Prevalence of MMTV-Like env Sequences and Its Association with BRCA1/2 Genes Mutations Among Egyptian Breast Cancer Patients

Background

Mouse mammary tumor virus (MMTV) is thought to have a role in human breast cancer (BC) pathogenesis. BRCA1 and 2 genes mutations are well-established risk factors for BC. The purpose of this study was to evaluate the presence of MMTV in familial and non-familial Egyptian breast cancer patients. We also aimed to establish a correlation between BRCAs genes mutations and MMTV infection in those patients.

Patients and Methods

The study was included 80 BC patients and 10 healthy women were included as a control group. We used PCR to amplify a 250-bp MMTV-like env sequence. We also used PCR followed by direct sequencing to identify the genetic variation of exons 2, 13, 19 of BRCA1 gene and exon 9 and region f of exon 11 of BRCA2 gene. High resolution melting (HRM) analysis was used to screen the selected exons of BRCA1/2 genes in order to detect different variants.

Results

MMTV DNA-like env sequences were detected in 70%, 76% of familial and non-familial BC patients, respectively, and it was not detected in any of the control subjects. The presence of viral sequences was associated with larger tumor size in the sporadic patients. Seventy BC patients showed variations in BRCA1/2 genes according to HRM analysis and sequencing analysis showed two different sequences of polymorphism among 22 familial and non-familial BC patients.

Conclusion

MMTV DNA was present among BC patients and it was associated with increased tumor growth. This indicates a potential role for MMTV in BC patients with and without deleterious mutation in BRCA1/2 genes.

AB0956 VERTICAL NAIL RIDGING IN PATIENTS WITH FIBROMYALGIA: FREQUENCY, PROPOSED GRADING AND CORRELATION WITH OTHER DISEASE FEATURES

Background:

The vertical nail ridging (VNR) has long been reported to be related to stressful conditions1

Objectives:

to evaluate the frequency of VNS in FM patients and its relation to other disease parameters depending on a proposed grading.

Methods:

VNR has been searched for in 212 FM patients (2016 criteria). The number of fingers, the degree of VNR according to this proposed grading (0: no ridging, 1: ridging only detected by a magnifying lens, 2: ridging seen by naked eye and 3: ridging that can be seen and felt) and other FM features according to the new and old ACR criteria have been recorded. 80 subjects of those consulting for knee osteoarthritis have been examined for VNR and those found positive were asked about the FM features and examined for tender points. Patients aged >50 years and those with psoriasis and fungal infections were excluded.

Results:

the mean age of patients was 32.4±9.9 (73.6% were female). The mean disease duration was 5.8±3.7, while the means of WPI, SSS and tender points were 9.4±2.9, 7.3±1.2 and 14.7±2.3 respectively. VNR was found in 209 patients (98.6%). Of 80 controls, VNR has been found in 61 subjects, of whom FM has been diagnosed in 32 patients (52.4%) by 2016 FM criteria and in 46 (75.4%) by 1990 criteria. The number of fingers with VNR has been found only correlated with the disease duration (r= 0.276, P = 0.000). The severity of VNR was significantly correlating with fatigue (P= 0.002), sleep disturbance (P= 0.001), awaking unrefreshed (P = 0.000), WPI (p = 0.01) and mean tender points (P =0.02). Considering the 2016 criteria as a gold standard, the sensitivity of VNR was 98.37%, the specificity was 9.68% and the diagnostic accuracy was 82.8%.

Conclusion:

vertical nail ridging is a frequent finding and can be considered helpful for diagnosis of patients with FM. Further studies are needed to validate this sign for diagnosis and follow up of FM patients.

References:

[1]American Academy of Dermatology. (2007, November 12). Feeling Stressed? How Your Skin, Hair And Nails Can Show It.Science Daily. Retrieved December 30, 2019 fromwww.sciencedaily.com/releases/2007/11/071109194053.htm

Disclosure of Interests:

None declared

Outcome of HER2 positive luminal operable breast cancer in comparison with outcome of other operable luminal breast cancer patients: Long follow-up of single center randomized study

INTRODUCTION

In clinical practice, there is increasing recognition that HER2-positive breast cancer patients are not a homogeneous group. Especially patients with luminal B breast cancers which are now subdivided to more than two groups.

AIM OF THE STUDY

The aim of this study is to know the effect of HER2 positivity on luminal breast cancer patients by comparing disease free survival DFS luminal of HER2 positive breast cancer patients with other luminal cases with HER2 negative disease. Also we explored the effect of HER2 positivity on different risk factors for breast cancer.

PATIENTS AND METHODS

We compared the outcome of 25 HER2 positive luminal breast cancer patients with a control group of other luminal operable breast cancer at the same period of time with the same eligibility and exclusive criteria.

RESULTS

Total of 59 operable luminal breast cancer patients were eligible for the study, 25 of them were luminal HER2 positive and the 34 were control group of luminal HER2 negative. We found that HER2 positive luminal breast cancer patients were having more unfavorable risk factors and have more incidence of relapse mainly after 48 months follow-up than other luminal patients: after 24 months follow-up period HER2 positive luminal patients have cumulative DFS of 91% compared with 93% in luminal HER2 negative patients but after 48 months follow-up the difference between the two groups became more obvious as it was 66% for luminal HER2 positive group and 90 % for the control group. High risk patients for luminal HER2 positive breast cancer patients have higher risk of relapse (60% compared with 86%), and this appeared also in other subgroups.

CONCLUSION

HER2 positive luminal breast cancer patients have a higher incidence of relapse compared with other luminal breast cancer, and this difference appear mainly after 48 months of follow-up. High risk patients for luminal HER2 positive breast cancer have higher risk of relapse than high risk patients of other luminal patients.

A new surgical strategy for breast conservation in locally advanced breast cancer that achieves a good locoregional control rate: preliminary report

The scope of breast conserving surgery has recently expanded to include locally advanced breast cancer (LABC) patients who are downstaged following neoadjuvant chemotherapy (NACT). However, the efficacy of this approach in achieving adequate locoregional control of disease is in doubt. Some reports have attributed the failure to the association of NACT-induced tumour downstaging which can leave multifocal in situ and invasive lesions around the main tumour mass. In the present study, in order to eradicate all possible tumour satellites, a very wide local excision that included the whole original tumour-bearing area was performed regardless of the expected wide defect. This defect was then immediately reconstructed by an ipsilateral pedicled latissimus dorsi myocutaneous (LDM) flap. The study included 26 patients with LABC without evidence of primary tumour-multicentricity. Tumours were downstaged following NACT. The early cosmetic outcome was good in the majority of cases. Early complications were minimal. Twenty-two patients had a mean follow up period of 30.2 (range 7-50) months. In those evaluable cases, locoregional control of the disease was excellent (100%) but distant metastases occurred in seven cases (31.8%).

Breast conservative surgery: is it appropriate for locally advanced breast cancer following downstaging by neoadjuvant chemotherapy? A pathological assessment

The application of breast conserving surgery to down-staged cases with locally advanced breast cancer (LABC) after neoadjuvant chemotherapy (NACT) is still a controversial issue with a variable incidence of locoregional failures. In this study, the response of LABC to NACT was assessed pathologically and the eligible candidates for breast conserving surgery were identified retrospectively. The efficacy of preoperative clinical examination and mammography in detecting these pathological changes were also evaluated. The study included 41 LABC cases. They received NACT (FAC) and were then subjected to a mastectomy. The cases were examined clinically and by mammography before starting treatment and immediately before surgery. Residual tumours in the mastectomy specimens were correlated with the pretreatment and preoperative clinical and mammographic findings in order to assess the efficacy of these tools for detection of NACT-induced changes. After 3 cycles of NACT, 78% of women showed an objective response. However, only 25% of them would have been eligible for breast conserving surgery. The remaining responders had an increased incidence of either multifocality and or peritumoural in situ carcinoma. Both clinical examination and mammography were inadequate for detection of these chemotherapy-induced changes and hence for selecting suitable candidates for breast conservation. This study has shown that tumour regression by NACT is probably induced by a process of tumour segmentation and is associated with an increased incidence of ductal in situ lesions in the original tumour bearing area.