1
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Lee M, Lee J, Lee A, Kang J. A Case Report of HER2-Amplification in the Breast Without Histological Abnormality. Int J Surg Pathol 2022:10668969221137514. [PMID: 36437641 DOI: 10.1177/10668969221137514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Atypical ductal hyperplasia and low-grade ductal carcinoma in situ (DCIS) are regarded as precursor lesions of estrogen receptor (ER)-positive invasive breast cancer. In HER2-amplified invasive breast cancer, a precursor lesion before DCIS has not yet been described. Here we introduce a case of HER2-positive lobules in the breast without histological abnormality. A 39-year-old premenopausal woman visited a hospital due to identification of microcalcifications on screening mammography. The subsequent biopsy confirmed high-grade DCIS. She underwent wide excision, and a residual high-grade DCIS with a size of 1.4 cm was found. The tumor cells were hormone receptor positive and HER2 negative on immunohistochemical (IHC) staining. Around DCIS, there were terminal duct lobular units (TDLUs) showing strong HER2 positivity on IHC. These HER2-positive lobules were 7 mm away from the high-grade DCIS and was 1.1 mm in size. These HER2-positive lobules showed no histologic abnormality and had no difference compared with the surrounding normal TDLUs. Nevertheless, in addition to showing HER2 overexpression in IHC, HER2 amplification was also identified in HER2 silver in situ hybridization. HER2 amplification plays an important role in breast cancer development, and HER2 amplification is known to occur as an early event in cancer development. There have been studies identifying driver mutations in normal tissues of other organs. These findings suggest that HER2 amplification in the breast without histological abnormality could occur, and the HER2-positive lobules could be “at risk” for transformation into the precursor lesion of HER2-positive breast cancer, although the biological significance of these findings is unclear.
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Affiliation(s)
- Miseon Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jieun Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Cancer Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Jun Kang
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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2
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Singh MP, Brahmachari S, Arya N. An elderly woman with multilobulated breast mass presenting as a diagnostic dilemma: A rare case report. J Family Med Prim Care 2021; 10:3916-3918. [PMID: 34934704 PMCID: PMC8653463 DOI: 10.4103/jfmpc.jfmpc_176_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/30/2021] [Accepted: 07/04/2021] [Indexed: 11/04/2022] Open
Abstract
A breast mass in women often presents a diagnostic challenge due to the diversity in the diagnosis. We herein report a rare variant of breast carcinoma, an invasive apocrine carcinoma (AC), in an elderly woman where the breast mass clinically mimicked phyllodes tumour. Immunohistochemistry (IHC) showed the tumour as triple-negative and also negative for androgen receptor (AR). Gross cystic disease fluid protein (GCDFP-15) was strongly and diffusely positive. It is an exceptional finding. It implies its significance as a diagnostic marker of AC of the breast. The accurate diagnostic criteria of AC are still lacking. Patients with breast lumps offer unique challenges and enormous responsibility to primary and family care physicians.
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Affiliation(s)
| | | | - Neha Arya
- Department of Biochemistry, AIIMS, Bhopal, Madhya Pradesh, India
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3
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Barron M, Asaad A, Idaewor P, Rasheed N, Saad Abdalla Al-Zawi A. Breast Apocrine Carcinoma Detected Incidentally as Axillary Lymphadenopathy in a CT Scan. Cureus 2021; 13:e18523. [PMID: 34754678 PMCID: PMC8569647 DOI: 10.7759/cureus.18523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 11/25/2022] Open
Abstract
Breast apocrine cell pathology varieties include benign papilloma, non-high-grade apocrine ductal carcinoma in situ (DCIS), and breast invasive apocrine carcinoma (BAC). BAC is a rare type of invasive breast cancer and is histologically distinguished by large-sized cells with copious eosinophilic granular cytoplasm, round nuclei, and prominent nucleoli. Its prognosis is similar to breast invasive ductal carcinoma, of no special type (IDC-NST), when matched for tumour stage and histological grade. In this paper, we report the case of a 75-year-old lady presenting with apocrine carcinoma of the left breast diagnosed at the stage of mediastinal lymph node metastasis.
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Affiliation(s)
- Marina Barron
- Emergency Department, South West Acute Hospital, Enniskillen, GBR
| | - Amira Asaad
- Research Unit, University College London, London, GBR
| | - Philip Idaewor
- Cellular Pathology/Histopathology, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Noreen Rasheed
- Breast Radiology, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Abdalla Saad Abdalla Al-Zawi
- General and Breast Surgery, Mid and South Essex University Hospital Group, Basildon, GBR.,General and Breast Surgery, Basildon and Thurrock University Hospital, Basildon, GBR.,General and Breast Surgery, Anglia Ruskin University, Chelmsford, GBR
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4
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Amirkhani Namagerdi A, d'Angelo D, Ciani F, Iannuzzi CA, Napolitano F, Avallone L, De Laurentiis M, Giordano A. Triple-Negative Breast Cancer Comparison With Canine Mammary Tumors From Light Microscopy to Molecular Pathology. Front Oncol 2020; 10:563779. [PMID: 33282730 PMCID: PMC7689249 DOI: 10.3389/fonc.2020.563779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/19/2020] [Indexed: 12/12/2022] Open
Abstract
Many similar characteristics in human and dog cancers including, spontaneous development, clinical presentation, tumor heterogeneity, disease progression, and response to standard therapies have promoted the approval of this comparative model as an alternative to mice. Breast cancer represents the second most frequent neoplasm in humans after lung cancer. Triple-negative breast cancers (TNBC) constitute around 15% of all cases of breast cancer and do not express estrogen receptor (ER), progesterone receptor (PR), and do not overexpress human epidermal growth factor receptor 2 (HER2). As a result, they do not benefit from hormonal or trastuzumab-based therapy. Patients with TNBC have worse overall survival than patients with non-TNBC. Lehmann and collaborators described six different molecular subtypes of TNBC which further demonstrated its transcriptional heterogeneity. This six TNBC subtype classification has therapeutic implications. Breast cancer is the second most frequent neoplasm in sexually intact female dogs after skin cancer. Canine mammary tumors are a naturally occurring heterogeneous group of cancers that have several features in common with human breast cancer (HBC). These similarities include etiology, signaling pathway activation, and histological classification. Molecularly CMTs are more like TNBCs, and therefore dogs are powerful spontaneous models of cancer to test new therapeutic approaches, particularly for human TNBCs. More malignant tumors of the breast are more often ER and PR negative in both humans and dogs. Promising breast cancer biomarkers in both humans and canines are cancer-associated stroma (CAS), circulating tumor cells and tumor DNA (ctDNA), exosomes and miRNAs, and metabolites.
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Affiliation(s)
| | - Danila d'Angelo
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Francesca Ciani
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | | | - Francesco Napolitano
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy.,CCEINGE, Biotecnologie Avanzate, Naples, Italy
| | - Luigi Avallone
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Michelino De Laurentiis
- Breast Oncology Division, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Antonio Giordano
- Center for Biotechnology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, United States.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
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5
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Arciero CA, Diehl AH, Liu Y, Sun Q, Gillespie T, Li X, Subhedar P. Triple-negative apocrine carcinoma: A rare pathologic subtype with a better prognosis than other triple-negative breast cancers. J Surg Oncol 2020; 122:1232-1239. [PMID: 32668059 PMCID: PMC10637266 DOI: 10.1002/jso.26129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND METHODS Apocrine adenocarcinoma is a rare subtype of breast cancer. We sought to compare the characteristics and survival of patients diagnosed with triple-negative apocrine adenocarcinoma to those of patients diagnosed with triple-negative invasive ductal carcinoma. Utilizing data from the National Cancer Database between 2004 and 2013, 70 524 eligible female patients with triple-negative breast cancer were identified including 566 patients with apocrine adenocarcinomas and 69 958 patients with invasive ductal carcinoma. Descriptive statistics for each variable were reported. A comparison of each covariate between the study cohorts was assessed in univariate and multivariate analysis. Cox proportional models were used to calculate hazard ratios. Additionally, the propensity score matching method was implemented to reduce treatment selection bias. RESULTS Patients with triple-negative apocrine tumors were more likely to be older, Caucasian, and have smaller, moderately to well-differentiated tumors. Multivariable analysis noted a significantly improved survival for patients with triple-negative apocrine carcinoma (TNAC) vs triple-negative invasive ductal carcinoma (TNBC) (hazard ratio [HR] 0.65 [95% confidence interval [CI] [0.53-0.81], P = 0 < .001). Propensity score matching analysis confirmed a significant difference in overall survival for patients with TNAC in comparison to TNBC (HR 0.79 [95% CI [0.63-1.00], P = .05). DISCUSSION Triple-negative apocrine adenocarcinomas have a modestly improved long-term survival when compared with triple-negative invasive ductal cancers.
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Affiliation(s)
- Cletus A Arciero
- Department of Surgery, Division of Surgical Oncology, Emory University School of Medicine, Atlanta, Georgia
- Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia
| | | | - Yuan Liu
- Department of Surgery, Division of Surgical Oncology, Emory University School of Medicine, Atlanta, Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Qin Sun
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Theresa Gillespie
- Department of Surgery, Division of Surgical Oncology, Emory University School of Medicine, Atlanta, Georgia
- Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia
| | - Xiaoxian Li
- Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Preeti Subhedar
- Department of Surgery, Division of Surgical Oncology, Emory University School of Medicine, Atlanta, Georgia
- Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia
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6
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Moorman AM, Vink R, Rutgers EJT, Kouwenhoven EA. Incidence, clinical features, and outcomes of special types in breast cancer in a single institution population. Breast J 2020; 26:2163-2169. [PMID: 33022133 DOI: 10.1111/tbj.14069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 01/22/2023]
Abstract
The low incidence of special types of breast cancer hinders adequate clinical research efforts. As such, collecting sufficient data to develop well-established therapy strategies are difficult. The aim of our study was to obtain more data on these special types in order to better understand the different characteristics and optimize therapy strategies. A single-institution retrospective cohort study from January 2007 until September 2015. One hundred and five patients remained after excluding the patients with invasive ductal and lobular carcinoma. The percentage of these so called special types in this population was 4%. Tubular carcinoma, cribriform carcinoma, carcinoma with medullary features, carcinoma with apocrine differentiation, secretory carcinoma, mucinous carcinoma, and invasive papillary carcinoma had a good or excellent prognosis, while invasive micropapillary carcinoma, adenoid cystic carcinoma, metaplastic carcinoma, and carcinoma with neuroendocrine features had a worse prognosis. Special types of breast cancer form a heterogeneous group. Submitting them all to the same treatment modality may lead to both over- and under-treatment. We need to combine our data to optimize treatment strategies for the different special types.
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Affiliation(s)
- A M Moorman
- Department of Surgery, Hospital Group Twente, Almelo, The Netherlands
| | - R Vink
- Laboratory for Pathology East Netherlands (LabPON), Hengelo, The Netherlands
| | - E J Th Rutgers
- Department of Surgery, Antoni van Leeuwenhoek Dutch Cancer centre, Amsterdam, The Netherlands
| | - E A Kouwenhoven
- Department of Surgery, Hospital Group Twente, Almelo, The Netherlands
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7
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Cao L, Niu Y. Triple negative breast cancer: special histological types and emerging therapeutic methods. Cancer Biol Med 2020; 17:293-306. [PMID: 32587770 PMCID: PMC7309458 DOI: 10.20892/j.issn.2095-3941.2019.0465] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/05/2020] [Indexed: 12/23/2022] Open
Abstract
Triple negative breast cancer (TNBC) is a complex and malignant breast cancer subtype that lacks expression of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), thereby making therapeutic targeting difficult. TNBC is generally considered to have high malignancy and poor prognosis. However, patients diagnosed with certain rare histomorphologic subtypes of TNBC have better prognosis than those diagnosed with typical triple negative breast cancer. In addition, with the discovery and development of novel treatment targets such as the androgen receptor (AR), PI3K/AKT/mTOR and AMPK signaling pathways, as well as emerging immunotherapies, the therapeutic options for TNBC are increasing. In this paper, we review the literature on various histological types of TNBC and focus on newly developed therapeutic strategies that target and potentially affect molecular pathways or emerging oncogenes, thus providing a basis for future tailored therapies focused on the mutational aspects of TNBC.
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Affiliation(s)
- Lu Cao
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Yun Niu
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
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8
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Columnar Cell Lesion and Apocrine Hyperplasia of the Breast: Is There a Common Origin? The Role of Prolactin-induced Protein. Appl Immunohistochem Mol Morphol 2020; 27:508-514. [PMID: 29084054 DOI: 10.1097/pai.0000000000000604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Noninvasive breast lesions encompass a heterogeneous group of risk indicators and nonobligate precursors of breast cancer, such as apocrine hyperplasia (AH) and columnar cell lesions (CCLs). Given the different expression of ER and ER-regulated genes in AH and CCL, these two alterations are currently considered discrete conditions. However, whether they share early biologic changes is not clear to date. Here, we sought to define the clinicopathologic and immunohistochemical features of a prospective series of combined lesions made up by CCLs and AH forming a continuum within single terminal duct-lobular units. The study group included 19 cases, whereas 25 cases of synchronous contiguous CCLs and AH served as control group. The different components of each case were subjected to immunohistochemical analysis for ER, PR, AR, HER2, BCL2, CCND1, MUC1, and PIP. Although CCLs and AHs arising in continuity showed opposite patterns of ER expression, the PIP-positive apocrine signature was consistently present in both components. In conclusion, apocrine changes are highly recurrent in CCLs growing within foci of AH, regardless of the ER activation. Our results suggest that PIP-positive and PIP-negative CCLs are likely to represent biologically distinct conditions and that apocrine changes might occur earlier than ER activation in the natural history of breast precursor lesions.
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9
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Coussy F, Lavigne M, de Koning L, Botty RE, Nemati F, Naguez A, Bataillon G, Ouine B, Dahmani A, Montaudon E, Painsec P, Chateau-Joubert S, Laetitia F, Larcher T, Vacher S, Chemlali W, Briaux A, Melaabi S, Salomon AV, Guinebretiere JM, Bieche I, Marangoni E. Response to mTOR and PI3K inhibitors in enzalutamide-resistant luminal androgen receptor triple-negative breast cancer patient-derived xenografts. Theranostics 2020; 10:1531-1543. [PMID: 32042320 PMCID: PMC6993232 DOI: 10.7150/thno.36182] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/18/2019] [Indexed: 02/07/2023] Open
Abstract
Luminal androgen receptor (LAR) breast cancer accounts for 10% of all triple-negative breast cancers (TNBC). Anti-androgen therapy for this subtype is in development, but yields only partial clinical benefits. In this study, we aimed to characterize the genomic alterations of LAR TNBC, to analyze activation of the PI3K signaling pathway and to compare the response to PI3K pathway inhibitors with that to anti-androgen therapy in patient-derived xenografts (PDX) of LAR TNBC. Methods: Four LAR PDX models were identified, on the basis of their transcriptomic profiles, in a cohort of 57 PDX models of TNBC. The expression of AR-related genes, basal and luminal cytokeratins and EMT genes was analyzed by RT-PCR and IHC. AKT1 and PIK3CA mutations were identified by targeted NGS, and activation of the PI3K pathway was analyzed with a reverse-phase protein array. Three LAR PDXs with a PIK3CA or AKT1 mutation were treated with the AR inhibitor enzalutamide, a PI3K inhibitor, a dual PI3K-mTOR inhibitor and a mTORC1-mTORC2 inhibitor. Finally, we screened a clinical cohort of 329 TNBC for PIK3CA and AKT1 hotspot mutations. Results: LAR TNBC PDXs were significantly enriched in PIK3CA and AKT1 mutations, and had higher levels of luminal-androgen-like gene expression and a higher PI3K pathway protein activation score than other TNBC subtypes. Immunohistochemistry analysis revealed strong expression of the luminal cytokeratin CK18 and AR in three LAR PDX models. We found that mTOR and PI3K inhibitors had marked antitumor activity in vivo in PDX harboring genomic alterations of PIK3CA and AKT1 genes that did not respond to the AR antagonist enzalutamide. PIK3CA mutations were detected in more than one third of AR+ TNBC from patients (38%), and only 10% of AR-negative TNBC. Conclusion: Our results for PDX models of LAR TNBC resistant to enzalutamide indicate that PIK3CA and AKT1 are potential therapeutic targets.
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10
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Abdelwahed A, Ahmed M. Rare epithelial breast cancer: surgery and adjuvant therapy. Transl Cancer Res 2019; 8:S479-S492. [PMID: 35117126 PMCID: PMC8797705 DOI: 10.21037/tcr.2019.05.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/10/2019] [Indexed: 01/30/2023]
Abstract
Breast cancer is a heterogenous disease, exhibiting a wide range of morphological phenotypes shaping its prognosis and clinical course. However, optimal management of rarer breast cancer subtypes is often undefined and controversial in literature due to the lack of large studies and randomised trials. This review aims to discuss the treatment of 13 rare epithelial subtypes, focussing on surgery and adjuvant therapies.
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Affiliation(s)
| | - Muneer Ahmed
- King's College London, Division of Cancer, Research Oncology, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
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11
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Sugiyama K, Iwakoshi A, Satoh M, Shiraishi K, Nozawa K, Kogure Y, Kitagawa C, Moritani S, Katoh E, Saka H. Primary Mediastinal HER2-positive Apocrine Carcinoma in Mature Teratoma Treated With Anti-HER2 Therapy and Chemoradiation. In Vivo 2019; 33:551-557. [PMID: 30804140 DOI: 10.21873/invivo.11509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND There are no established guidelines for the management of apocrine carcinomas of the breast; they are treated as a non-specific type of breast cancer. CASE REPORT We report on the case of a 40-year-old man who developed primary mediastinal apocrine carcinoma overexpressing human epidermal growth factor-2 (HER2). The patient initially underwent complete resection of a mediastinal mature teratoma with a focal apocrine carcinoma component. Two years after surgery, relapse was detected in multiple mediastinal lymph nodes. He received induction chemotherapy including docetaxel, trastuzumab, and pertuzumab; consolidative concurrent chemoradiation was added after six cycles. A complete response was confirmed using computed tomography following this multimodal therapy. After chemoradiation, adjuvant trastuzumab and pertuzumab were administered for 1 year and the patient has since had no evidence of progressive disease. CONCLUSION A multi-modal regimen that includes an anti-HER2 agent appears to be a promising treatment for patients with HER2-positive extramammary apocrine carcinoma.
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Affiliation(s)
- Keiji Sugiyama
- Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan
| | - Akari Iwakoshi
- Department of Pathology, Nagoya Medical Center, Nagoya, Japan.,Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Mariko Satoh
- Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan
| | | | - Kazuki Nozawa
- Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan
| | - Yoshihito Kogure
- Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan.,Department of Respirology Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Chiyoe Kitagawa
- Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan.,Department of Respirology Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Suzuko Moritani
- Department of Pathology, Nagoya Medical Center, Nagoya, Japan.,Division of Molecular and Diagnostic Pathology, Shiga University of Medical Science, Otsu, Japan
| | - Eriko Katoh
- Department of Radiation Oncology, Nagoya Medical Center, Nagoya, Japan
| | - Hideo Saka
- Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan.,Department of Respirology Medicine, Nagoya Medical Center, Nagoya, Japan
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12
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D'Arcy C, Quinn CM. Apocrine lesions of the breast: part 2 of a two-part review. Invasive apocrine carcinoma, the molecular apocrine signature and utility of immunohistochemistry in the diagnosis of apocrine lesions of the breast. J Clin Pathol 2018; 72:7-11. [PMID: 30425121 DOI: 10.1136/jclinpath-2018-205485] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 12/20/2022]
Abstract
Pure apocrine carcinoma of the breast is rare and has been defined by using a combination of morphologic (apocrine morphology in >90% of tumour cells) and immunohistochemical criteria (oestrogen receptor (ER) and progesterone receptor (PR) negative and androgen receptor (AR) positive). Recent advances in the molecular classification of breast tumours have uncovered a subset of breast tumours associated with high expression of androgen receptor mRNA including the so-called 'luminal androgen receptor (LAR) tumours' and 'molecular apocrine tumours' (MATs). Recognition of these tumour subsets has opened potential avenues for therapies exploiting the AR pathway in triple negative breast carcinoma (TNBC). In this second part of our two-part review, we focus on the definition of pure apocrine carcinoma, recent advances in understanding the molecular apocrine signature in breast carcinoma, its relationship to pure apocrine carcinoma defined at the level of light microscopy and immunohistochemistry (IHC) and the therapeutic implications of androgen expression in TNBC. We complete the article with a summary of the utility of IHC in stratifying apocrine lesions of the breast.
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Affiliation(s)
- Clare D'Arcy
- Histopathology, Breast Check, Irish National Breast Screening Programme and St. Vincent's University Hospital, Dublin, Ireland
| | - Cecily M Quinn
- Histopathology, Breast Check, Irish National Breast Screening Programme and St. Vincent's University Hospital, Dublin, Ireland
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13
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D'Arcy C, Quinn C. Apocrine lesions of the breast: part 1 of a two-part review: benign, atypical and in situ apocrine proliferations of the breast. J Clin Pathol 2018; 72:1-6. [PMID: 30409840 DOI: 10.1136/jclinpath-2018-205484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/03/2018] [Accepted: 10/03/2018] [Indexed: 01/25/2023]
Abstract
Apocrine morphology is a common phenomenon encountered in everyday breast pathology practice, and is defined as cuboidal or columnar cells exhibiting abundant eosinophilic granular cytoplasm, prominent apical granules, a low nuclear-cytoplasmic ratio, and round nuclei with pale chromatin and prominent nucleoli. Apocrine morphology is recognised in benign, atypical and malignant lesions of the breast. The morphology of apocrine atypia and non-high-grade apocrine ductal carcinoma in situ (DCIS) is less well defined due to the relative rarity of these lesions. In part 1 of this two-part review, we focus on the morphological characteristics of benign, atypical and in situ apocrine lesions of the breast, summarise the available data to date regarding distinction of atypical apocrine proliferations from non-high-grade apocrine DCIS and the biological significance of apocrine atypia, and provide practical guidance on handling these difficult lesions. Part 2 of this review will focus on the concept of pure apocrine carcinoma with emphasis on its definition and molecular data, including the current understanding of the molecular apocrine signature in breast carcinoma. We complete the review with a synopsis on the utility of immunohistochemistry in the diagnosis of apocrine lesions of the breast.
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Affiliation(s)
- Clare D'Arcy
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
| | - Cecily Quinn
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
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14
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Zhang N, Zhang H, Chen T, Yang Q. Dose invasive apocrine adenocarcinoma has worse prognosis than invasive ductal carcinoma of breast: evidence from SEER database. Oncotarget 2018; 8:24579-24592. [PMID: 28445946 PMCID: PMC5421871 DOI: 10.18632/oncotarget.15597] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/13/2017] [Indexed: 12/13/2022] Open
Abstract
Background Invasive apocrine adenocarcinoma (AAC) of breast is a rare histopathological subtype of breast carcinomas. We aim to investigate the different characteristics and prognostic outcomes between AAC and invasive ductal carcinoma (IDC) of breast cancer. RESULTS AAC patients presented with older ages, more aggressive behaviors, lower ER and PR proportions, higher HER2 amplification rates and less application of breast-conserving therapy and adjuvant chemotherapy compared to IDC patients. Long-term OS and DSS were both worse in ACC patients (p = 0.006, p = 0.012 respectively) than in IDC patients by Kaplan-Meier analysis. However, no significant difference was detected in DSS (p = 0.181) and OS (p = 0.116) between the matched two histological subtypes. Further subgroup analysis indicated that AJCC stage, ER status, PR status and HER2 status may be principal confounders for AAC prognosis. Materials and Methods With accession to the Surveillance, Epidemiology and End Result (SEER) database, a total of 260,596 patients met the eligibility criteria. Clinicopathological characteristics were compared between groups using Chi-square test. Univariate and multivariate analyses were applied to evaluate the overall survival (OS) and disease-specific survival (DSS). Subgroup analyses summarized the hazard ratio (HR) of AAC versus IDC using a forest plot. Conclusions AAC had unique clinicopathological characteristics and it tended to be a more aggressive type than IDC. However, the worse prognosis was diminished after matching for demographic and clinicopathological factors. Deeper insights into AAC are in need to contribute to individualized and tailored therapy, which thereby may improve clinical management and outcomes.
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Affiliation(s)
- Ning Zhang
- Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China
| | - Hanwen Zhang
- Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China
| | - Tong Chen
- Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China
| | - Qifeng Yang
- Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China.,Pathology Tissue Bank, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China
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15
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Kővári B, Vranic S, Marchio C, Sapino A, Cserni G. The expression of GHRH and its receptors in breast carcinomas with apocrine differentiation-further evidence of the presence of a GHRH pathway in these tumors. Hum Pathol 2017; 64:164-170. [PMID: 28438614 DOI: 10.1016/j.humpath.2017.03.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/14/2017] [Accepted: 03/29/2017] [Indexed: 02/07/2023]
Abstract
Apocrine breast carcinomas were evaluated for the expression of components of the growth hormone-releasing hormone (GHRH) autocrine/paracrine pathway: GHRH and its receptors (GHRH-R), as mammary apocrine carcinomas and epithelium seemed to be uniformly positive for GHRH-R in a pilot study. The apocrine phenotype was determined on the basis of hematoxylin-eosin morphology and a congruent immunohistochemical profile (estrogen receptor negativity, androgen receptor and gross cystic disease fluid protein-15 positivity). Thirty-five formalin-fixed, paraffin-embedded apocrine breast cancers in tissue microarrays and 24 cases using whole-tissue sections were evaluated for GHRH-R and GHRH expression by immunohistochemistry using polyclonal antibodies raised against various domains of GHRH-R and one polyclonal antibody specific for GHRH. GHRH-R positivity was detected in the overwhelming majority (ranging from 90% to 100%) of apocrine breast carcinomas with all but one of the antibodies applied. The expression was usually diffuse with only isolated cases showing positivity in less than 50% of tumor cells. With the PA5-33583 antibody, GHRH-R positivity was seen only in 73% of the cases in at least 50% of the tumor cells. GHRH expression was also present in all but one case tested, with more than 50% of the cells expressing it in 30/34 cases. These results support a high rate of GHRH-R and GHRH expression in apocrine breast carcinomas. Whether these findings can be exploited for the targeted treatment of apocrine breast carcinomas with GHRH antagonists requires further study.
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Affiliation(s)
- Bence Kővári
- Department of Pathology, University of Szeged, 6720 Szeged, Hungary.
| | - Semir Vranic
- Department of Pathology, Clinical Center of the University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina; School of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Caterina Marchio
- Department of Medical Sciences, University of Turin, Pathology Unit, 10126 Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Pathology Unit, 10126 Turin, Italy; Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia (FPO), IRCCS, 10060, Candiolo (To), Italy
| | - Gábor Cserni
- Department of Pathology, University of Szeged, 6720 Szeged, Hungary; Department of Pathology, Bács-Kiskun County Teaching Hospital, 6000 Kecskemét, Hungary
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16
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Hou Y, Chaudhary S, Gao FF, Li Z. Surgical follow-up results for apocrine adenosis and atypical apocrine adenosis diagnosed on breast core biopsy. Ann Diagn Pathol 2016; 24:4-6. [DOI: 10.1016/j.anndiagpath.2016.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
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17
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Nozaki F, Hirotani Y, Nakanishi Y, Yamaguchi H, Nishimaki H, Noda H, Tang X, Yamamoto H, Suzuki A, Seki T, Masuda S. p62 Regulates the Proliferation of Molecular Apocrine Breast Cancer Cells. Acta Histochem Cytochem 2016; 49:125-30. [PMID: 27682016 PMCID: PMC5011237 DOI: 10.1267/ahc.16013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/28/2016] [Indexed: 11/22/2022] Open
Abstract
p62, also called sequestosome 1 (SQSTM1), is a multifunctional signaling molecule that affects cell proliferation. Recently, we found accumulation of p62 in apocrine carcinoma of the breast, however, the biological role of p62 expression in apocrine carcinoma still remains unclear. To investigate whether p62 might contribute to tumor cell proliferation in apocrine carcinomas, we used the MDA-MB-453 (androgen receptor-positive, HER2-type) and MFM223 (androgen receptor-positive, triple-negative type) breast cancer cell lines as models of molecular apocrine carcinoma. Both MDA-MB-453 and MFM223 showed strong and d high p62 protein expression than MCF7 cells (androgen receptor-negative, luminal A type). Knockdown of p62 resulted in significant reduction of the cell proliferative activity in both MDA-MB-453 (P<0.01) and MFM223 (P<0.05). In conclusion, p62 could contribute to cell proliferation and represent a therapeutic target in apocrine carcinoma.
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Affiliation(s)
- Fumi Nozaki
- Department of Pathology, St. Luke’s International Hospital
- Department of Oncologic Pathology, Nihon University School of Medicine
| | - Yukari Hirotani
- Division of Morphological and Functional Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine
| | - Yoko Nakanishi
- Department of Oncologic Pathology, Nihon University School of Medicine
| | - Hiromi Yamaguchi
- Division of Morphological and Functional Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine
| | - Haruna Nishimaki
- Department of Oncologic Pathology, Nihon University School of Medicine
| | - Hiroko Noda
- Department of Oncologic Pathology, Nihon University School of Medicine
| | - Xiaoyan Tang
- Department of Oncologic Pathology, Nihon University School of Medicine
| | - Hisae Yamamoto
- Division of Pathology, Nihon University Itabashi Hospital
| | - Atsuko Suzuki
- Division of Pathology, Nihon University Itabashi Hospital
| | - Toshimi Seki
- Division of Pathology, Nihon University Itabashi Hospital
| | - Shinobu Masuda
- Department of Oncologic Pathology, Nihon University School of Medicine
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18
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Jongen L, Paridaens R, Floris G, Wildiers H, Neven P. Androgen deprivation by adrenal suppression using low-dose hydrocortisone for the treatment of breast carcinoma with apocrine features: a case report illustrating this new paradigm. Breast Cancer Res Treat 2016; 155:603-7. [PMID: 26868122 DOI: 10.1007/s10549-016-3708-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 02/05/2016] [Indexed: 12/11/2022]
Abstract
We report on a postmenopausal patient with a secondary metastatic apocrine breast cancer successfully treated with low-dose hydrocortisone only following several lines of chemotherapy. The tumor cells in the primary and metastatic lesion exhibited a 'triple-negative' status (estrogen receptor (ER)-, progesterone receptor (PR)-, and human epidermal growth factor receptor 2 (HER2)-negative); the androgen receptor (AR) was strongly expressed. Twenty milligrams of hydrocortisone, a low substitution dose known to suppress adrenal steroid production, twice daily led to a clinical benefit lasting for one year, with symptom control, radiologically stable disease, and steady decrease in CA15.3. Our observation demonstrates that an AR-expressing apocrine breast cancer may respond to androgen deprivation, as an ER-positive breast cancer may benefit from estrogen deprivation. It highlights the importance of further research targeting the AR pathway in apocrine carcinoma, for which androgens represent the sole (known) steroid hormone stimulating tumor growth. Future clinical trials should not only focus on AR inhibitors like enzalutamide, but also on ablative modalities like low-dose hydrocortisone aiming at medical adrenalectomy. This method of androgen deprivation is largely available, cheap, and nearly devoid of toxicity.
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Affiliation(s)
- Lynn Jongen
- Department of Oncology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium.
| | - Robert Paridaens
- Department of Oncology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
| | - Giuseppe Floris
- Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Pathology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
| | - Hans Wildiers
- Department of Oncology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
| | - Patrick Neven
- Department of Oncology, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Gynecology and Obstetrics, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium
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19
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Gromov P, Espinoza JA, Gromova I. Molecular and diagnostic features of apocrine breast lesions. Expert Rev Mol Diagn 2015; 15:1011-22. [DOI: 10.1586/14737159.2015.1057125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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20
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Gromova I, Gromov P, Honma N, Kumar S, Rimm D, Talman MLM, Wielenga VT, Moreira JMA. High level PHGDH expression in breast is predominantly associated with keratin 5-positive cell lineage independently of malignancy. Mol Oncol 2015; 9:1636-54. [PMID: 26026368 DOI: 10.1016/j.molonc.2015.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 04/14/2015] [Accepted: 05/04/2015] [Indexed: 12/16/2022] Open
Abstract
We have previously reported the 2D PAGE-based proteomic profiling of a prospective cohort of 78 triple negative breast cancer (TNBC) patients, and the establishment of a cumulative TNBC protein database. Analysis of this database identified a number of proteins as being specifically overexpressed in TNBC samples. One such protein was D-3-phosphoglycerate dehydrogenase (Phgdh), a candidate oncogene. We analysed expression of Phgdh in normal and TNBC mammary tissue samples by 2D gel-based proteomics and immunohistochemistry (IHC), and show here that high-level expression of Phgdh in mammary epithelial cells is primarily associated with cell lineage, as we found that Phgdh expression was predominant in CK5-positive cells, normal as well as malignant, thus identifying an association of this protein with the basal phenotype. Quantitative IHC analysis of Phgdh expression in normal breast tissue showed high-level expression of Phgdh in normal CK5-positive mammary epithelial cells, indicating that expression of this protein was not associated with malignancy, but rather with cell lineage. However, proteomic profiling of Phgdh showed it to be expressed in two major protein forms, and that the ratio of expression between these variants was associated with malignancy. Overexpression of Phgdh in CK5-positive cell lineages, and differential protein isoform expression, was additionally found in other tissues and cancer types, suggesting that overexpression of Phgdh is generally associated with CK5 cells, and that oncogenic function may be determined by isoform expression.
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Affiliation(s)
- Irina Gromova
- Cancer Proteomics, Genome Integrity Unit, Danish Cancer Society Research Center, Copenhagen, Denmark; Danish Centre for Translational Breast Cancer Research (DCTB), Copenhagen, Denmark
| | - Pavel Gromov
- Cancer Proteomics, Genome Integrity Unit, Danish Cancer Society Research Center, Copenhagen, Denmark; Danish Centre for Translational Breast Cancer Research (DCTB), Copenhagen, Denmark
| | - Naoko Honma
- Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Sudha Kumar
- Department of Pathology, Yale University Medical School, New Haven, USA
| | - David Rimm
- Department of Pathology, Yale University Medical School, New Haven, USA
| | - Maj-Lis Møller Talman
- Department of Pathology, The Centre of Diagnostic Investigations, Copenhagen University Hospital, Denmark
| | - Vera Timmermans Wielenga
- Department of Pathology, The Centre of Diagnostic Investigations, Copenhagen University Hospital, Denmark
| | - José M A Moreira
- Danish Centre for Translational Breast Cancer Research (DCTB), Copenhagen, Denmark; Section for Molecular Disease Biology and Sino-Danish Breast Cancer Research Centre, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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21
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Gromov P, Espinoza JA, Talman ML, Honma N, Kroman N, Wielenga VT, Moreira JMA, Gromova I. FABP7 and HMGCS2 are novel protein markers for apocrine differentiation categorizing apocrine carcinoma of the breast. PLoS One 2014; 9:e112024. [PMID: 25389781 PMCID: PMC4229141 DOI: 10.1371/journal.pone.0112024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 10/09/2014] [Indexed: 02/01/2023] Open
Abstract
Apocrine carcinoma of the breast is a distinctive malignancy with unique morphological and molecular features, generally characterized by being negative for estrogen and progesterone receptors, and thus not electable for endocrine therapy. Despite the fact that they are morphologically distinct from other breast lesions, no standard molecular criteria are currently available for their diagnosis. Using gel-based proteomics in combination with mass spectrometry and immunohistochemistry we have identified two novel markers, HMGCS2 and FABP7 that categorize the entire breast apocrine differentiation spectrum from benign metaplasia and cysts to invasive stages. Expression of HMGCS2 and FABP7 is strongly associated with apocrine differentiation; their expression is retained by most invasive apocrine carcinomas (IAC) showing positive immunoreactivity in 100% and 78% of apocrine carcinomas, respectively, as compared to non-apocrine tumors (16.7% and 6.8%). The nuclear localization of FABP7 in tumor cells was shown to be associated with more aggressive stages of apocrine carcinomas. In addition, when added to the panel of apocrine biomarkers previously reported by our group: 15-PGDH, HMGCR and ACSM1, together they provide a signature that may represent a golden molecular standard for defining the apocrine phenotype in the breast. Moreover, we show that combining HMGCS2 to the steroidal profile (HMGCS2+/Androgen Receptor (AR)+/Estrogen Receptor(ER)-/Progesteron Receptor (PR)- identifies IACs with a greater sensitivity (79%) as compared with the steroidal profile (AR+/ER-/PR-) alone (54%). We have also presented a detailed immunohistochemical analysis of breast apocrine lesions with a panel of antibodies against proteins which correspond to 10 genes selected from published transcriptomic signatures that currently characterize molecular apocrine subtype and shown that except for melanophilin that is overexpressed in benign apocrine lesions, these proteins were not specific for morphological apocrine differentiation in breast.
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Affiliation(s)
- Pavel Gromov
- Danish Cancer Society Research Center, Genome Integrity Unit, Copenhagen, Denmark
- * E-mail:
| | - Jaime A. Espinoza
- Department of Pathology, Center for Investigation in Translational Oncology (CITO), School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maj-Lis Talman
- Department of Pathology, the Centre of Diagnostic Investigations, Copenhagen University Hospital, Copenhagen, Denmark
| | - Naoko Honma
- Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Niels Kroman
- Department of Breast Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Vera Timmermans Wielenga
- Department of Pathology, the Centre of Diagnostic Investigations, Copenhagen University Hospital, Copenhagen, Denmark
| | - José M. A. Moreira
- Section of Molecular Disease Biology and Sino-Danish Breast Cancer Research Centre, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Irina Gromova
- Danish Cancer Society Research Center, Genome Integrity Unit, Copenhagen, Denmark
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22
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Calhoun BC, Booth CN. Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management. Hum Pathol 2014; 45:2130-5. [DOI: 10.1016/j.humpath.2014.06.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 06/06/2014] [Accepted: 06/11/2014] [Indexed: 11/26/2022]
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23
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Khandeparkar SGS, Deshmukh SD, Bhayekar PD. A rare case of apocrine carcinoma of the breast: Cytopathological and immunohistopathological study. J Cytol 2014; 31:96-8. [PMID: 25210239 PMCID: PMC4159906 DOI: 10.4103/0970-9371.138679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Invasive apocrine carcinomas of the breast are rare. Fine needle aspiration cytology (FNAC) has been increasingly used as a primary screening tool for breast lumps, with high level of sensitivity and specificity. Preoperatively, apocrine carcinoma needs to be distinguished from benign apocrine lesions and other eosinophilic and granular cell tumors. We report a rare case of invasive apocrine carcinoma in a 70-year-old female presenting with a breast lump and no axillary lymphadenopathy. FNAC was advised which yielded moderately cellular smears composed of loosely cohesive clusters of large, polygonal cells with centrally located pleomorphic, vesicular nucleus with prominent nucleoli and abundant, basophilic and granular cytoplasm. Based on above cytomorphological findings, diagnosis of apocrine carcinoma was offered. The patient then underwent right modified radical mastectomy with axillary clearance. Based on histomorphology and panel of immunohistochemical (IHC) markers the diagnosis was confirmed. Although apocrine/oncocytic cytomorphology is seen in few types of breast neoplasms, high index of suspicion and subsequent IHC study clinches the diagnosis.
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Affiliation(s)
| | - Sanjay D Deshmukh
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | - Pallavi D Bhayekar
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
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24
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Lee SG, Jung SP, Lee HY, Kim S, Kim HY, Kim I, Bae JW. Secretory breast carcinoma: A report of three cases and a review of the literature. Oncol Lett 2014; 8:683-686. [PMID: 25009650 PMCID: PMC4081125 DOI: 10.3892/ol.2014.2213] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 04/29/2014] [Indexed: 12/21/2022] Open
Abstract
Secretory breast carcinoma is a very rare and distinct subtype of breast cancer, characterized by the presence of intracellular and extracellular secretory material. Secretory breast carcinoma has a good clinical outcome and systemic involvement is rare. The majority of studies of this tumor have been case reports or separate analyses, and due to the rarity of these tumors, it has been difficult to fully elucidate their characteristics and define optimal treatment strategies. To add to the current knowledge of secretory breast carcinoma, the present study reports three cases of secretory breast carcinoma in patients of different ages, and with different hormone receptor statuses and treatment methods. The present study identified that each patient with secretory breast carcinoma may present with different symptoms and clinical characteristics. Therefore, therapeutic options should be selected based on the overall status of the patient and the characteristics of this rare disease.
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Affiliation(s)
| | - Seung Pil Jung
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hye Yoon Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sinill Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hoon Yub Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Insun Kim
- Department of Pathology, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeoung Won Bae
- Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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25
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Farkaš R, Ďatková Z, Mentelová L, Löw P, Beňová-Liszeková D, Beňo M, Sass M, Řehulka P, Řehulková H, Raška O, Kováčik L, Šmigová J, Raška I, Mechler BM. Apocrine secretion in Drosophila salivary glands: subcellular origin, dynamics, and identification of secretory proteins. PLoS One 2014; 9:e94383. [PMID: 24732043 PMCID: PMC3986406 DOI: 10.1371/journal.pone.0094383] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/14/2014] [Indexed: 01/29/2023] Open
Abstract
In contrast to the well defined mechanism of merocrine exocytosis, the mechanism of apocrine secretion, which was first described over 180 years ago, remains relatively uncharacterized. We identified apocrine secretory activity in the late prepupal salivary glands of Drosophila melanogaster just prior to the execution of programmed cell death (PCD). The excellent genetic tools available in Drosophila provide an opportunity to dissect for the first time the molecular and mechanistic aspects of this process. A prerequisite for such an analysis is to have pivotal immunohistochemical, ultrastructural, biochemical and proteomic data that fully characterize the process. Here we present data showing that the Drosophila salivary glands release all kinds of cellular proteins by an apocrine mechanism including cytoskeletal, cytosolic, mitochondrial, nuclear and nucleolar components. Surprisingly, the apocrine release of these proteins displays a temporal pattern with the sequential release of some proteins (e.g. transcription factor BR-C, tumor suppressor p127, cytoskeletal β-tubulin, non-muscle myosin) earlier than others (e.g. filamentous actin, nuclear lamin, mitochondrial pyruvate dehydrogenase). Although the apocrine release of proteins takes place just prior to the execution of an apoptotic program, the nuclear DNA is never released. Western blotting indicates that the secreted proteins remain undegraded in the lumen. Following apocrine secretion, the salivary gland cells remain quite vital, as they retain highly active transcriptional and protein synthetic activity.
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Affiliation(s)
- Robert Farkaš
- Laboratory of Developmental Genetics, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia,
| | - Zuzana Ďatková
- Laboratory of Developmental Genetics, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia,
- Department of Genetics, Comenius University, Bratislava, Slovakia
| | - Lucia Mentelová
- Laboratory of Developmental Genetics, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia,
- Department of Genetics, Comenius University, Bratislava, Slovakia
| | - Péter Löw
- Department of Anatomy and Cell Biology, Lorand Eötvös University, Budapest, Hungary
| | - Denisa Beňová-Liszeková
- Laboratory of Developmental Genetics, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia,
| | - Milan Beňo
- Laboratory of Developmental Genetics, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia,
| | - Miklós Sass
- Department of Anatomy and Cell Biology, Lorand Eötvös University, Budapest, Hungary
| | - Pavel Řehulka
- Institute of Molecular Pathology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Helena Řehulková
- 1st Department of Internal Medicine - Cardioangiology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic
| | - Otakar Raška
- Institute of Cellular Biology and Pathology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Lubomír Kováčik
- Institute of Cellular Biology and Pathology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jana Šmigová
- Institute of Cellular Biology and Pathology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Ivan Raška
- Institute of Cellular Biology and Pathology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Bernard M. Mechler
- Institute of Cellular Biology and Pathology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
- Deutsches Krebsforschungszentrum, Heidelberg, Germany
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26
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[Diagnostics of benign ductal epithelial cell proliferation of the breast in biopsy material]. DER PATHOLOGE 2014; 35:18-25. [PMID: 24448666 DOI: 10.1007/s00292-013-1886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The pathological evaluation of radiological or sonographical abnormalities by needle core biopsy of the breast frequently involves the differential diagnosis of benign epithelial cell proliferations. The lesions to be considered include usual type and atypical ductal epithelial cell hyperplasia, columnar cell changes including flat epithelial cell atypia, the spectrum of hyperplastic and atypical apocrine epithelial cell proliferations and papillary lesions. This review provides an overview of the diagnostic criteria, the current terminology and the differential diagnosis of these lesions. The clinical management and the prognosis of the lesions are discussed.
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27
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Gerhard R, Costa JL, Schmitt F. Benign and malignant apocrine lesions of the breast. Expert Rev Anticancer Ther 2014; 12:215-21. [DOI: 10.1586/era.11.213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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28
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Boyle DP, McCourt CM, Matchett KB, Salto-Tellez M. Molecular and clinicopathological markers of prognosis in breast cancer. Expert Rev Mol Diagn 2013; 13:481-98. [PMID: 23782255 DOI: 10.1586/erm.13.29] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A vast body of research in breast cancer prognostication has accumulated. Yet despite this, patients within current prognostic categories may have significantly different outcomes. There is a need to more accurately divide those cancer types associated with an excellent prognosis from those requiring more aggressive therapy. Gene expression array studies have revealed the numerous molecular breast cancer subtypes that are associated with differing outcomes. Furthermore, as next generation technologies evolve and further reveal the complexities of breast cancer, it is likely that existing prognostic approaches will become progressively refined. Future prognostication in breast cancer requires a morphomolecular, multifaceted approach involving the assessment of anatomical disease extent and levels of protein, DNA and RNA expression. One of the major challenges in prognostication will be the integration of potential assays into existing clinical systems and identification of appropriate patient subgroups for analysis.
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Affiliation(s)
- David P Boyle
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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29
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Ductal carcinoma in situ: what the pathologist needs to know and why. Int J Breast Cancer 2013; 2013:914053. [PMID: 23476791 PMCID: PMC3580892 DOI: 10.1155/2013/914053] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 12/19/2012] [Accepted: 01/02/2013] [Indexed: 11/26/2022] Open
Abstract
Ductal carcinoma in situ is a proliferation of malignant epithelial cells confined to the ductolobular system of the breast. It is considered a pre-cursor lesion for invasive breast cancer and when identified patients are treated with some combination of surgery, +/− radiation therapy, and +/adjuvant tamoxifen. However, no good biomarkers exist that can predict with accuracy those cases of DCIS destined to progress to invasive disease or once treated those patients that are likely to suffer a recurrence; thus, in the era of screening mammography it seems likely that many patients with DCIS are overtreated. This paper details the parameters that should be included in a pathology report for a case of DClS with some explanations as to their importance for good clinical decision making.
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30
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Cadoo KA, McArdle O, O'Shea AM, Power CP, Hennessy BT. Management of unusual histological types of breast cancer. Oncologist 2012; 17:1135-45. [PMID: 22826373 DOI: 10.1634/theoncologist.2012-0134] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
There is increased understanding of the heterogeneity of breast tumors, with greater emphasis now being placed on histological and molecular profiles and, in particular, their implications for prognosis and therapy. This review addresses breast cancers of unusual histological subtype with an approximate incidence ≤1%. Given the rarity of these tumors, the literature contains primarily case reports, small series, and population-based studies. Data are heterogeneous and almost entirely retrospective, frequently gathered over long time periods, in the context of changing pathological techniques and reporting. In addition, our understanding of the disease biology and therapeutic context has also evolved significantly over this time. There is often limited information about the specific therapies used and the rationale for choosing such an approach. Meaningful comparisons of treatment modalities are not feasible and it is not possible to define management guidelines. Instead, this review correlates the available information to give an impression of how each subgroup behaves-of the favored surgical technique, responses to therapy, and prognosis-as well as the emerging molecular data, highlighting new research areas for potential target in clinical trials. Each tumor subtype described represents a small but real cohort of patients with breast cancer, and although inferences may be made from this review, we are mindful of the paucity of data. The management of each patient must be considered in the context of their unique clinical presentation and correlated with the evidence-based principles that apply to more common breast cancer histologies.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenocarcinoma/therapy
- Breast Neoplasms/classification
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma/diagnosis
- Carcinoma/pathology
- Carcinoma/therapy
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/therapy
- Female
- Humans
- Prognosis
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Affiliation(s)
- Karen A Cadoo
- Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA.
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31
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Hickey TE, Robinson JLL, Carroll JS, Tilley WD. Minireview: The androgen receptor in breast tissues: growth inhibitor, tumor suppressor, oncogene? Mol Endocrinol 2012; 26:1252-67. [PMID: 22745190 DOI: 10.1210/me.2012-1107] [Citation(s) in RCA: 203] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Androgen receptor (AR) signaling exerts an antiestrogenic, growth-inhibitory influence in normal breast tissue, and this role may be sustained in estrogen receptor α (ERα)-positive luminal breast cancers. Conversely, AR signaling may promote growth of a subset of ERα-negative, AR-positive breast cancers with a molecular apocrine phenotype. Understanding the molecular mechanisms whereby androgens can elicit distinct gene expression programs and opposing proliferative responses in these two breast cancer phenotypes is critical to the development of new therapeutic strategies to target the AR in breast cancer.
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Affiliation(s)
- T E Hickey
- Dame Roma Mitchell Cancer Research Laboratory, School of Medicine, Hanson Institute and University of Adelaide, Adelaide SA 5000, Australia
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32
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Masuda S. Breast cancer pathology: The impact of molecular taxonomy on morphological taxonomy. Pathol Int 2012; 62:295-302. [DOI: 10.1111/j.1440-1827.2012.02790.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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33
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Carcinome apocrine in situ du sein : corrélation anatomo-radiologique. IMAGERIE DE LA FEMME 2012. [DOI: 10.1016/j.femme.2012.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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34
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Brown JP, Pinder SE. Ductal carcinoma in situ: current morphological and molecular subtypes. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.mpdhp.2012.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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35
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FOXA1: master of steroid receptor function in cancer. EMBO J 2011; 30:3885-94. [PMID: 21934649 DOI: 10.1038/emboj.2011.340] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 08/29/2011] [Indexed: 12/15/2022] Open
Abstract
FOXA transcription factors are potent, context-specific mediators of development that hold specialized functions in hormone-dependent tissues. Over the last several years, FOXA1 has emerged as a critical mediator of nuclear steroid receptor signalling, manifest at least in part through regulation of androgen receptor and oestrogen receptor activity. Recent findings point towards a major role for FOXA1 in modulating nuclear steroid receptor activity in breast and prostate cancer, and suggest that FOXA1 may significantly contribute to pro-tumourigenic phenotypes. The present review article will focus on the mechanisms, consequence, and clinical relevance of FOXA1-mediated steroid nuclear receptor signalling in human malignancy.
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36
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Banneau G, Guedj M, MacGrogan G, de Mascarel I, Velasco V, Schiappa R, Bonadona V, David A, Dugast C, Gilbert-Dussardier B, Ingster O, Vabres P, Caux F, de Reynies A, Iggo R, Sevenet N, Bonnet F, Longy M. Molecular apocrine differentiation is a common feature of breast cancer in patients with germline PTEN mutations. Breast Cancer Res 2010; 12:R63. [PMID: 20712882 PMCID: PMC2949656 DOI: 10.1186/bcr2626] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 07/07/2010] [Accepted: 08/16/2010] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Breast carcinoma is the main malignant tumor occurring in patients with Cowden disease, a cancer-prone syndrome caused by germline mutation of the tumor suppressor gene PTEN characterized by the occurrence throughout life of hyperplastic, hamartomatous and malignant growths affecting various organs. The absence of known histological features for breast cancer arising in a PTEN-mutant background prompted us to explore them for potential new markers. METHODS We first performed a microarray study of three tumors from patients with Cowden disease in the context of a transcriptomic study of 74 familial breast cancers. A subsequent histological and immunohistochemical study including 12 additional cases of Cowden disease breast carcinomas was performed to confirm the microarray data. RESULTS Unsupervised clustering of the 74 familial tumors followed the intrinsic gene classification of breast cancer except for a group of five tumors that included the three Cowden tumors. The gene expression profile of the Cowden tumors shows considerable overlap with that of a breast cancer subgroup known as molecular apocrine breast carcinoma, which is suspected to have increased androgenic signaling and shows frequent ERBB2 amplification in sporadic tumors. The histological and immunohistochemical study showed that several cases had apocrine histological features and expressed GGT1, which is a potential new marker for apocrine breast carcinoma. CONCLUSIONS These data suggest that activation of the ERBB2-PI3K-AKT pathway by loss of PTEN at early stages of tumorigenesis promotes the formation of breast tumors with apocrine features.
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Affiliation(s)
- Guillaume Banneau
- INSERM U916, Université de Bordeaux, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
| | - Mickaël Guedj
- Tumor Identity Card program (CIT3), Ligue Nationale Contre le Cancer, 12 rue Corvisart, 75013 Paris, France
| | - Gaëtan MacGrogan
- INSERM U916, Université de Bordeaux, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
- Pathology Department, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
| | - Isabelle de Mascarel
- Pathology Department, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
| | - Valerie Velasco
- Pathology Department, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
| | - Renaud Schiappa
- Tumor Identity Card program (CIT3), Ligue Nationale Contre le Cancer, 12 rue Corvisart, 75013 Paris, France
| | - Valerie Bonadona
- Cancer Genetics Unit, Centre Léon Bérard, 28 rue Laennec, 69008 Lyon, France
| | - Albert David
- Medical Genetics Unit, CHU de Nantes, 5 allée de l'Île Gloriette, 44000 Nantes, France
| | - Catherine Dugast
- Cancer Genetics Unit, Centre Eugène Marquis, avenue de la Bataille Flandres-Dunkerque, 35000 Rennes, France
| | | | - Olivier Ingster
- Medical Genetics Unit, CHU d'Angers, rue Larrey, 49100 Angers, France
| | - Pierre Vabres
- Dermatology Department, CHU de Dijon, 2 boulevard du Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Frederic Caux
- Dermatology Department, Hôpital Avicenne, 125 rue Stalingrad, 93000 Bobigny, France
| | - Aurelien de Reynies
- Tumor Identity Card program (CIT3), Ligue Nationale Contre le Cancer, 12 rue Corvisart, 75013 Paris, France
| | - Richard Iggo
- INSERM U916, Université de Bordeaux, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
| | - Nicolas Sevenet
- INSERM U916, Université de Bordeaux, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
- Cancer Genetics Unit, Institut Bergonié, 229 cours de l'Argonne, 33000 Bordeaux, France
| | - Françoise Bonnet
- INSERM U916, Université de Bordeaux, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
- Cancer Genetics Unit, Institut Bergonié, 229 cours de l'Argonne, 33000 Bordeaux, France
| | - Michel Longy
- INSERM U916, Université de Bordeaux, Institut Bergonié, 229 cours de l'Argonne, 33000, Bordeaux, France
- Cancer Genetics Unit, Institut Bergonié, 229 cours de l'Argonne, 33000 Bordeaux, France
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Lopez-Garcia MA, Geyer FC, Lacroix-Triki M, Marchió C, Reis-Filho JS. Breast cancer precursors revisited: molecular features and progression pathways. Histopathology 2010; 57:171-92. [PMID: 20500230 DOI: 10.1111/j.1365-2559.2010.03568.x] [Citation(s) in RCA: 215] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Increasingly more coherent data on the molecular characteristics of benign breast lesions and breast cancer precursors have led to the delineation of new multistep pathways of breast cancer progression through genotypic-phenotypic correlations. It has become apparent that oestrogen receptor (ER)-positive and -negative breast lesions are fundamentally distinct diseases. Within the ER-positive group, histological grade is strongly associated with the number and complexity of genetic abnormalities in breast cancer cells. Genomic analyses of high-grade ER-positive breast cancers have revealed that a substantial proportion of these tumours harbour the characteristic genetic aberrations found in low-grade ER-positive disease, suggesting that at least a subgroup of high-grade ER-positive breast cancers may originate from low-grade lesions. The ER-negative group is more complex and heterogeneous, comprising distinct molecular entities, including basal-like, HER2 and molecular apocrine lesions. Importantly, the type and pattern of genetic aberrations found in ER-negative cancers differ from those of ER-positive disease. Here, we review the available molecular data on breast cancer risk indicator and precursor lesions, the putative mechanisms of progression from in situ to invasive disease, and propose a revised model of breast cancer evolution based on the molecular characteristics of distinct subtypes of in situ and invasive breast cancers.
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Affiliation(s)
- Maria A Lopez-Garcia
- Molecular Pathology Team, The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, 237 Fulham Road, London, UK
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38
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Vranic S, Tawfik O, Palazzo J, Bilalovic N, Eyzaguirre E, Lee LM, Adegboyega P, Hagenkord J, Gatalica Z. EGFR and HER-2/neu expression in invasive apocrine carcinoma of the breast. Mod Pathol 2010; 23:644-53. [PMID: 20208479 DOI: 10.1038/modpathol.2010.50] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study was undertaken to investigate epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER-2)/neu expression in a cohort of apocrine carcinomas of the breast with emphasis on the classification of the breast tumors with apocrine morphology. In total, 55 breast carcinomas morphologically diagnosed as apocrine were evaluated for the steroid receptor expression profile characteristic of normal apocrine epithelium (androgen receptor positive/estrogen receptor (ER) negative/progesterone receptor (PR) negative), and for the expression of EGFR and Her-2/neu proteins, and the copy number ratios of the genes EGFR/CEP7 and HER-2/CEP17. On the basis of the results of steroid receptors expression, 38 (69%) cases were classified as pure apocrine carcinoma (androgen receptor positive/ER negative/PR negative), whereas 17 (31%) were re-classified as apocrine-like carcinomas because they did not have the characteristic steroid receptor expression profile. Her-2/neu overexpression was observed in 54% of the cases (57% pure apocrine carcinomas vs 47% apocrine-like carcinomas). HER-2/neu gene amplification was demonstrated in 52% of all cases (54% pure apocrine carcinomas vs 46% apocrine-like carcinomas). EGFR protein (scores 1 to 3+) was detected in 62% of all cases and was expressed in a higher proportion of pure apocrine carcinomas than in the apocrine-like carcinomas group (76 vs 29%, P=0.006). In the pure apocrine carcinoma group, Her-2/neu and EGFR protein expression were inversely correlated (P=0.006, r=-0.499). EGFR gene amplification was observed in two pure apocrine carcinomas and one apocrine-like carcinoma. Polysomy 7 was commonly present in pure apocrine carcinomas (61 vs 27% of apocrine-like carcinomas; P=0.083) and showed a weak positive correlation with EGFR protein expression (P=0.025, r=0.326). Our study showed that apocrine breast carcinomas are molecularly diverse group of carcinomas. Strictly defined pure apocrine carcinomas are either HER-2-overexpressing breast carcinomas or triple-negative breast carcinomas, whereas apocrine-like carcinomas predominantly belong to the luminal phenotype. Pure apocrine carcinomas show consistent overexpression of either EGFR or HER-2/neu, which could have significant therapeutic implications.
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Affiliation(s)
- Semir Vranic
- Department of Pathology, Creighton University Medical Center, Omaha, NE 68131, USA
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39
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Cytokeratin 5 and estrogen receptor immunohistochemistry as a useful adjunct in identifying atypical papillary lesions on breast needle core biopsy. Am J Surg Pathol 2009; 33:1615-23. [PMID: 19675450 DOI: 10.1097/pas.0b013e3181aec446] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The presence of atypical or usual epithelial proliferations within papillary breast lesions complicates their interpretation on core biopsy. We evaluated the combination of estrogen receptor (ER) and cytokeratin 5 (CK5) as an aid in the distinction of usual duct hyperplasia from atypical proliferations in this setting. Core biopsies from 185 papillary lesions were reviewed and of these, 82 cases were selected for immunohistochemical study based on the presence of an epithelial proliferation between the fibrovascular cores. Fifty-two cases were used as the test set and 30 cases, with subsequent surgical excision, were used as the validation set. The epithelial proliferation was evaluated for staining intensity and percentage of positive cells using CK5 and ER. Expression of both CK5 and ER was significantly different in nonatypical lesions when compared with atypical lesions (P<0.0001). Nonatypical lesions typically showed an ER-low/CK5-high profile and atypical lesions showed an ER-high/CK5-low profile with ER-high expression defined as diffuse strong staining in >90% of cells. CK5-high expression was defined as a mosaic pattern of staining in >20% of cells and CK5-low as absent or staining in <20% of cells. On the basis of their staining profile, 29 of the 30 validation cases were correctly classified using the excision specimen as the gold standard. Patterns and extent of ER and CK5 staining, when used together, are valuable adjunct stains to differentiate usual duct hyperplasia from atypical proliferations within papillary lesions on core biopsy.
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40
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Suciu V, Menet E, Guinebretière JM, Trassard M, Vielh P. [Apocrine lesions in breast pathology]. Ann Pathol 2009; 29 Spec No 1:S112-3. [PMID: 19887237 DOI: 10.1016/j.annpat.2009.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 07/22/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Voichita Suciu
- Service de pathologie, centre René-Huguenin, rue Dailly, Saint-Cloud, France.
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41
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Apocrine metaplasia of breast cancer: clinicopathological features and predicting response. Breast Cancer 2009; 17:290-7. [PMID: 19789945 DOI: 10.1007/s12282-009-0178-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Tailor-made therapies are currently gaining prominence, and the clarification of predictive markers for anticancer agents represents an important research issue. From our institutional neoadjuvant experience, apocrine carcinoma showed a high correlation with therapeutic effect against breast cancer. We thus considered that apocrine metaplasia (AM) might represent a predictive marker for breast cancer. METHODS A total of 210 primary invasive breast cancers from Japanese patients were scored according to the size of cytoplasmic granules and abundance of cytoplasm, then classified into three categories: non-AM, incomplete AM and complete AM. Clinicopathological features were evaluated based on these classifications. RESULTS Distribution according to the classification of AM was: non-AM, 61%; incomplete AM, 36%; and complete AM, 3%. No significant differences with regard to estrogen receptor, progesterone receptor, human epidermal growth factor receptor type 2, androgen receptor or bcl-2 were observed among the three groups. Gross cystic fluid protein-15 showed a high positive rate (83%) for complete AM. Cases of incomplete AM and complete AM were combined to form the AM group. Among lymph node-positive patients without chemotherapy, the 10-year recurrence-free survival (RFS) rate was 85% for non-AM and 44% for AM (p < 0.05). Conversely, among the lymph node-positive group with chemotherapy, the 10-year RFS rate was 45% for non-AM and 75% for AM (p < 0.05). Prognoses for non-AM and AM were turned around by chemotherapy. Lymph node metastasis was related to prognosis in multivariate analysis, although AM did not remain an independent prognosticator. CONCLUSIONS Apocrine metaplasia appears to offer an effective predictive marker for anticancer therapy.
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42
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Vincent-Salomon A. [Diagnostic pitfalls in mammary pathology. Case 2. Atypical duct hyperplasia within columnar cell changes with atypia]. Ann Pathol 2009; 29:194-8. [PMID: 19619825 DOI: 10.1016/j.annpat.2009.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2009] [Indexed: 10/20/2022]
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43
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Yerushalmi R, Hayes MM, Gelmon KA. Breast carcinoma--rare types: review of the literature. Ann Oncol 2009; 20:1763-70. [PMID: 19602565 DOI: 10.1093/annonc/mdp245] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Invasive breast cancer is a heterogeneous disease in its presentation, pathological classification and clinical course. However, there are more than a dozen variants which are less common but still very well defined by the World Health Organization (WHO) classification. The rarity of many of these neoplasms does not allow large or randomized studies to define the optimal treatment. Many of the descriptions of these cancers are from case reports and small series. Our review brings updated information on 16 epithelial subtypes as classified by the WHO system with a very concise histopathology description and parameters helpful in the clinic. The aim of our review is to provide a tool for breast cancer caregivers which will enable a better understanding of the disease and its optimal approach to therapy. This may also stand as a clinical framework for a future understanding of these rarer breast cancers when gene analysis work is reported.
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Affiliation(s)
- R Yerushalmi
- British Columbia Cancer Agency, Vancouver, Canada.
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44
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Tsuda H. Gene and chromosomal alterations in sporadic breast cancer: correlation with histopathological features and implications for genesis and progression. Breast Cancer 2009; 16:186-201. [PMID: 19472036 DOI: 10.1007/s12282-009-0124-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Accepted: 03/29/2009] [Indexed: 12/31/2022]
Abstract
A number of gene and chromosome alterations have been identified in sporadic breast carcinomas, and their clinical implications have been investigated. Changes in proto-oncogenes and tumor-suppressor genes, e.g., HER2, p53, and E-cadherin, and various numerical and structural chromosome alterations are strongly correlated with histological type and grade in breast carcinomas. The amount of information on these alterations has been dramatically increased by the introduction of high-throughput molecular cytogenetic approaches. In the near future, breast cancers will be classified into specific groups according to their profile of gene and chromosome alterations, allowing more effective personalized therapies targeting the associated molecular pathways.
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Affiliation(s)
- Hitoshi Tsuda
- Pathology Section, Clinical Laboratory Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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45
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Celis JE, Cabezón T, Moreira JMA, Gromov P, Gromova I, Timmermans-Wielenga V, Iwase T, Akiyama F, Honma N, Rank F. Molecular characterization of apocrine carcinoma of the breast: validation of an apocrine protein signature in a well-defined cohort. Mol Oncol 2009; 3:220-37. [PMID: 19393583 DOI: 10.1016/j.molonc.2009.01.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 01/23/2009] [Accepted: 01/26/2009] [Indexed: 12/12/2022] Open
Abstract
Invasive apocrine carcinomas (IACs), as defined by morphological features, correspond to 0.3-4% of all invasive ductal carcinomas (IDC), and despite the fact that they are histologically distinct from other breast lesions there are currently no standard molecular criteria available for their diagnosis and no unequivocal information as to their prognosis. In an effort to address these concerns we have been using protein expression profiling technologies in combination with mass spectrometry and immunohistochemistry (IHC) to discover specific biomarkers that could allow us to molecularly characterize these lesions as well as to dissect some of the steps in the processes underlying breast apocrine metaplasia and development of precancerous apocrine lesions. Establishing these apocrine-specific markers as best practice for the routine pathology evaluation of breast cancer, however, will require their validation in large cohorts of patients. Towards this goal we have composed a panel of antibodies against components of an apocrine protein signature that includes probes against the apocrine-specific markers 15-prostaglandin dehydrogenase (15-PGDH), and acyl-CoA synthetase medium-chain family member 1 (ACSM1), in addition to a set of categorizing markers that are consistently expressed (AR, CD24) or not expressed (ERα, PgR, Bcl-2, and GATA-3) by apocrine metaplasia in benign breast lesions and apocrine sweat glands. This panel was used to analyze a well-defined cohort consisting of 14 apocrine ductal carcinoma in situ (ADCIS), and 33 IACs diagnosed at the Cancer Institute Hospital, Tokyo between 1997 and 2001. Samples were originally classified on the basis of cellular morphology with all cases having more than 90% of the tumour cells exhibiting cytological features typical of apocrine cells. Using the expression of 15-PGDH and/or ACSM1 as the main criterion, but taking into account the expression of other markers, we were able to identify unambiguously 13 out of 14 ADCIS (92.9%) and 20 out of 33 (60.6%) IAC samples, respectively, as being of apocrine origin. Our results demonstrate that IACs correspond to a distinct, even if heterogeneous, molecular subgroup of breast carcinomas that can be readily identified in an unbiased way using a combination of markers that recapitulate the phenotype of apocrine sweat glands (15-PGDH(+), ACSM1(+), AR(+), CD24(+), ERα(-), PgR(-), Bcl-2(-), and GATA-3(-)). These results pave the way for addressing issues such as prognosis of IACs, patient stratification for targeted therapeutics, as well as research strategies for identifying novel therapeutic targets for developing new cancer therapies.
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Affiliation(s)
- Julio E Celis
- Danish Centre for Translational Breast Cancer Research (DCTB), Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
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46
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Provenzano E, Pinder SE. Pre-operative diagnosis of breast cancer in screening: problems and pitfalls. Pathology 2009; 41:3-17. [DOI: 10.1080/00313020802563478] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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47
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Choi SY, Kim SJ, Cho YU, Park JY, Park JM, Chu YC, Choe YM, Choi SK, Heo YS, Lee KY, Ahn SI, Hong KC, Shin SH, Kim KR. Clinicopathological Characteristics of Apocrine Carcinoma of the Breast. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2009. [DOI: 10.4174/jkss.2009.76.5.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- So Young Choi
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Sei Joong Kim
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Young Up Cho
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Jae Young Park
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Jeong Mi Park
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Young Chae Chu
- Department of Pathology, Inha University College of Medicine, Incheon, Korea
| | - Yun Mee Choe
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Sun Keun Choi
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Yoon Seok Heo
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Keon Young Lee
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Seung Ik Ahn
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Kee Chun Hong
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Seok Hwan Shin
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Kyung Rae Kim
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
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48
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Celis JE, Gromov P, Cabezón T, Moreira JMA, Friis E, Jirström K, Llombart-Bosch A, Timmermans-Wielenga V, Rank F, Gromova I. 15-prostaglandin dehydrogenase expression alone or in combination with ACSM1 defines a subgroup of the apocrine molecular subtype of breast carcinoma. Mol Cell Proteomics 2008; 7:1795-809. [PMID: 18632593 DOI: 10.1074/mcp.r800011-mcp200] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Established histopathological criteria divide invasive breast carcinomas into defined groups. Ductal of no specific type and lobular are the two major subtypes accounting for around 75 and 15% of all cases, respectively. The remaining 10% include rarer types such as tubular, cribriform, mucinous, papillary, medullary, metaplastic, and apocrine breast carcinomas. Molecular profiling technologies, on the other hand, subdivide breast tumors into five subtypes, basal-like, luminal A, luminal B, normal breast tissue-like, and ERBB2-positive, that have different prognostic characteristics. An additional subclass termed "molecular apocrine" has recently been described, but these lesions did not exhibit all the histopathological features of classical invasive apocrine carcinomas (IACs). IACs make up 0.5-3% of the invasive ductal carcinomas, and despite the fact that they are morphologically distinct from other breast lesions, there are presently no standard molecular criteria available for their diagnosis and as a result no precise information as to their prognosis. Toward this goal our laboratories have embarked in a systematic proteomics endeavor aimed at identifying biomarkers that may characterize and subtype these lesions as well as targets that may lead to the development of novel targeted therapies and chemoprevention strategies. By comparing the protein expression profiles of apocrine macrocysts and non-malignant breast epithelial tissue we have previously reported the identification of a few proteins that are specifically expressed by benign apocrine lesions as well as by the few IACs that were available to us at the time. Here we reiterate our strategy to reveal apocrine cell markers and present novel data, based on the analysis of a considerably larger number of samples, establishing that IACs correspond to a distinct molecular subtype of breast carcinomas characterized by the expression of 15-prostaglandin dehydrogenase alone or in combination with a novel form of acyl-CoA synthetase medium-chain family member 1 (ACSM1). Moreover we show that 15-prostaglandin dehydrogenase is not expressed by other breast cancer types as determined by gel-based proteomics and immunohistochemistry analysis and that antibodies against this protein can identify IACs in an unbiased manner in a large breast cancer tissue microarray making them potentially useful as a diagnostic aid.
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Affiliation(s)
- Julio E Celis
- Department of Proteomics in Cancer, Institute of Cancer Biology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
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