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Dou H, Li F, Wang Y, Chen X, Yu P, Jia S, Ba Y, Luo D, Gao T, Li Z, Xiao M. Estrogen receptor-negative/progesterone receptor-positive breast cancer has distinct characteristics and pathologic complete response rate after neoadjuvant chemotherapy. Diagn Pathol 2024; 19:5. [PMID: 38178166 PMCID: PMC10765627 DOI: 10.1186/s13000-023-01433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE The status of hormone receptors (HR) is an independent factor affecting survival and chemotherapy sensitivity in breast cancer (BC) patients, with estrogen receptor (ER) and progesterone receptor (PR) having the most significant effects. The ER-/PR + phenotype has been controversial in BC, and experts will face many challenges in determining treatment strategies. Herein, we systematically analyzed the clinicopathological characteristics of the ER-/PR + phenotype in BC patients and the response to chemotherapy. PATIENTS AND METHODS We included two cohorts. The first cohort counted the relationship between clinicopathologic data and survival outcomes for 72,666 female patients in the Surveillance, Epidemiology, and End Results (SEER) database. The second cohort analyzed the relationship between clinicopathological data and pathologic complete response (pCR) rate in 879 patients at the Harbin Medical University Cancer Hospital. The classification data were compared by the chi-square test and Fister's exact test of the Logistic regression model, and predictor variables with P < 0.05 in the univariate analysis were included in the multivariate regression analysis. The Kaplan-Meier method evaluated breast cancer-specific survival (BCSS) and overall survival (OS) to investigate the relationship between different HR typing and survival and pCR. RESULTS In the two cohorts, 704 (0.9%) and 11 (1.3%) patients had the ER-/PR + phenotype, respectively. The clinicopathologic features of patients with the ER-/PR + phenotype are more similar to those of the ER-/PR- phenotype. The ER-/PR + phenotype is more common in younger and premenopausal women, and most ER-/PR + phenotypes exhibit higher histological grades. Survival analysis showed that there were significant differences in OS and BCSS among patients with different HR states (P < 0.001). The survival results of patients with the ER + /PR + phenotype were the best. The prognosis of the ER-/PR + phenotype was similar to that of the ER-/PR- phenotype. On the other hand, we found that HR status was also an independent predictor of post-NAC pCR rate in BC patients. The ER + /PR- and ER-/PR- phenotypes were more sensitive to chemotherapy than the ER + /PR + phenotypes. CONCLUSION HR status is the main factor affecting BC's survival outcome and pCR rate. Patients with the ER-/PR + phenotype possess more aggressive biological factors and can benefit significantly from chemotherapy. We need to pay more attention to this group and achieve individualized treatment, which will help us treat BC better and provide new targets and blueprints for our clinical treatment.
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Affiliation(s)
- He Dou
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Fucheng Li
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Youyu Wang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Xingyan Chen
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Pingyang Yu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Siyuan Jia
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Yuling Ba
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Danli Luo
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Tian Gao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Zhaoting Li
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China
| | - Min Xiao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China.
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Predicting Characteristics Associated with Breast Cancer Survival Using Multiple Machine Learning Approaches. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1249692. [PMID: 35509861 PMCID: PMC9060999 DOI: 10.1155/2022/1249692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/29/2022] [Indexed: 11/23/2022]
Abstract
Breast cancer is one of the most commonly diagnosed female disorders globally. Numerous studies have been conducted to predict survival markers, although the majority of these analyses were conducted using simple statistical techniques. In lieu of that, this research employed machine learning approaches to develop models for identifying and visualizing relevant prognostic indications of breast cancer survival rates. A comprehensive hospital-based breast cancer dataset was collected from the National Cancer Institute's SEER Program's November 2017 update, which offers population-based cancer statistics. The dataset included female patients diagnosed between 2006 and 2010 with infiltrating duct and lobular carcinoma breast cancer (SEER primary cites recode NOS histology codes 8522/3). The dataset included nine predictor factors and one predictor variable that were linked to the patients' survival status (alive or dead). To identify important prognostic markers associated with breast cancer survival rates, prediction models were constructed using K-nearest neighbor (K-NN), decision tree (DT), gradient boosting (GB), random forest (RF), AdaBoost, logistic regression (LR), voting classifier, and support vector machine (SVM). All methods yielded close results in terms of model accuracy and calibration measures, with the lowest achieved from logistic regression (accuracy = 80.57 percent) and the greatest acquired from the random forest (accuracy = 94.64 percent). Notably, the multiple machine learning algorithms utilized in this research achieved high accuracy, suggesting that these approaches might be used as alternative prognostic tools in breast cancer survival studies, especially in the Asian area.
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Nardi RPD, Uchoa D, Remonatto G, Biazus JV, Damin AP. Immunohistochemical and clinicopathologic features of estrogen receptor-negative, progesterone receptor-positive, HER-2 negative breast carcinomas. ACTA ACUST UNITED AC 2021; 67:265-270. [PMID: 34406251 DOI: 10.1590/1806-9282.67.02.20200683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Currently, there is an ongoing debate whether progesterone receptor positive and estrogen receptor negative breast carcinomas represent a true distinct subtype of tumor or a mere immunohistochemical artifact. In this study, we conducted an immunohistochemistry panel with the antibodies TFF1, EGFR, and CK5 to reclassify this phenotype in a luminal or basal-like subtype. METHODS Tumors estrogen receptor -/progesterone receptor +, Her-2 - from a large population of breast cancer patients were selected to be studied. Immunohistochemistry with the antibodies TFF1, EGFR, and CK5 was performed. Tumors showing positivity for TFF1, regardless of EGFR and CK5 results, were classified as luminal-like carcinomas. Those lesions that were negative for TFF1, but were positive for EGFR and/or CK5, were classified as basal-like triple-negative carcinomas. When the three markers were negative, tumors were classified as undetermined. Clinical pathologic characteristics of patients and tumor recurrence were evaluated. RESULTS Out of 1188 breast carcinomas investigated, 30 cases (2.5%) presented the estrogen receptor -/progesterone receptor +/HER2- phenotype. Of them, 27 tumors (90%) were classified as basal-like triple-negative carcinomas, one as luminal-like (3.3%), and two as undetermined tumors (6.7%). The mean follow-up for the study group was 27.7 (2.7 to 50) months. Out of the 26 patients, 6 had cancer recurrence: 2 local and 4 systemic recurrences. The average time for recurrence was 17 (8 to 38) months. CONCLUSION Estrogen receptor -/progesterone receptor +/tumors exhibit aggressive behavior, similar to triple-negative tumors. An appropriate categorization of these tumors should be made to improve their therapeutic management.
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Affiliation(s)
- Rosana Pellin De Nardi
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Gynecology and Obstetrics - Porto Alegre (RS), Brazil
| | - Diego Uchoa
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Division of Pathology - Porto Alegre (RS), Brazil
| | - Gabriela Remonatto
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Division of Pathology - Porto Alegre (RS), Brazil
| | - Jorge Villanova Biazus
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Gynecology and Obstetrics - Porto Alegre (RS), Brazil.,Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre Breast Surgery Division - Porto Alegre (RS), Brazil
| | - Andrea Pires Damin
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Gynecology and Obstetrics - Porto Alegre (RS), Brazil.,Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre Breast Surgery Division - Porto Alegre (RS), Brazil
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Lv M, Mao Y, Song Y, Wang Y, Liu X, Wang X, Nie G, Wang H. Clinical Features and Survival of Single Hormone Receptor-Positive Breast Cancer: A Population-Based Study of 531,605 Patients. Clin Breast Cancer 2020; 20:e589-e599. [PMID: 32565109 DOI: 10.1016/j.clbc.2020.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/18/2020] [Accepted: 04/19/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the prognosis of single hormone receptor-positive (HR+) breast cancer (estrogen receptor [ER] positive and progesterone receptor [PR] negative, and ER-PR+) compared to double HR+ (ER+PR+) and double HR- (ER-PR-) tumors. METHODS We included 531,605 cases of invasive breast cancer between 1990 and 2012 from the US Surveillance, Epidemiology, and End Results (SEER) database for study and classified cases into 4 phenotypes according to expression of ER and PR: ER+PR+, ER+PR-, ER-PR+, and ER-PR-. RESULTS Overall, 66,091 ER+PR- tumors and 9320 ER-PR+ tumors were identified. The clinical characteristics of the ER+PR- group were similar to those of the double HR+ group, while those of the ER-PR+ and double HR- groups were similar. Overall survival of patients with single HR+ tumors was intermediate between that of double HR+ and double HR- tumors. However, we observed no differences in disease-specific survival between ER-PR+ and ER-PR- patients. In multivariate analysis, outcomes were similar. Relative to the double HR+ patient group, risk of death in the ER+PR- group was higher (hazard ratio, 1.422, 95% confidence interval, 1.394-1.452). However, risk of death was comparable between ER-PR+ and ER-PR- patients (hazard ratio, 1.03; 95% confidence interval, 0.98-1.08). Multivariate Cox proportional analysis showed that survival times of patients in the younger age bracket (< 60 years), those positive for human epidermal growth factor receptor 2 (HER2), and patients with tumor stage I-III were longer in the ER-PR+ group. CONCLUSION Disease-specific survival of single HR+ tumor cases was longer than that of double HR- tumors but poorer than double HR+ tumors. However, differences in disease-specific survival were not significant between the ER-PR+ and ER-PR- groups.
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Affiliation(s)
- Meng Lv
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China.
| | - Yan Mao
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Yuhua Song
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Yongmei Wang
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Xiaoyi Liu
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Xingang Wang
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Gang Nie
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Haibo Wang
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China.
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Wu N, Fu F, Chen L, Lin Y, Yang P, Wang C. Single hormone receptor-positive breast cancer patients experienced poor survival outcomes: a systematic review and meta-analysis. Clin Transl Oncol 2019; 22:474-485. [PMID: 31222450 DOI: 10.1007/s12094-019-02149-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/28/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The prognostic and clinical significance of single hormone receptor expression in breast cancer has not been clearly established. The goal of this study was to conduct a meta-analysis to compare the clinical outcomes of patients with ER+PR- tumours and ER-PR+ tumours to those of patients with ER+PR+ tumours. METHODS A systematic review of the literature was conducted to identify studies that compared the clinical outcome of patients with ER+PR- tumours or ER-PR+ tumours with those of patients with ER+PR+ tumours. A total of 18 studies met the inclusion criteria and included 217,485 women. Standard methods for meta-analysis were used, including fixed-effect models. RESULTS Patients with ER+PR- tumours or ER-PR+ tumours had significantly worse DFS (HR 1.60, 95% CI 1.44-1.77 and HR 2.27, 95% CI 1.67-3.09), BCSS (HR 1.43, 95% CI 1.33-1.53 and HR 1.82, 95% CI 1.68-1.98) and OS (HR 1.38, 95% CI 1.28-1.47 and HR 1.48, 95% CI 1.17-1.89) than those of patients with ER+PR+ tumours. In subgroup analyses, patients who had ER+PR- tumours experienced a higher risk of recurrence than patients with ER+PR+ tumours in the HER2- (HR 1.57, 95% CI 1.32-1.87), LN - (HR 2.07, 95% CI 1.44-2.86) and endocrine therapy (HR 1.65, 95% CI 1.45-1.89) subgroup. Patients who had HER2- and ER-PR+ tumours had an increased risk of recurrence compared with patients who had HER2- and ER+PR+ tumours (HR 3.10, 95% CI 1.92-5.10). CONCLUSIONS Among patients with hormone receptor-positive breast cancer, patients with either ER+PR- tumours or ER-PR+ tumours have a higher risk of recurrence and a shorter survival time than those with ER+PR+ tumours. Patients with both types of breast cancer need additional or better treatments.
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Affiliation(s)
- N Wu
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - F Fu
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China.
| | - L Chen
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - Y Lin
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - P Yang
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - C Wang
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China.
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Ganggayah MD, Taib NA, Har YC, Lio P, Dhillon SK. Predicting factors for survival of breast cancer patients using machine learning techniques. BMC Med Inform Decis Mak 2019; 19:48. [PMID: 30902088 PMCID: PMC6431077 DOI: 10.1186/s12911-019-0801-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/18/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Breast cancer is one of the most common diseases in women worldwide. Many studies have been conducted to predict the survival indicators, however most of these analyses were predominantly performed using basic statistical methods. As an alternative, this study used machine learning techniques to build models for detecting and visualising significant prognostic indicators of breast cancer survival rate. METHODS A large hospital-based breast cancer dataset retrieved from the University Malaya Medical Centre, Kuala Lumpur, Malaysia (n = 8066) with diagnosis information between 1993 and 2016 was used in this study. The dataset contained 23 predictor variables and one dependent variable, which referred to the survival status of the patients (alive or dead). In determining the significant prognostic factors of breast cancer survival rate, prediction models were built using decision tree, random forest, neural networks, extreme boost, logistic regression, and support vector machine. Next, the dataset was clustered based on the receptor status of breast cancer patients identified via immunohistochemistry to perform advanced modelling using random forest. Subsequently, the important variables were ranked via variable selection methods in random forest. Finally, decision trees were built and validation was performed using survival analysis. RESULTS In terms of both model accuracy and calibration measure, all algorithms produced close outcomes, with the lowest obtained from decision tree (accuracy = 79.8%) and the highest from random forest (accuracy = 82.7%). The important variables identified in this study were cancer stage classification, tumour size, number of total axillary lymph nodes removed, number of positive lymph nodes, types of primary treatment, and methods of diagnosis. CONCLUSION Interestingly the various machine learning algorithms used in this study yielded close accuracy hence these methods could be used as alternative predictive tools in the breast cancer survival studies, particularly in the Asian region. The important prognostic factors influencing survival rate of breast cancer identified in this study, which were validated by survival curves, are useful and could be translated into decision support tools in the medical domain.
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Affiliation(s)
- Mogana Darshini Ganggayah
- Data Science and Bioinformatics Laboratory, Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Yip Cheng Har
- Department of Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Pietro Lio
- Department of Computer Science and Technology, University of Cambridge, 15 JJ Thomson Avenue, Cambridge, CB3 0FD, England
| | - Sarinder Kaur Dhillon
- Data Science and Bioinformatics Laboratory, Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Raphael J, Kiss A, Nofech-Mozes S, Trudeau M. Clinical Outcomes of Single Versus Double Hormone Receptor–Positive Breast Cancer Patients Treated With Neoadjuvant Chemotherapy. Clin Breast Cancer 2018; 18:e1381-e1387. [DOI: 10.1016/j.clbc.2018.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/10/2018] [Accepted: 07/22/2018] [Indexed: 01/13/2023]
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Kuroda H, Muroi N, Hayashi M, Harada O, Hoshi K, Fukuma E, Abe A, Kubota K, Imai Y. Oestrogen receptor-negative/progesterone receptor-positive phenotype of invasive breast carcinoma in Japan: re-evaluated using immunohistochemical staining. Breast Cancer 2018; 26:249-254. [PMID: 30066060 PMCID: PMC6394606 DOI: 10.1007/s12282-018-0898-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/26/2018] [Indexed: 12/01/2022]
Abstract
Background The existence of progesterone receptor (PgR) expression in oestrogen receptor (ER)-negative breast carcinoma is controversial. Here, we re-evaluated ER-negative/PgR-positive (ER−/PgR+) carcinoma cases by immunohistochemical staining (IHC). Materials and methods We selected patients who underwent surgery for primary breast carcinoma from our databases at Dokkyo Medical University Hospital and Kameda General Hospital. Among the 9844 patients, the largest series in Japan, 27 (0.3%) were initially diagnosed as ER−/PgR+ breast carcinomas and we re-evaluated by IHC. Results The re-evaluated IHC showed that of the 27 patients with the initial results of ER−/PgR+, 12 were ER+/PgR+, 8 were ER−/PgR−, and 7 were ER−/PgR+. ER was negative in 12 of 27 patients (44.4%), and PgR was positive in 8 of 27 patients (29.6%). In our seven re-evaluated and confirmed as ER−/PgR+ cases, the staining proportions of tumor cells were 0% in ER and 1–69% (average 15.8%) in PgR. The average staining proportion of PgR in the re-evaluated ER−/PgR+ phenotype was lower than the initial diagnosis. Histological grading was as follows: grade I, one case; grade II, two cases; grade III, four cases. There were two lymph-node-positive cases. Conclusions The ER−/PgR+ phenotype was confirmed after re-evaluation of ER and PgR assessment by a different pathologist. We recommend that pathologists discuss with clinicians, or re-test and re-evaluate ER/PgR expression, particularly in low-grade carcinoma and with a high staining proportion of PgR in the ER−/PgR+ phenotype.
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Affiliation(s)
- Hajime Kuroda
- Department of Diagnostic Pathology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
| | - Nozomi Muroi
- Department of Surgery I, Dokkyo Medical University, Mibu, Japan
| | | | - Oi Harada
- Department of Pathology, Kameda Medical Center Hospital, Kamogawa, Japan
| | - Kazuei Hoshi
- Department of Pathology, Kameda Medical Center Hospital, Kamogawa, Japan
| | - Eisuke Fukuma
- Department of Breast Surgery, Kameda Medical Center Hospital, Kamogawa, Japan
| | - Akihito Abe
- Department of Surgery II, Dokkyo Medical University, Mibu, Japan
| | - Keiichi Kubota
- Department of Surgery II, Dokkyo Medical University, Mibu, Japan
| | - Yasuo Imai
- Department of Diagnostic Pathology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
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Estrogen receptor-negative progesterone receptor-positive breast cancer – “Nobody's land“ or just an artifact? Cancer Treat Rev 2018; 67:78-87. [DOI: 10.1016/j.ctrv.2018.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 12/27/2022]
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Du F, Yuan P, Wang JY, Ma F, Fan Y, Luo Y, Xu BH. Effect of hormone therapy on long-term outcomes of patients with human epidermal growth factor receptor 2- and hormone receptor-positive metastatic breast cancer: real world experience in China. Asian Pac J Cancer Prev 2015; 16:903-7. [PMID: 25735380 DOI: 10.7314/apjcp.2015.16.3.903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among human epidermal growth factor receptor 2 (HER2)-positive breast cancer, more than half are also hormone receptor (HR)-positive. Although HR is a predictive factor for the efficacy of hormone therapy, there are still some uncertainties in regard to the effects on patients with HR-positive and HER2-positive metastatic breast cancers due to the potential resistance to hormone therapy caused by co-expression of HR and HER2. There are no clinical trials directly comparing the efficacy of hormonal therapy with chemotherapy. MATERIALS AND METHODS To examine the real-world effect of hormone therapy on patients with HR-positive and HER2-positive metastatic breast cancers, a cross-sectional study of a representative sample of the Chinese population was conducted. The study included 113 patients who received first-line and second-line palliative treatment between 2005 and 2010 in the Cancer Institute and Hospital, Chinese Academy of Medical Science. The effect of hormone therapy on overall survival (OS) was studied. RESULTS The patients who received hormone therapy (n=51) had better overall survival in contrast to those who received chemotherapy with anti-HER2 therapy (n=62) in first- or second-line treatment. The difference was of borderline statistical significance (51.8m vs 31.9m, p=0.065). In addition, the effect of hormone therapy did not differ significantly with other prognostic factors, including age (≤50 years or >50 years), disease free survival (≥2 years or < 2 years) and site of metastasis (visceral or bone/soft tissue). On multivariate analysis, administration of hormone therapy was associated with a trend toward a favorable prognosis (p=0.148, HR=0.693, 95%CI 0.422-1.139). Age more than 50 years was the sole independent harmful prognostic factor (p<0.001, HR=2.797, 95%CI 1.676-4.668). CONCLUSIONS Our data suggest that hormonel therapy may improve outcomes of the patients with ER-positive and HER2-positive metastatic breast cancer.
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Affiliation(s)
- Feng Du
- Department of Medical Oncology, Cancer Institute and Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China E-mail :
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Khabaz MN, Gari MA, Al-Maghrabi JA, Nedjadi T, Bakarman M. Association between GSTP1 genotypes and hormone receptor phenotype in invasive ductal carcinomas of breast. Asian Pac J Cancer Prev 2015; 16:1707-13. [PMID: 25773813 DOI: 10.7314/apjcp.2015.16.5.1707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Eighty six cases of invasive ductal breast carcinomas were utilized to investigate GSTP1 polymorphisms in certain immunohistochemistry (IHC) subtypes of breast cancer with respect to ER, PR and HER2 expression. The frequency of wild allele homozygote, heterozygote and variant allele homozygote genotypes were 46.5%, 52.3% and 1.16% respectively; Whereas 54.3% of the control subjects were GSTP1 wild type allele homozygous, 40.0% were heterozygous and 5.71% mutant allele homozygous. There was dramatic inverted relation between positive IHC ER staining and increasing grade of tumors in general (100%, 88.6%, 40.4%) and especially among tumors with heterozygote genotype of GSTP1 (70%, 35.4%, 22.7). There was increase in positive IHC HER2 staining consistent with higher grades in general (20%, 29.6%, 50.0%), especially among tumors with GSTP1 wild allele homozygote genotype (5.0%, 9.1%, 31.8%). A remarkable reverse relation was also observed between the fraction of IHC hormone receptor phenotype ER+/PR+/ HER2- and increased grade of tumors (60.0%, 45.5%, and 27.3%) especially among tumors with GSTP1 heterozygote genotype, and a similar link was noted regarding ER+/PR-/ HER2- and tumor grade. There was increase in frequency of ER-/PR-/ HER2- (0.0%, 6.8%, and 18.2%) and ER-/PR-/ HER2+ (0.0%, 4.54%, and 40.9%) consistent with the higher grades of tumors in general and especially GSTP1 heterozygote genotype tumors. As a conclusion, there is no correlation between GSTP1 polymorphism and increased risk of breast cancer i.e. the mutant allele is randomly distributed in cancer and control cases. However, there is a link between GSTP1 genotypes and hormone receptor expression status and certain phenotypes of breast cancer, which may have clinical importance.
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Affiliation(s)
- Mohamad Nidal Khabaz
- Department of Pathology, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia E-mail : ;
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Sevinc ED, Egeli U, Cecener G, Tezcan G, Tunca B, Gokgoz S, Tasdelen I, Tolunay S, Evrensel T. Association of miR-1266 with Recurrence/Metastasis Potential in Estrogen Receptor Positive Breast Cancer Patients. Asian Pac J Cancer Prev 2015; 16:291-7. [DOI: 10.7314/apjcp.2015.16.1.291] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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