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Carrasco-Tenezaca F, Moreira-Dinzey J, Manrai PA, Bearse M, Burela S, Podany P, Singh K, Pareja F, Zheng J, Muscato NE, Liang Y, Zhan H, Krishnamurti U, Dolezal D, Wang J, Harigopal M. Breast Carcinoma With Tubulopapillary Features Has a Distinct Immunophenotypic and Molecular Signature: A Report of Two Tumors and Literature Review. Int J Surg Pathol 2023:10668969231209780. [PMID: 37908113 DOI: 10.1177/10668969231209780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Breast carcinoma with tubulopapillary features is a newly described entity associated with poor prognosis with only 14 tumors reported in the literature. We report 2 additional tumors and identify novel immunohistochemical and molecular features of the tumor. The first tumor was from a 72-year-old woman with nonmetastatic breast carcinoma and the second was from a 32-year-old woman with metastatic breast carcinoma who received neoadjuvant therapy. Both tumors had high-grade nuclear features with a distinctive morphology characterized by infiltrating open glands with intratubular papillary and micropapillary projections in >90% of the invasive carcinoma. In addition to the usual predictors of aggressive behavior, both tumors showed a high expression of p16 and SOX10, which has not been previously described. Targeted tumor sequencing revealed pathogenic variants of TP53 in both tumors, in agreement with previous reports. Prior studies have shown a correlation between p16 and SOX10 expression with high-grade features and worse prognosis; typically seen in triple-negative carcinomas as demonstrated in both of our tumors. However, not all reported tumors of breast carcinoma with tubulopapillary features have demonstrated a triple-negative profile as there are a few reports of tumors with estrogen receptor and/or human epidermal growth factor 2 expression. Due to their distinct morphologic and molecular characteristics, breast carcinoma with tubulopapillary features may represent a new breast cancer histologic subtype.
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Affiliation(s)
| | | | - Padmini A Manrai
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Mayara Bearse
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | | | - Peter Podany
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Kamaljeet Singh
- Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Fresia Pareja
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Nicole E Muscato
- Department of Pathology, Lawrence and Memorial Hospital, New London, CT, USA
| | - Yuanxin Liang
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Haiying Zhan
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Uma Krishnamurti
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Darin Dolezal
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Jianhui Wang
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
| | - Malini Harigopal
- Department of Pathology, Yale New Haven Hospital, New Haven, CT, USA
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Moreira-Dinzey J, Zhan H, Rozenblit M, Krishnamurti U, Harigopal M, Zhong M, Liang Y. The correlation of ESR1 genetic aberrations with estrogen receptor and progesterone receptor status in metastatic and primary estrogen receptor-positive breast carcinomas. Hum Pathol 2023; 137:56-62. [PMID: 37127079 DOI: 10.1016/j.humpath.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/14/2023] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Genetic aberrations in the Estrogen Receptor 1 (ESR1) gene have been identified as an important mechanism of resistance to endocrine therapy in metastatic breast carcinoma. In this study, we aimed to correlate ESR1 genetic aberrations with the ER and PR status in paired metastatic and primary breast carcinomas. METHODS Patients with ER-positive breast cancer were divided into two groups: ESR1 genetic aberration (n=26) and wild-type control (n=29) based on genetic profiling of their metastatic tumors. Clinicopathological features and ER/PR status were analyzed in paired primary and metastatic tumors. RESULTS Although there was no significant difference in ER expression between the ESR1 aberration and control groups in primary tumors, ER positivity rate in metastatic tumors was significantly higher in the ESR1 aberration group than in the control group (100% vs. 86%, p<0.05). ESR1 aberrated cases were associated with more liver metastases than control tumors (46% vs. 10%, p<0.01). The ER percentage and intensity slightly increased from primary to metastatic tumors in the ESR1 aberration group compared to a decrease in both in the wild-type group (percentage increase 2% vs. decrease 19%, p=0.0594; intensity increase 0.04 vs. decrease 0.8, p<0.05). Patients with ESR1 aberrated metastases were more likely than those with wild-type ESR1 metastases to have the following characteristics: 1) ER percentage ≥ 90% and intensity >2, as well as PR percentage ≥ 30% and intensity >1 in metastatic tumors; 2) ER percentage ≥ 90% and PR percentage ≥ 70% in primary tumors; and 3) slightly increase in ER percentage and intensity from primary to metastatic tumors. CONCLUSION Based on the ER/PR parameters of paired primary and metastatic breast cancer, ESR1 aberration in metastasis may be predicted.
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Affiliation(s)
| | - Haiying Zhan
- Department of Pathology, Yale University School of Medicine, New Haven, CT
| | - Mariya Rozenblit
- Department of Medical Oncology, Smilow Cancer Hospital at Yale New Haven, New Haven, CT
| | - Uma Krishnamurti
- Department of Pathology, Yale University School of Medicine, New Haven, CT
| | - Malini Harigopal
- Department of Pathology, Yale University School of Medicine, New Haven, CT
| | - Minghao Zhong
- Department of Pathology, Yale University School of Medicine, New Haven, CT
| | - Yuanxin Liang
- Department of Pathology, Yale University School of Medicine, New Haven, CT.
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