Tomography Scan with Immunohistochemistry and Other Prognostic Factors in Breast Cancer.

Objectives:The objective of this study was to correlate maximum standardized uptake value (SUVmax) with different immunohistochemical subtypes of breast cancer and other prognostic factors in breast cancer.Subjects and Methods:This was a retrospective study including 219 consecutive patients undergoing whole-body fluorodeoxyglucose positron emission tomography/computed tomography scan for the staging of breast cancer. Out of 219 patients, two were male and 217 were female; age ranged from 26 to 85 years with mean age of 54 years. On histopathological examination (HPE), 197 patients were of invasive ductal carcinoma type and two of lobular type. Histopathological grades, immunohistochemistry (IHC) types, and ki-67 values were compared with SUVmax values.Results:The mean SUVmax of the population was 11.39 (±6.05). The mean SUVmax in different HPE grades was Grade 1 = 6.81 ± 5.6, Grade 2 = 11.4 ± 6.12, and Grade 3 = 13.14 ± 5. The mean SUVmax values in different IHC types were Luminal A = 7.75 ± 4.2, Luminal B = 10.01 ± 5.3, triple negative = 15.26 ± 5.6, and HER2 enriched = 11.27 ± 5.2. The mean SUVmax in high ki-67 patients was 11.97 ± 5.85 compared with 7.25 ± 3.43 patients with low ki-67. Univariate analysis showed significant difference in SUVmax in patients with different grades (P = 0.013), hormone receptor positivity (P ≤ 0.001), ki-67 (P < 0.001), and axillary lymph node positivity (P ≤ 0.001). In multivariate regression analysis, there was significantly higher SUVmax value in triple-negative patients after correcting for tumor size, ki-67 value, axillary lymph node status, and grade of tumor.Conclusion:High SUVmax values were noted in high-grade, high ki-67, triple-negative, and axillary lymph node positive tumors.

Subtype of Breast Cancer in Lao People’s Democratic Republic: A Study in a Limited-Resource Setting

Purpose Three main treatment markers—estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) —are not routinely tested as a result of a lack of infrastructure of health care facilities. Quality control with which to validate these tests is also not available, and patients or their families have to pay for additional examination cost. Without hormonal receptor and HER2 status, treatment decisions are based on clinical finding; therefore, it is almost impossible to select patients who will benefit from therapy. Currently, none of the related research has ever been published in Lao People’s Democratic Republic. Methods From 2013 to 2016, formalin-fixed, paraffin embedded tissue blocks of 76 patients with primary breast cancer were retrieved at the University of Health Sciences (Vientiane, Lao People’s Democratic Republic). Patient information and previous histologic reports were reviewed. Immunohistochemistry was performed using antibodies against estrogen receptor, progesterone receptor, HER2/neu, and the protein encoded by the MKI67 gene (MIB-I). Results Mean age of patients was 49 years, with a majority of histologic type of invasive ductal carcinoma, not otherwise specified (90.7%). Proportions of each subtype were as follows: hormone receptor positive and HER2 negative, 44.7%; hormone receptor positive and HER2 positive, 3.9%; hormone receptor negative and HER2 positive,13.2%; and triple negative, 38.2%. Of patients, 40.8% were estrogen receptor positive and 47.4% were progesterone receptor positive. More than one half had poorly differentiated cancer (65.8%), followed by moderately differentiated cancer (34.2%). Tumors presented with pT2 (60.5%), followed by pT3 (25.0%) and pT4 (7.9%). Conclusion Breast cancer among Lao women is characterized by a large percentage of the triple-negative subtype as well as by being less susceptible to hormonal receptors. Most of our patients presented with locally advanced stage. HER2-positive and triple-negative breast cancer must be further investigated. To provide adequate care, basic pathology services should be the first requirement in Lao People’s Democratic Republic. Our findings could provide fundamental, useful data for a national policy to control breast cancer in the future. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.