Clinical features and prognostic factors of breast cancer in young women: a retrospective single-center study

Correlation between ultrasonography and elastography parameters and molecular subtypes of breast cancer in young women

OBJECTIVE

To explore the differences of conventional ultrasound characteristics, elastic imaging parameters and clinicopathological characteristics of distinct molecular subtypes of breast cancer in young women, and to identify imaging parameters that exhibited significant associations with each molecular subtype.

METHODS

We performed a retrospective analysis encompassing 310 young women with breast cancer. Observations were made regarding the ultrasonography and elastography characteristics of the identified breast lesions. Subsequently, based on immunohistochemistry results patients were classified into five distinct molecular subtypes: luminal A, luminal B (HER2-), luminal B (HER2+), HER2+, and triple-negative breast cancer (TNBC). Clinical, pathological, and ultrasound imaging features were compared among these subtypes using binary logistic regression analysis.

RESULTS

Statistically significant differences were observed in various parameters across the five molecular subtypes (p < 0.05), including tumor size, morphology, margins, calcification, posterior echo features, blood flow (Adler grading), and tumor hardness. Specifically, luminal A subtype exhibited propensity for spiculated margins, lower blood flow grading, and decreased hardness; luminal B subtype was characterized by angular margins; HER2+ subtype manifested higher blood flow grading, calcification, and elevated hardness. Conversely, TNBC subtype displayed smooth margins, absence of calcification, and heightened hardness.

CONCLUSION

Specific molecular subtypes of breast cancer have unique ultrasonic and elastic imaging characteristics.

Predicting recurrence in adult granulosa cell tumors: the role of Ki67, p53, and TERT mutations

PURPOSE

Adult granulosa cell tumors (aGCTs) are a rare type of ovarian malignancy. While most aGCTs have an indolent course, up to 25% experience recurrence. Identifying markers for disease recurrence is crucial for optimal management.

METHODS

Our study consisted of a total of 55 patients, comprising primary non-recurrent aGCTs (n = 30), aGCT recurrences without corresponding primary tumors (n = 19), and primary aGCTs which later recurred along with their matched recurrences (n = 6). Immunohistochemical analysis was conducted for CD73, Ki67, and p53, along with TERT mutation analysis on selected tissue samples.

RESULTS

Immunohistochemical analysis revealed higher Ki67 proliferation index in recurrent aGCTs compared to non-recurrent cases. Mutational p53 staining was only present in recurrent cases. CD73 expression did not differ significantly between primary non-recurrent and recurrent aGCTs. A notably increased occurrence of TERT promoter mutations was identified in recurrent aGCTs (14/25, 56%) in contrast to primary non-recurrent instances (8/27, 29.6%) (p = 0.05). In primary non-recurrent aGCTs with identified TERT mutations, the C250T locus was impacted in 2 cases, while the C228T locus was affected in 6 cases. Recurrent aGCT cases predominantly exhibited TERT C228T mutation in 13 out of 14 patients. Among the six pairs of primary and recurrent aGCTs studied, four pairs displayed TERT mutations in both primary and recurrence samples. Moreover, cases with TERT mutations exhibited a higher Ki67 index.

CONCLUSION

Identifying patients with high Ki67 and mutational p53 together with TERT mutations may help predict potential recurrence in aGCT cases.

Association of imaging and pathological findings of breast cancer in very young women: Report of a twenty-year retrospective study

PURPOSE

In this study, we aimed to assess the new trends in characteristics, molecular subtypes, and imaging findings of breast cancer in very young women.

METHODS

We retrospectively reviewed the database of a primary breast cancer referral center in southern Iran in 342 cases of 30-year-old or younger women from 2001 to 2020. Pathologic data, including nuclear subtype and grade, tumor stage, presence of in situ cancer, imaging data including lesion type in mammogram and ultrasound, and treatment data were recorded. Descriptive statistics were applied. Differences between categorical values between groups were compared using Pearson's Chi-square test.

RESULTS

The mean age was 27.89 years. The tumor type was invasive ductal carcinoma in 82 % of cases. Fourteen patients (4.4 %) had only in situ cancer, and 170 patients had in situ components (49.7 %). Molecular subtypes were available in 278 patients, including 117 (42.1 %) Luminal A, 64 (23.0 %) Luminal B, 58 (20.9 %) triple negative, and 39 (14 %) HER2 Enriched. In those with mammograms available, 63 (30.1 %) had no findings, 53 (25.3 %) had mass, 27 (12.9 %) had asymmetry, whether focal or global, 21 (10 %) had microcalcifications solely, and 45 (21.5 %) had more than one finding. Microcalcifications were significantly more common in Luminal cancers than HER2 and triple-negative cancers (p = 0.041).

CONCLUSION

Our study shows the most common subtype to be Luminal A cancer, with 74 % of the tumors being larger than 2 cm at the time of diagnosis. Irregular masses with non-circumscribed margins were the most common imaging findings.

Status of breast cancer detection in young women and potential of liquid biopsy

Young onset breast cancer (YOBC) is an increasing demographic with unique biology, limited screening, and poor outcomes. Further, women with postpartum breast cancers (PPBCs), cancers occurring up to 10 years after childbirth, have worse outcomes than other young breast cancer patients matched for tumor stage and subtype. Early-stage detection of YOBC is critical for improving outcomes. However, most young women (under 45) do not meet current age guidelines for routine mammographic screening and are thus an underserved population. Other challenges to early detection in this population include reduced performance of standard of care mammography and reduced awareness. Women often face significant barriers in accessing health care during the postpartum period and disadvantaged communities face compounding barriers due to systemic health care inequities. Blood tests and liquid biopsies targeting early detection may provide an attractive option to help address these challenges. Test development in this area includes understanding of the unique biology involved in YOBC and in particular PPBCs that tend to be more aggressive and deadly. In this review, we will present the status of breast cancer screening and detection in young women, provide a summary of some unique biological features of YOBC, and discuss the potential for blood tests and liquid biopsy platforms to address current shortcomings in timely, equitable detection.

Integrating Bioinformatics and Drug Sensitivity Analyses to Identify Molecular Characteristics Associated with Targeting Necroptosis in Breast Cancer and their Clinical Prognostic Significance

BACKGROUND

Breast cancer accounts for over 1.8 million new cases worldwide annually, and prompt diagnosis and treatment are imperative to prevent mortality. Necroptosis, a form of programmed cell death, is thought to be a critical pathway for cancer cell apoptosis, yet, its relationship with breast cancer progression and molecular mechanisms remains largely unexplored.

OBJECTIVES

Our study aims to investigate the molecular characteristics and clinical prognostic value of necroptosis-related genes in breast cancer using a comprehensive approach that involves integrated bioinformatics analysis along with drug sensitivity assessment.

METHODS

Transcriptional, clinical, and tumor mutation burden (TMB) data related to breast cancer from the TCGA and GEO databases were integrated, and the necroptosis gene set was downloaded from the GSEA website for analysis. The screening conditions were set as adjusted p < 0.05 and |log2FC(fold change)| > 0.585 to screen for differential expression genes related to breast cancer necroptosis. Survival prognosis analysis was conducted on breast cancer necroptosis genes. Further analysis was conducted on prognosis-related necroptosis genes, including immune infiltration analysis and GO/KEGG enrichment analysis, to explore the potential biological functions and signaling pathway mechanisms of breast cancer necroptosis genes. Drug sensitivity screening was conducted on the prognosis-related necroptosis to identify potential drugs that target the promotion of necroptosis gene expression, and ultimately, single-gene analysis was performed on the core target genes obtained.

RESULTS

Through integrated bioinformatics analysis, 29 differentially expressed mRNAs related to BRCA-Necroptosis were identified, including 18 upregulated mRNAs and 11 downregulated mRNAs. In addition, single-factor analysis of differential genes showed that the expression of HSPA4, PLK1, TNFRSF1B, FLT3, and LEF1 was closely related to BRCA survival prognosis. Based on the expression of these genes, a breast cancer prognosis model was constructed, and it was found that the area under the curve (AUC) of the curve of the risk genes for necroptosis was the largest, indicating that these genes have a certain clinical predictive significance for the occurrence and prognosis of BRCA. Additionally, there were significant differences in clinical characteristics of BRCA patients with different necroptosis gene expressions. Furthermore, GSVA and immune infiltration analysis revealed that Necroptosis-DEGs mainly affect the occurrence and progression of BRCA by participating in immune functions such as APC co-inhibition, APC costimulation, CCR, checkpoint, as well as infiltrating immune cells such as B cells naive, plasma cells, and T cells CD8. Moreover, the necroptosis gene group column chart indicated a 1-year survival rate of 0.979, a 3-year survival rate of 0.883, and a 5-year survival rate of 0.774. The necroptosis gene group and column chart are important indicators for evaluating BRCA prognosis. Finally, drug sensitivity screening of BRCA-Necroptosis genes showed that compounds such as A- 770041, AC220, AP-24534, Bexarotene, and BMS-509744 have certain effects as potential targeted drugs for the treatment of BRCA necroptosis genes.

CONCLUSION

Necroptosis genes are implicated in the pathogenesis and progression of breast cancer and are thought to impact the prognosis and response to drug treatments in individuals with BRCA. Consequently, understanding the role of these genes in breast cancer may aid in identifying more precise and efficacious therapeutic targets.

Emerging role of toll-like receptors signaling and its regulators in preterm birth: a narrative review

INTRODUCTION

Despite intensive research, preterm birth (PTB) rates have not decreased significantly in recent years due to a lack of understanding of the underlying causes and insufficient treatment options for PTB. We are committed to finding promising biomarkers for the treatment of PTB.

METHODS

An extensive search of the literature was conducted with MEDLINE/PubMed, and in total, 151 studies were included and summarized in the present review.

RESULTS

Substantial evidence supports that the infection and/or inflammatory cascade associated with infection is an early event in PTB. Toll-like receptor (TLR) is a prominent pattern recognition receptor (PRR) found on both immune and non-immune cells, including fetal membrane cells. The activation of TLR downstream molecules, followed by TLR binding to its ligand, is critical for infection and inflammation, leading to the involvement of the TLR signaling pathway in PTB. TLR ligands are derived from microbial components and molecules released by damaged and dead cells. Particularly, TLR4 is an essential TLR because of its ability to recognize lipopolysaccharide (LPS). In this comprehensive overview, we discuss the role of TLR signaling in PTB, focus on numerous host-derived genetic and epigenetic regulators of the TLR signaling pathway, and cover ongoing research and prospective therapeutic options for treating PTB by inhibiting TLR signaling.

CONCLUSION

This is a critical topic because TLR-related molecules and mechanisms may enable obstetricians to better understand the physiological changes in PTB and develop new treatment and prevention strategies.