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Wang J, Li B, Luo M, Huang J, Zhang K, Zheng S, Zhang S, Zhou J. Progression from ductal carcinoma in situ to invasive breast cancer: molecular features and clinical significance. Signal Transduct Target Ther 2024; 9:83. [PMID: 38570490 PMCID: PMC10991592 DOI: 10.1038/s41392-024-01779-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024] Open
Abstract
Ductal carcinoma in situ (DCIS) represents pre-invasive breast carcinoma. In untreated cases, 25-60% DCIS progress to invasive ductal carcinoma (IDC). The challenge lies in distinguishing between non-progressive and progressive DCIS, often resulting in over- or under-treatment in many cases. With increasing screen-detected DCIS in these years, the nature of DCIS has aroused worldwide attention. A deeper understanding of the biological nature of DCIS and the molecular journey of the DCIS-IDC transition is crucial for more effective clinical management. Here, we reviewed the key signaling pathways in breast cancer that may contribute to DCIS initiation and progression. We also explored the molecular features of DCIS and IDC, shedding light on the progression of DCIS through both inherent changes within tumor cells and alterations in the tumor microenvironment. In addition, valuable research tools utilized in studying DCIS including preclinical models and newer advanced technologies such as single-cell sequencing, spatial transcriptomics and artificial intelligence, have been systematically summarized. Further, we thoroughly discussed the clinical advancements in DCIS and IDC, including prognostic biomarkers and clinical managements, with the aim of facilitating more personalized treatment strategies in the future. Research on DCIS has already yielded significant insights into breast carcinogenesis and will continue to pave the way for practical clinical applications.
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Affiliation(s)
- Jing Wang
- The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Breast Surgery and Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, China
| | - Baizhou Li
- Department of Pathology, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Meng Luo
- The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, China
- Department of Plastic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jia Huang
- The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, China
| | - Kun Zhang
- Department of Breast Surgery and Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shu Zheng
- The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, China
| | - Suzhan Zhang
- The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, China.
| | - Jiaojiao Zhou
- The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Department of Breast Surgery and Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou, China.
- Cancer Center, Zhejiang University, Hangzhou, China.
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2
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Chen H, Li X, Li F, Li Y, Chen F, Zhang L, Ye F, Gong M, Bu H. Prediction of coexisting invasive carcinoma on ductal carcinoma in situ (DCIS) lesions by mass spectrometry imaging. J Pathol 2023; 261:125-138. [PMID: 37555360 DOI: 10.1002/path.6154] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 08/10/2023]
Abstract
Due to limited biopsy samples, ~20% of DCIS lesions confirmed by biopsy are upgraded to invasive ductal carcinoma (IDC) upon surgical resection. Avoiding underestimation of IDC when diagnosing DCIS has become an urgent challenge in an era discouraging overtreatment of DCIS. In this study, the metabolic profiles of 284 fresh frozen breast samples, including tumor tissues and adjacent benign tissues (ABTs) and distant surrounding tissues (DSTs), were analyzed using desorption electrospray ionization-mass spectrometry (DESI-MS) imaging. Metabolomics analysis using DESI-MS data revealed significant differences in metabolite levels, including small-molecule antioxidants, long-chain polyunsaturated fatty acids (PUFAs) and phospholipids between pure DCIS and IDC. However, the metabolic profile in DCIS with invasive carcinoma components clearly shifts to be closer to adjacent IDC components. For instance, DCIS with invasive carcinoma components showed lower levels of antioxidants and higher levels of free fatty acids compared to pure DCIS. Furthermore, the accumulation of long-chain PUFAs and the phosphatidylinositols (PIs) containing PUFA residues may also be associated with the progression of DCIS. These distinctive metabolic characteristics may offer valuable indications for investigating the malignant potential of DCIS. By combining DESI-MS data with machine learning (ML) methods, various breast lesions were discriminated. Importantly, the pure DCIS components were successfully distinguished from the DCIS components in samples with invasion in postoperative specimens by a Lasso prediction model, achieving an AUC value of 0.851. In addition, pixel-level prediction based on DESI-MS data enabled automatic visualization of tissue properties across whole tissue sections. Summarily, DESI-MS imaging on histopathological sections can provide abundant metabolic information about breast lesions. By analyzing the spatial metabolic characteristics in tissue sections, this technology has the potential to facilitate accurate diagnosis and individualized treatment of DCIS by inferring the presence of IDC components surrounding DCIS lesions. © 2023 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Hong Chen
- Department of Pathology and Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, PR China
- Key Laboratory of Transplant Engineering and Immunology of the National Health Commission, West China Hospital, Sichuan University, Chengdu, PR China
| | - Xin Li
- Laboratory of Clinical Proteomics and Metabolomics, Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Fengling Li
- Department of Pathology and Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, PR China
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yijie Li
- Department of Pathology and Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, PR China
- Key Laboratory of Transplant Engineering and Immunology of the National Health Commission, West China Hospital, Sichuan University, Chengdu, PR China
| | - Fei Chen
- Department of Pathology and Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Lu Zhang
- Image Processing and Parallel Computing Laboratory, School of Computer Science, Southwest Petroleum University, Chengdu, PR China
| | - Feng Ye
- Department of Pathology and Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, PR China
- Key Laboratory of Transplant Engineering and Immunology of the National Health Commission, West China Hospital, Sichuan University, Chengdu, PR China
| | - Meng Gong
- Laboratory of Clinical Proteomics and Metabolomics, Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Hong Bu
- Department of Pathology and Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, PR China
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, PR China
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3
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Saatchi Y, Schanen P, Cheung RA, Petty HR. Computer Vision Identifies Recurrent and Nonrecurrent Ductal Carcinoma in Situ Lesions with Special Emphasis on African-American Women. Am J Pathol 2023; 193:1195-1207. [PMID: 37355038 DOI: 10.1016/j.ajpath.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/26/2023]
Abstract
Although nonrecurrent and recurrent forms of ductal carcinoma in situ (DCIS) of the breast are observed, no evidence-based test can make this distinction. The current retrospective case-control study used archival DCIS samples stained with anti-phospho-Ser226-glucose transporter type 1 and anti-phosphofructokinase type L antibodies. Immunofluorescence micrographs were used to create machine learning models of recurrent and nonrecurrent biomarker patterns, which were evaluated in cross-validation studies. Clinical performance was assessed by holdout studies using patients whose data were not used in training. Micrographs were stratified according to the recurrence probability of each image. Recurrent patients were defined by at least one image with a probability of recurrence ≥98%, whereas nonrecurrent patients had none. These studies found no false-negatives, identified true-positives, and uniquely identified true-negatives. Roughly 20% of the microscope fields of recurrent lesions were computationally recurrent. Strong prognostic results were obtained for both white and African-American women. This machine tool provides the first means to accurately predict recurrent and nonrecurrent patient outcomes. Data indicate that at least some false-positive findings were true-positive findings that benefited from surgical intervention. The intracellular locations of phospho-Ser226-glucose transporter type 1 and phosphofructokinase type L likely participate in cancer recurrences by accelerating glucose flux, a key feature of the Warburg effect.
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MESH Headings
- Female
- Humans
- Black or African American
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/ethnology
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/ethnology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/ethnology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Case-Control Studies
- Glucose Transporter Type 1/metabolism
- Neoplasm Recurrence, Local/diagnostic imaging
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Retrospective Studies
- White
- Recurrence
- Diagnosis, Computer-Assisted
- Microscopy, Fluorescence
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Affiliation(s)
| | - Parker Schanen
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan
| | - Richard A Cheung
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan
| | - Howard R Petty
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan.
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4
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Wright S, Burkholz SR, Zelinsky C, Wittman C, Carback RT, Harris PE, Blankenberg T, Herst CV, Rubsamen RM. Survivin Expression in Luminal Breast Cancer and Adjacent Normal Tissue for Immuno-Oncology Applications. Int J Mol Sci 2023; 24:11827. [PMID: 37511584 PMCID: PMC10380623 DOI: 10.3390/ijms241411827] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Survivin (BIRC5) is a tumor-associated antigen (TAA) overexpressed in various tumors but present at low to undetectable levels in normal tissue. Survivin is known to have a high expression in breast cancer (e.g., Ductal Carcinoma in situ (DCIS) and triple negative breast cancer). Previous studies have not compared survivin expression levels in DCIS tumor samples to levels in adjacent, normal breast tissue from the same patient. To ensure the effective use of survivin as a target for T cell immunotherapy of breast cancer, it is essential to ascertain the varying levels of survivin expression between DCIS tumor tissue samples and the adjacent normal breast tissue taken from the same patient simultaneously. Next-generation sequencing of RNA (RNA-seq) in normal breast tissue and tumor breast tissue from five women presenting with DCIS for lumpectomy was used to identify sequence variation and expression levels of survivin. The identity of both tumor and adjacent normal tissue samples were corroborated by histopathology. Survivin was overexpressed in human breast tissue tumor samples relative to the corresponding adjacent human normal breast tissue. Wild-type survivin transcripts were the predominant species identified in all tumor tissue sequenced. This study demonstrates upregulated expression of wild type survivin in DCIS tumor tissue versus normal breast tissue taken from the same patient at the same time, and provides evidence that developing selective cytotoxic T lymphocyte (CTL) immunotherapy for DCIS targeting survivin warrants further study.
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Affiliation(s)
- Sharon Wright
- Saint Mary’s Regional Medical Center, Reno, NV 89503, USA; (S.W.); (C.Z.); (C.W.)
- Western Surgical Group, Reno, NV 89502, USA
| | - Scott R. Burkholz
- Flow Pharma Inc., Warrensville Heights, OH 44128, USA; (S.R.B.); (R.T.C.); (P.E.H.); (T.B.); (C.V.H.)
| | - Cathy Zelinsky
- Saint Mary’s Regional Medical Center, Reno, NV 89503, USA; (S.W.); (C.Z.); (C.W.)
| | - Connor Wittman
- Saint Mary’s Regional Medical Center, Reno, NV 89503, USA; (S.W.); (C.Z.); (C.W.)
| | - Richard T. Carback
- Flow Pharma Inc., Warrensville Heights, OH 44128, USA; (S.R.B.); (R.T.C.); (P.E.H.); (T.B.); (C.V.H.)
| | - Paul E. Harris
- Flow Pharma Inc., Warrensville Heights, OH 44128, USA; (S.R.B.); (R.T.C.); (P.E.H.); (T.B.); (C.V.H.)
| | - Tikoes Blankenberg
- Flow Pharma Inc., Warrensville Heights, OH 44128, USA; (S.R.B.); (R.T.C.); (P.E.H.); (T.B.); (C.V.H.)
- Shasta Pathology Associates, Redding, CA 96001, USA
| | - Charles V. Herst
- Flow Pharma Inc., Warrensville Heights, OH 44128, USA; (S.R.B.); (R.T.C.); (P.E.H.); (T.B.); (C.V.H.)
| | - Reid M. Rubsamen
- Saint Mary’s Regional Medical Center, Reno, NV 89503, USA; (S.W.); (C.Z.); (C.W.)
- Flow Pharma Inc., Warrensville Heights, OH 44128, USA; (S.R.B.); (R.T.C.); (P.E.H.); (T.B.); (C.V.H.)
- Cleveland Medical Center, University Hospitals, Cleveland, OH 44106, USA
- Case Western Reserve School of Medicine, Cleveland, OH 44106, USA
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5
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Strand SH, Rivero-Gutiérrez B, Houlahan KE, Seoane JA, King LM, Risom T, Simpson LA, Vennam S, Khan A, Cisneros L, Hardman T, Harmon B, Couch F, Gallagher K, Kilgore M, Wei S, DeMichele A, King T, McAuliffe PF, Nangia J, Lee J, Tseng J, Storniolo AM, Thompson AM, Gupta GP, Burns R, Veis DJ, DeSchryver K, Zhu C, Matusiak M, Wang J, Zhu SX, Tappenden J, Ding DY, Zhang D, Luo J, Jiang S, Varma S, Anderson L, Straub C, Srivastava S, Curtis C, Tibshirani R, Angelo RM, Hall A, Owzar K, Polyak K, Maley C, Marks JR, Colditz GA, Hwang ES, West RB. Molecular classification and biomarkers of clinical outcome in breast ductal carcinoma in situ: Analysis of TBCRC 038 and RAHBT cohorts. Cancer Cell 2022; 40:1521-1536.e7. [PMID: 36400020 PMCID: PMC9772081 DOI: 10.1016/j.ccell.2022.10.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/29/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022]
Abstract
Ductal carcinoma in situ (DCIS) is the most common precursor of invasive breast cancer (IBC), with variable propensity for progression. We perform multiscale, integrated molecular profiling of DCIS with clinical outcomes by analyzing 774 DCIS samples from 542 patients with 7.3 years median follow-up from the Translational Breast Cancer Research Consortium 038 study and the Resource of Archival Breast Tissue cohorts. We identify 812 genes associated with ipsilateral recurrence within 5 years from treatment and develop a classifier that predicts DCIS or IBC recurrence in both cohorts. Pathways associated with recurrence include proliferation, immune response, and metabolism. Distinct stromal expression patterns and immune cell compositions are identified. Our multiscale approach employed in situ methods to generate a spatially resolved atlas of breast precancers, where complementary modalities can be directly compared and correlated with conventional pathology findings, disease states, and clinical outcome.
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MESH Headings
- Humans
- Female
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Disease Progression
- Breast Neoplasms/pathology
- Biomarkers
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/analysis
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Affiliation(s)
- Siri H Strand
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Belén Rivero-Gutiérrez
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kathleen E Houlahan
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jose A Seoane
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Lorraine M King
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA
| | - Tyler Risom
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lunden A Simpson
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA
| | - Sujay Vennam
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Aziz Khan
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Luis Cisneros
- School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Timothy Hardman
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA
| | - Bryan Harmon
- Department of Pathology, Montefiore Medical Center, Bronx, NY 10467, USA; TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA
| | - Fergus Couch
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Pathology, Mayo Clinic, Rochester, MN 55902, USA
| | - Kristalyn Gallagher
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Mark Kilgore
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Pathology, University of Washington, Seattle, WA 98195, USA
| | - Shi Wei
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Angela DeMichele
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tari King
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Priscilla F McAuliffe
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Julie Nangia
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston TX 77030, USA
| | - Joanna Lee
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Surgery, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer Tseng
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Surgery, University of Chicago, Chicago, IL 60637, USA
| | - Anna Maria Storniolo
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Medicine, Indiana University, Indianapolis, IN 46202, USA
| | - Alastair M Thompson
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston TX 77030, USA; Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Gaorav P Gupta
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Robyn Burns
- TBCRC Loco-Regional Working Group, Baltimore, MD 21287, USA; TBCRC, The EMMES Corporation, Rockville, MD 20850, USA
| | - Deborah J Veis
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA; Departments of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Katherine DeSchryver
- Departments of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Chunfang Zhu
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Magdalena Matusiak
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jason Wang
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Shirley X Zhu
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jen Tappenden
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Daisy Yi Ding
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, USA
| | - Dadong Zhang
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27708, USA
| | - Jingqin Luo
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Shu Jiang
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Sushama Varma
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lauren Anderson
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA
| | - Cody Straub
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA
| | - Sucheta Srivastava
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Christina Curtis
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Medicine and Genetics, Stanford University, Stanford, CA 94305, USA
| | - Rob Tibshirani
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, USA; Department of Statistics, Stanford University, Stanford, CA 94305, USA
| | - Robert Michael Angelo
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Allison Hall
- Department of Pathology, Duke University School of Medicine, Durham, NC 27708, USA
| | - Kouros Owzar
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27708, USA; Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC 27708, USA
| | - Kornelia Polyak
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Carlo Maley
- School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Jeffrey R Marks
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA
| | - Graham A Colditz
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - E Shelley Hwang
- Department of Surgery, Duke University School of Medicine, Durham, NC 27708, USA.
| | - Robert B West
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA.
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6
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Dawoud MM, Jones DT, Chelala C, Abdou AG, Dreger SA, Asaad N, Abd El-Wahed M, Jones L. Expression Profile of Myoepithelial Cells in DCIS: Do They Change From Protective Angels to Wicked Witches? Appl Immunohistochem Mol Morphol 2022; 30:397-409. [PMID: 35467556 DOI: 10.1097/pai.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/18/2022] [Indexed: 11/02/2022]
Abstract
The mechanism of transition of ductal carcinoma in situ (DCIS) to invasive cancer is elusive but recently changes in the myoepithelial cells (MECs) have been implicated. The aim of this study is to investigate the changes in gene profile of MECs in DCIS that could compromise their tumor suppressor function leading to promotion of tumor progression. Immuno-laser capture microdissection (LCM) was used to isolate MECs from normal and DCIS breast tissues followed by whole genome expression profiling using Affymetrix HGU-133 plus2.0 arrays. The data were analyzed using Bioconductor packages then validated by using real-time quantitative polymerase chain reaction and immunohistochemistry. Ingenuity Pathways software analysis showed clustering of most of the altered genes in cancer and cell death networks, with the Wnt/B-catenin pathway as the top canonical pathway. Validation revealed a 71.4% correlation rate with the array results. Most dramatic was upregulation of Fibronectin 1 ( FN1 ) in DCIS-associated MECs. Immunohistochemistry analysis for FN1 on normal and DCIS tissues confirmed a strong correlation between FN1 protein expression by MECs and DCIS ( P <0.0001) and between high expression level and presence of invasion ( P =0.006) in DCIS. Other validated alterations in MEC expression profile included upregulation of Nephronectin and downregulation of parathyroid hormone like hormone ( PTHLH ), fibroblast growth factor receptor 2 ( FGFR2 ), ADAMTS5 , TGFBR3 , and CAV1 . In vitro experiments revealed downregulation of PTHLH in DCIS-modified MECs versus normal lines when cultured on Fibronectin matrix. This is the first study to use this in vivo technique to investigate molecular changes in MECs in DCIS. This study adds more evidences to the molecular deviations in MECs toward tumor progression in DCIS through upregulation of the tumor-promoting molecules that may lead to novel predictive and therapeutic targets.
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Affiliation(s)
- Marwa M Dawoud
- Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Dylan T Jones
- Centre for Tumour Biology, Institute of Cancer & CR-UK Clinical Centre, Barts and The London School of Medicine & Dentistry, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ
| | - Claude Chelala
- Centre for Tumour Biology, Institute of Cancer & CR-UK Clinical Centre, Barts and The London School of Medicine & Dentistry, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ
| | - Asmaa G Abdou
- Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Sally A Dreger
- Centre for Tumour Biology, Institute of Cancer & CR-UK Clinical Centre, Barts and The London School of Medicine & Dentistry, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ
- Gut Microbes in Health, Quadram Institute Bioscience, Norwich, UK
| | - Nancy Asaad
- Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | | | - Louise Jones
- Centre for Tumour Biology, Institute of Cancer & CR-UK Clinical Centre, Barts and The London School of Medicine & Dentistry, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ
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7
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Matar R, Barrio AV, Sevilimedu V, Le T, Heerdt A, Morrow M, Tadros A. Can We Successfully De-Escalate Axillary Surgery in Women Aged ≥ 70 Years with Ductal Carcinoma in Situ or Early-Stage Breast Cancer Undergoing Mastectomy? Ann Surg Oncol 2022; 29:2263-2272. [PMID: 34994896 DOI: 10.1245/s10434-021-11140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/08/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Omission of sentinel lymph node biopsy (SLNB) in older women with clinically node-negative, hormone receptor-positive (HR+) early-stage breast cancer undergoing lumpectomy is accepted, given established low rates of regional recurrence. The safety of omitting SLNB in women undergoing mastectomy is unknown and may differ depending on extent of breast disease and variation in radiotherapy use. PATIENTS AND METHODS From 2006 to 2018, 123 cTis and 328 cT1-2 HR+/HER2- tumors from 410 women aged ≥ 70 years who underwent mastectomy and SLNB were included (41 bilateral cases). The rate of nodal positivity and effect of nodal positivity on adjuvant therapy use were examined. RESULTS Median age was 74 years; 21% of patients had positive sentinel lymph nodes, 7% had micrometastases, and 14% had macrometastases. Of cases of cTis tumors, 31% were upstaged to invasive carcinoma; 1% had macrometastases. Fewer cases of cT1 than cT2 tumors had macrometastases [13% (26/200) versus 29% (37/128); p < 0.001]. Eight percent of patients with pT1 tumors (18/228) and 27% of patients with pT2 tumors (30/113) received chemotherapy. Most patients with pT1, pN1 disease (78%; 25/32) did not receive chemotherapy. Rates of locoregional recurrence were similar between patients with cT1 or cT2 tumors with and without nodal metastases (median follow-up, 4.5 years). CONCLUSIONS Women aged ≥ 70 years with cTis and cT1N0 HR+/HER2- tumors who underwent mastectomy had low rates of nodal positivity, similar to rates reported for lumpectomy. Given this and the RxPONDER results, omission of SLNB may be considered, as findings are unlikely to alter adjuvant therapy recommendations.
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MESH Headings
- Aged
- Axilla/pathology
- Axilla/surgery
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Female
- Humans
- Mastectomy/methods
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Receptor, ErbB-2/biosynthesis
- Receptors, Estrogen/biosynthesis
- Receptors, Progesterone/biosynthesis
- Sentinel Lymph Node Biopsy
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Affiliation(s)
- Regina Matar
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrea V Barrio
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Varadan Sevilimedu
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tiana Le
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexandra Heerdt
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Audree Tadros
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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8
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Hong Y, Limback D, Elsarraj HS, Harper H, Haines H, Hansford H, Ricci M, Kaufman C, Wedlock E, Xu M, Zhang J, May L, Cusick T, Inciardi M, Redick M, Gatewood J, Winblad O, Aripoli A, Huppe A, Balanoff C, Wagner JL, Amin AL, Larson KE, Ricci L, Tawfik O, Razek H, Meierotto RO, Madan R, Godwin AK, Thompson J, Hilsenbeck SG, Futreal A, Thompson A, Hwang ES, Fan F, Behbod F. Mouse-INtraDuctal (MIND): an in vivo model for studying the underlying mechanisms of DCIS malignancy. J Pathol 2022; 256:186-201. [PMID: 34714554 PMCID: PMC8738143 DOI: 10.1002/path.5820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/05/2021] [Accepted: 10/25/2021] [Indexed: 11/24/2022]
Abstract
Due to widespread adoption of screening mammography, there has been a significant increase in new diagnoses of ductal carcinoma in situ (DCIS). However, DCIS prognosis remains unclear. To address this gap, we developed an in vivo model, Mouse-INtraDuctal (MIND), in which patient-derived DCIS epithelial cells are injected intraductally and allowed to progress naturally in mice. Similar to human DCIS, the cancer cells formed in situ lesions inside the mouse mammary ducts and mimicked all histologic subtypes including micropapillary, papillary, cribriform, solid, and comedo. Among 37 patient samples injected into 202 xenografts, at median duration of 9 months, 20 samples (54%) injected into 95 xenografts showed in vivo invasive progression, while 17 (46%) samples injected into 107 xenografts remained non-invasive. Among the 20 samples that showed invasive progression, nine samples injected into 54 xenografts exhibited a mixed pattern in which some xenografts showed invasive progression while others remained non-invasive. Among the clinically relevant biomarkers, only elevated progesterone receptor expression in patient DCIS and the extent of in vivo growth in xenografts predicted an invasive outcome. The Tempus XT assay was used on 16 patient DCIS formalin-fixed, paraffin-embedded sections including eight DCISs that showed invasive progression, five DCISs that remained non-invasive, and three DCISs that showed a mixed pattern in the xenografts. Analysis of the frequency of cancer-related pathogenic mutations among the groups showed no significant differences (KW: p > 0.05). There were also no differences in the frequency of high, moderate, or low severity mutations (KW; p > 0.05). These results suggest that genetic changes in the DCIS are not the primary driver for the development of invasive disease. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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MESH Headings
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cell Movement
- Cell Proliferation
- Disease Progression
- Epithelial Cells/metabolism
- Epithelial Cells/pathology
- Epithelial Cells/transplantation
- Female
- Heterografts
- Humans
- Mice, Inbred NOD
- Mice, SCID
- Mutation
- Neoplasm Invasiveness
- Neoplasm Transplantation
- Receptors, Progesterone/metabolism
- Time Factors
- Mice
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Affiliation(s)
- Yan Hong
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Darlene Limback
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Hanan S Elsarraj
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Haleigh Harper
- University of Kansas School of MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Haley Haines
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Hayley Hansford
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Michael Ricci
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Carolyn Kaufman
- University of Kansas School of MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Emily Wedlock
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Mingchu Xu
- Department of Genomic MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Jianhua Zhang
- Department of Genomic MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Lisa May
- Department of RadiologyThe University of Kansas School of Medicine‐WichitaWichitaKSUSA
| | - Therese Cusick
- Department of SurgeryThe University of Kansas School of Medicine‐WichitaWichitaKSUSA
| | - Marc Inciardi
- Department of RadiologyThe University of Kansas Medical CenterKansas CityKSUSA
| | - Mark Redick
- Department of RadiologyThe University of Kansas Medical CenterKansas CityKSUSA
| | - Jason Gatewood
- Department of RadiologyThe University of Kansas Medical CenterKansas CityKSUSA
| | - Onalisa Winblad
- Department of RadiologyThe University of Kansas Medical CenterKansas CityKSUSA
| | - Allison Aripoli
- Department of RadiologyThe University of Kansas Medical CenterKansas CityKSUSA
| | - Ashley Huppe
- Department of RadiologyThe University of Kansas Medical CenterKansas CityKSUSA
| | - Christa Balanoff
- Department of General Surgery, Breast Surgical Oncology DivisionThe University of Kansas Medical CenterKansas CityKSUSA
| | - Jamie L Wagner
- Department of General Surgery, Breast Surgical Oncology DivisionThe University of Kansas Medical CenterKansas CityKSUSA
| | - Amanda L Amin
- Department of General Surgery, Breast Surgical Oncology DivisionThe University of Kansas Medical CenterKansas CityKSUSA
| | - Kelsey E Larson
- Department of General Surgery, Breast Surgical Oncology DivisionThe University of Kansas Medical CenterKansas CityKSUSA
| | - Lawrence Ricci
- Department of RadiologyTruman Medical CenterKansas CityMOUSA
| | - Ossama Tawfik
- Department of Pathology, St Luke's Health System of Kansas CityMAWD Pathology GroupKansas CityMOUSA
| | | | - Ruby O Meierotto
- Breast RadiologySaint Luke's Cancer Institute, Saint Luke's Health SystemKansas CityMOUSA
| | - Rashna Madan
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Andrew K Godwin
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
| | - Jeffrey Thompson
- Department of BiostatisticsThe University of Kansas Medical CenterKansas CityKSUSA
| | - Susan G Hilsenbeck
- Lester and Sue Smith Breast Center, Biostatistics and Informatics Shared Resources, Duncan Cancer CenterBaylor College of MedicineHoustonTXUSA
| | - Andy Futreal
- Department of Genomic Medicine, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Alastair Thompson
- Section of Breast SurgeryBaylor College of Medicine, Lester and Sue Smith Breast Center, Dan L Duncan Comprehensive Cancer CenterHoustonTXUSA
| | | | - Fang Fan
- Department of PathologyCity of Hope Medical CenterDuarteCAUSA
| | - Fariba Behbod
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKSUSA
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9
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Deshpande RP, Sharma S, Liu Y, Pandey PR, Pei X, Wu K, Wu SY, Tyagi A, Zhao D, Mo YY, Watabe K. LncRNA IPW inhibits growth of ductal carcinoma in situ by downregulating ID2 through miR-29c. Breast Cancer Res 2022; 24:6. [PMID: 35078502 PMCID: PMC8787949 DOI: 10.1186/s13058-022-01504-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/11/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Ductal carcinoma in situ (DCIS) of breast is the noninvasive lesion that has propensity to progress to the malignant form. At present, it is still unknown which lesions can potentially progress to invasive forms. In this study, we aimed to identify key lncRNAs involved in DCIS growth. METHODS We employ disease-related lncProfiler array to identify IPW in specimens of DCIS and matching control samples and validate the observations in three DCIS-non-tumorigenic cell lines. Further, we examine the mechanism of IPW action and the downstream signaling in in vitro and in vivo assays. Importantly, we screened a library containing 390 natural compounds to identify candidate compound selectively inhibiting IPW low DCIS cells. RESULTS We identified lncRNA IPW as a novel tumor suppressor critical for inhibiting DCIS growth. Ectopic expression of IPW in DCIS cells strongly inhibited cell proliferation, colony formation and cell cycle progression while silencing IPW in primary breast cells promoted their growth. Additionally, orthotropic implantation of cells with ectopic expression of IPW exhibited decreased tumor growth in vivo. Mechanistically, IPW epigenetically enhanced miR-29c expression by promoting H3K4me3 enrichment in its promoter region. Furthermore, we identified that miR-29c negatively regulated a stemness promoting gene, ID2, and diminished self-renewal ability of DCIS cells. Importantly, we screened a library containing 390 natural compounds and identified toyocamycin as a compound that selectively inhibited the growth of DCIS with low expression of IPW, while it did not affect DCIS with high IPW expression. Toyocamycin also suppressed genes associated with self-renewal ability and inhibited DCIS growth in vivo. CONCLUSION Our findings revealed a critical role of the IPW-miR-29c-ID2 axis in DCIS formation and suggested potential clinical use of toyocamycin for the treatment of DCIS.
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MESH Headings
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Carcinoma, Intraductal, Noninfiltrating/drug therapy
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Cell Line, Tumor
- Female
- Gene Expression Regulation, Neoplastic
- Genes, Tumor Suppressor
- Humans
- Inhibitor of Differentiation Protein 2/metabolism
- MicroRNAs/genetics
- MicroRNAs/metabolism
- RNA, Long Noncoding/genetics
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Affiliation(s)
| | | | - Yin Liu
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Puspa Raj Pandey
- Frederick National Laboratory for Cancer Research, Frederick, MD, 21701, USA
| | - Xinhong Pei
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Kerui Wu
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Shih-Ying Wu
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Abhishek Tyagi
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Dan Zhao
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Yin-Yuan Mo
- Department of Pharmacology and Toxicology, Cancer Institute, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Kounosuke Watabe
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
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10
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Kim JI, Fine JP, Sandler DP, Zhao S. Accounting for Preinvasive Conditions in Analysis of Invasive Cancer Risk: Application to Breast Cancer. Epidemiology 2022; 33:48-54. [PMID: 34561346 PMCID: PMC8633059 DOI: 10.1097/ede.0000000000001423] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Preinvasive cancer conditions are often actively treated to minimize progression to life-threatening invasive cancers, but this creates challenges for analysis of invasive cancer risk. Conventional methods of treating preinvasive conditions as censoring events or targeting at the composite outcome could both lead to bias. METHODS We propose two solutions: one that provides exact estimates of risk based on distributional assumptions about progression, and one that provides risk bounds corresponding to extreme cases of no or complete progression. We compare these approaches through simulations and an analysis of the Sister Study data in the context of ductal carcinoma in situ (DCIS) and invasive breast cancer. RESULTS Simulations suggested important biases with conventional approaches, whereas the proposed estimate is consistent when progression parameters are correctly specified, and the risk bounds are robust in all scenarios. With Sister Study, the estimated lifetime risks for invasive breast cancer are 0.220 and 0.269 with DCIS censored or combined. Without detailed progression information, a sensitivity analysis suggested lifetime risk falls between the bounds of 0.214 and 0.269 across assumptions of 10%-95% of DCIS patients progressing to invasive cancer in an average of 1-10 years. CONCLUSIONS When estimating invasive cancer risk while preinvasive conditions are actively treated, it is important to consider the implied assumptions and potential biases of conventional approaches. Although still not perfect, we proposed two practical solutions that provide improved understanding of the underlying mechanism of invasive cancer.
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Affiliation(s)
- Jung In Kim
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Jason P. Fine
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences
| | - Shanshan Zhao
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences
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11
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Niehoff NM, O’Brien KM, Keil AP, Levine KE, Liyanapatirana C, Haines LG, Waidyanatha S, Weinberg CR, White AJ. Metals and Breast Cancer Risk: A Prospective Study Using Toenail Biomarkers. Am J Epidemiol 2021; 190:2360-2373. [PMID: 34268559 PMCID: PMC8799900 DOI: 10.1093/aje/kwab204] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
The role of metals in breast cancer is of interest because of their carcinogenic and endocrine-disrupting capabilities. Evidence from epidemiologic studies remains elusive, and prior studies have not investigated metal mixtures. In a case cohort nested within the Sister Study (enrolled in 2003-2009; followed through September 2017), we measured concentrations of 15 metals in toenails collected at enrollment in a race/ethnicity-stratified sample of 1,495 cases and a subcohort of 1,605 women. We estimated hazard ratios and 95% confidence intervals for each metal using Cox regression and robust variance. We used quantile g-computation to estimate the joint association between multiple metals and breast cancer risk. The average duration of follow-up was 7.5 years. There was little evidence supporting an association between individual metals and breast cancer. An exception was molybdenum, which was associated with reduced incidence of overall breast cancer risk (third tertile vs. first tertile: hazard ratio = 0.82, 95% confidence interval: 0.67, 1.00). An inverse association for antimony was observed among non-Hispanic Black women. Predefined groups of metals (all metals, nonessential metals, essential metals, and metalloestrogens) were not strongly associated with breast cancer. This study offers little support for metals, individually or as mixtures, as risk factors for breast cancer. Mechanisms for inverse associations with some metals warrant further study.
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Affiliation(s)
- Nicole M Niehoff
- Correspondence to Dr. Nicole M. Niehoff, Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Room A344, Research Triangle Park, NC 27709 (e-mail: )
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12
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Thorat MA, Levey PM, Jones JL, Pinder SE, Bundred NJ, Fentiman IS, Cuzick J. Prognostic and Predictive Value of HER2 Expression in Ductal Carcinoma In Situ: Results from the UK/ANZ DCIS Randomized Trial. Clin Cancer Res 2021; 27:5317-5324. [PMID: 34380636 PMCID: PMC7612534 DOI: 10.1158/1078-0432.ccr-21-1239] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/23/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE HER2 is overexpressed more frequently in ductal carcinoma in situ (DCIS) than in invasive breast cancer but its prognostic significance and predictive role for radiotherapy has not been clearly established. We investigated the prognostic and predictive value of HER2 overexpression in DCIS. EXPERIMENTAL DESIGN HER2 expression was evaluated by IHC using the HercepTest™ in samples from UK/ANZ DCIS trial participants (n = 755) with IHC 3+ expression categorized as HER2 positive for primary analyses. Sensitivity analyses included HER2 categorization as negative (IHC 0,1+), equivocal (IHC 2+), and positive (IHC 3+) and analyses restricted to a nested case-control component where 181 cases (with recurrence) were matched to 362 controls by treatment arm and age. RESULTS Two-hundred and forty-five (34.4%) of evaluable 713 samples [181 ipsilateral breast events (IBE)] were HER2 positive. HER2 overexpression was associated with significantly increased risk of IBE [HR = 2.29; 95% confidence interval (95% CI), 1.64-3.14; P < 0.0001] and in situ IBE (DCIS-IBE; HR = 2.90; 95% CI, 1.91-4.40; P < 0.0001), but not of invasive IBE (I-IBE; HR = 1.40; 95% CI, 0.81-2.42; P = 0.23; Pheterogeneity = 0.04). Inclusion of HER2 significantly improved [Δχ2 (1d.f.) 12.25; P = 0.0005] a prognostic model of clinicopathological and treatment variables, HER2 being an independent predictor of IBE (multivariate HR = 1.91; 95% CI, 1.33-2.76; P = 0.0004). Radiotherapy benefit in preventing DCIS-IBE was significantly greater (Pheterogeneity = 0.04) in HER2-positive DCIS (HR = 0.16; 95% CI, 0.07-0.41) compared with HER2-negative DCIS (HR = 0.58; 95% CI, 0.28-1.19). CONCLUSIONS HER2 overexpression is associated with significantly increased risk of in situ recurrence and is also predictive of radiotherapy benefit, with greater reductions in in situ but not invasive recurrences in HER2-positive DCIS.
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Affiliation(s)
- Mangesh A. Thorat
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
- Breast Services, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Pauline M. Levey
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - J. Louise Jones
- Barts Cancer Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sarah E. Pinder
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
- Department of Pathology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Nigel J. Bundred
- Manchester University NHS Foundation Trust, Wythenshawe, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Ian S. Fentiman
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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13
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Brock EJ, Jackson RM, Boerner JL, Li Q, Tennis MA, Sloane BF, Mattingly RR. Sprouty4 negatively regulates ERK/MAPK signaling and the transition from in situ to invasive breast ductal carcinoma. PLoS One 2021; 16:e0252314. [PMID: 34048471 PMCID: PMC8162601 DOI: 10.1371/journal.pone.0252314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022] Open
Abstract
Breast ductal carcinoma in situ (DCIS) is a non-obligate precursor of invasive ductal carcinoma (IDC). It is still unclear which DCIS will become invasive and which will remain indolent. Patients often receive surgery and radiotherapy, but this early intervention has not produced substantial decreases in late-stage disease. Sprouty proteins are important regulators of ERK/MAPK signaling and have been studied in various cancers. We hypothesized that Sprouty4 is an endogenous inhibitor of ERK/MAPK signaling and that its loss/reduced expression is a mechanism by which DCIS lesions progress toward IDC, including triple-negative disease. Using immunohistochemistry, we found reduced Sprouty4 expression in IDC patient samples compared to DCIS, and that ERK/MAPK phosphorylation had an inverse relationship to Sprouty4 expression. These observations were reproduced using a 3D culture model of disease progression. Knockdown of Sprouty4 in MCF10.DCIS cells increased ERK/MAPK phosphorylation as well as their invasive capability, while overexpression of Sprouty4 in MCF10.CA1d IDC cells reduced ERK/MAPK phosphorylation, invasion, and the aggressive phenotype exhibited by these cells. Immunofluorescence experiments revealed reorganization of the actin cytoskeleton and relocation of E-cadherin back to the cell surface, consistent with the restoration of adherens junctions. To determine whether these effects were due to changes in ERK/MAPK signaling, MEK1/2 was pharmacologically inhibited in IDC cells. Nanomolar concentrations of MEK162/binimetinib restored an epithelial-like phenotype and reduced pericellular proteolysis, similar to Sprouty4 overexpression. From these data we conclude that Sprouty4 acts to control ERK/MAPK signaling in DCIS, thus limiting the progression of these premalignant breast lesions.
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MESH Headings
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Cell Line, Tumor
- Cells, Cultured
- Female
- Humans
- Immunoblotting
- Immunohistochemistry
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/metabolism
- Mitogen-Activated Protein Kinase 1/genetics
- Mitogen-Activated Protein Kinase 1/metabolism
- Mitogen-Activated Protein Kinase 3/genetics
- Mitogen-Activated Protein Kinase 3/metabolism
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/metabolism
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Affiliation(s)
- Ethan J. Brock
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United states of America
| | - Ryan M. Jackson
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, United states of America
| | - Julie L. Boerner
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United states of America
| | - Quanwen Li
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, United states of America
| | - Meredith A. Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, United states of America
| | - Bonnie F. Sloane
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United states of America
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, United states of America
| | - Raymond R. Mattingly
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, United states of America
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, United states of America
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14
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Badve SS, Cho S, Gökmen-Polar Y, Sui Y, Chadwick C, McDonough E, Sood A, Taylor M, Zavodszky M, Tan PH, Gerdes M, Harris AL, Ginty F. Multi-protein spatial signatures in ductal carcinoma in situ (DCIS) of breast. Br J Cancer 2021; 124:1150-1159. [PMID: 33414541 PMCID: PMC7961015 DOI: 10.1038/s41416-020-01216-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 09/10/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND There is limited knowledge about DCIS cellular composition and relationship with breast cancer events (BCE). METHODS Immunofluorescence multiplexing (MxIF) was used to image and quantify 32 cellular biomarkers in FFPE DCIS tissue microarrays. Over 75,000 DCIS cells from 51 patients (median 9 years follow-up for non-BCE cases) were analysed for profiles predictive of BCE. K-means clustering was used to evaluate cellular co-expression of epithelial markers with ER and HER2. RESULTS Only ER, PR and HER2 significantly correlated with BCE. Cluster analysis identified 6 distinct cell groups with different levels of ER, Her2, cMET and SLC7A5. Clusters 1 and 3 were not significant. Clusters 2 and 4 (high ER/low HER2 and SLC7A5/mixed cMET) significantly correlated with low BCE risk (P = 0.001 and P = 0.034), while cluster 6 (high HER2/low ER, cMET and SLC7A5) correlated with increased risk (P = 0.018). Cluster 5 (similar to cluster 6, except high SLC7A5) trended towards significance (P = 0.072). A continuous expression score (Escore) based on these 4 clusters predicted likelihood of BCE (AUC = 0.79, log-rank test P = 5E-05; LOOCV AUC = 0.74, log-rank test P = 0.006). CONCLUSION Multiplexed spatial analysis of limited tissue is a novel method for biomarker analysis and predicting BCEs. Further validation of Escore is needed in a larger cohort.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Mastectomy/methods
- Middle Aged
- Prognosis
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- Sunil S Badve
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
| | | | - Yesim Gökmen-Polar
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | | | | | | | - Anup Sood
- GE Research, Niskayuna, NY, 12309, USA
| | - Marian Taylor
- Department of Oncology, Cancer and Haematology Centre, Oxford University, Oxford, OX37LJ, UK
| | | | - Puay Hoon Tan
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | | | - Adrian L Harris
- Department of Oncology, Cancer and Haematology Centre, Oxford University, Oxford, OX37LJ, UK
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15
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Abba MC, Canzoneri R, Gurruchaga A, Lee J, Tatineni P, Kil H, Lacunza E, Aldaz CM. LINC00885 a Novel Oncogenic Long Non-Coding RNA Associated with Early Stage Breast Cancer Progression. Int J Mol Sci 2020; 21:ijms21197407. [PMID: 33049922 PMCID: PMC7582527 DOI: 10.3390/ijms21197407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 12/19/2022] Open
Abstract
Long intergenic non-protein coding RNA 885 (LINC00885) was identified as significantly upregulated in breast ductal carcinoma in situ (DCIS). The aim of this study was to characterize the phenotypic effects and signaling pathways modulated by LINC00885 in non-invasive and invasive breast cancer models. We determined that LINC00885 induces premalignant phenotypic changes by increasing cell proliferation, motility, migration and altering 3D growth in normal and DCIS breast cell lines. Transcriptomic studies (RNA-seq) identified the main signaling pathways modulated by LINC00885, which include bioprocesses related to TP53 signaling pathway and proliferative signatures such as activation of EREG, EGFR and FOXM1 pathways. LINC00885 silencing in breast cancer lines overexpressing this lncRNA leads to downregulation of proliferation related transcripts such as EREG, CMYC, CCND1 and to significant decrease in cell migration and motility. TCGA-BRCA data analyses show an association between high LINC00885 expression and worse overall survival in patients with primary invasive breast carcinomas (p = 0.024), suggesting that the pro-tumorigenic effects of LINC00885 overexpression persist post-invasion. We conclude that LINC00885 behaves as a positive regulator of cell growth both in normal and DCIS breast cells possibly operating as a ceRNA and representing a novel oncogenic lncRNA associated with early stage breast cancer progression.
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Affiliation(s)
- Martin C. Abba
- Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata CP1900, Argentina; (R.C.); (A.G.); (E.L.)
- Correspondence: (M.C.A.); (C.M.A.)
| | - Romina Canzoneri
- Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata CP1900, Argentina; (R.C.); (A.G.); (E.L.)
| | - Agustina Gurruchaga
- Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata CP1900, Argentina; (R.C.); (A.G.); (E.L.)
| | - Jaeho Lee
- Department of Epigenetics and Molecular Carcinogenesis, The University of Texas M.D. Anderson Cancer Center, Science Park, Smithville, TX 78957, USA; (J.L.); (P.T.); (H.K.)
| | - Pradeep Tatineni
- Department of Epigenetics and Molecular Carcinogenesis, The University of Texas M.D. Anderson Cancer Center, Science Park, Smithville, TX 78957, USA; (J.L.); (P.T.); (H.K.)
| | - Hyunsuk Kil
- Department of Epigenetics and Molecular Carcinogenesis, The University of Texas M.D. Anderson Cancer Center, Science Park, Smithville, TX 78957, USA; (J.L.); (P.T.); (H.K.)
| | - Ezequiel Lacunza
- Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata CP1900, Argentina; (R.C.); (A.G.); (E.L.)
| | - C. Marcelo Aldaz
- Department of Epigenetics and Molecular Carcinogenesis, The University of Texas M.D. Anderson Cancer Center, Science Park, Smithville, TX 78957, USA; (J.L.); (P.T.); (H.K.)
- Correspondence: (M.C.A.); (C.M.A.)
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16
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Krasny L, Bland P, Burns J, Lima NC, Harrison PT, Pacini L, Elms ML, Ning J, Martinez VG, Yu YR, Acton SE, Ho PC, Calvo F, Swain A, Howard BA, Natrajan RC, Huang PH. A mouse SWATH-mass spectrometry reference spectral library enables deconvolution of species-specific proteomic alterations in human tumour xenografts. Dis Model Mech 2020; 13:dmm044586. [PMID: 32493768 PMCID: PMC7375474 DOI: 10.1242/dmm.044586] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/20/2020] [Indexed: 12/11/2022] Open
Abstract
SWATH-mass spectrometry (MS) enables accurate and reproducible proteomic profiling in multiple model organisms including the mouse. Here, we present a comprehensive mouse reference spectral library (MouseRefSWATH) that permits quantification of up to 10,597 proteins (62.2% of the mouse proteome) by SWATH-MS. We exploit MouseRefSWATH to develop an analytical pipeline for species-specific deconvolution of proteomic alterations in human tumour xenografts (XenoSWATH). This method overcomes the challenge of high sequence similarity between mouse and human proteins, facilitating the study of host microenvironment-tumour interactions from 'bulk tumour' measurements. We apply the XenoSWATH pipeline to characterize an intraductal xenograft model of breast ductal carcinoma in situ and uncover complex regulation consistent with stromal reprogramming, where the modulation of cell migration pathways is not restricted to tumour cells but also operates in the mouse stroma upon progression to invasive disease. MouseRefSWATH and XenoSWATH open new opportunities for in-depth and reproducible proteomic assessment to address wide-ranging biological questions involving this important model organism.
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MESH Headings
- Animals
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cell Communication
- Cell Line, Tumor
- Chromatography, Liquid
- Databases, Protein
- Female
- Heterografts
- Humans
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Nude
- Mice, SCID
- NIH 3T3 Cells
- Neoplasm Proteins/metabolism
- Neoplasm Transplantation
- Proteome
- Proteomics
- Species Specificity
- Stromal Cells/metabolism
- Stromal Cells/pathology
- Tandem Mass Spectrometry
- Tumor Microenvironment
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Affiliation(s)
- Lukas Krasny
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
| | - Philip Bland
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Jessica Burns
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
| | - Nadia Carvalho Lima
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
| | - Peter T Harrison
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
| | - Laura Pacini
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
| | - Mark L Elms
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
| | - Jian Ning
- Tumour Profiling Unit, The Institute of Cancer Research, London SW3 6JB, UK
| | - Victor Garcia Martinez
- Stromal Immunology Group, MRC Laboratory for Molecular Cell Biology, University College London WC1E 6BT, London, UK
| | - Yi-Ru Yu
- Department of Oncology, University of Lausanne, Lausanne CH-1066, Switzerland
- Ludwig Institute for Cancer Research, Lausanne CH-1066, Switzerland
| | - Sophie E Acton
- Stromal Immunology Group, MRC Laboratory for Molecular Cell Biology, University College London WC1E 6BT, London, UK
| | - Ping-Chih Ho
- Department of Oncology, University of Lausanne, Lausanne CH-1066, Switzerland
- Ludwig Institute for Cancer Research, Lausanne CH-1066, Switzerland
| | - Fernando Calvo
- The Tumour Microenvironment Team, Institute of Biomedicine and Biotechnology of Cantabria, Santander 39011, Spain
| | - Amanda Swain
- Tumour Profiling Unit, The Institute of Cancer Research, London SW3 6JB, UK
| | - Beatrice A Howard
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Rachael C Natrajan
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Paul H Huang
- Division of Molecular Pathology, The Institute of Cancer Research, London SW3 6JB, UK
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17
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Strell C, Paulsson J, Jin SB, Tobin NP, Mezheyeuski A, Roswall P, Mutgan C, Mitsios N, Johansson H, Wickberg SM, Svedlund J, Nilsson M, Hall P, Mulder J, Radisky DC, Pietras K, Bergh J, Lendahl U, Wärnberg F, Östman A. Impact of Epithelial-Stromal Interactions on Peritumoral Fibroblasts in Ductal Carcinoma in Situ. J Natl Cancer Inst 2020; 111:983-995. [PMID: 30816935 DOI: 10.1093/jnci/djy234] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 11/13/2018] [Accepted: 12/21/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A better definition of biomarkers and biological processes related to local recurrence and disease progression is highly warranted for ductal breast carcinoma in situ (DCIS). Stromal-epithelial interactions are likely of major importance for the biological, clinical, and pathological distinctions between high- and low-risk DCIS cases. METHODS Stromal platelet derived growth factor receptor (PDGFR) was immunohistochemically assessed in two DCIS patient cohorts (n = 458 and n = 80). Cox proportional hazards models were used to calculate the hazard ratios of recurrence. The molecular mechanisms regulating stromal PDGFR expression were investigated in experimental in vitro co-culture systems of DCIS cells and fibroblasts and analyzed using immunoblot and quantitative real-time PCR. Knock-out of JAG1 in DCIS cells and NOTCH2 in fibroblasts was obtained through CRISPR/Cas9. Experimental data were validated by mammary fat pad injection of DCIS and DCIS-JAG1 knock-out cells (10 mice per group). All statistical tests were two-sided. RESULTS PDGFRα(low)/PDGFRβ(high) fibroblasts were associated with increased risk for recurrence in DCIS (univariate hazard ratio = 1.59, 95% confidence interval [CI] = 1.02 to 2.46; P = .04 Wald test; multivariable hazard ratio = 1.78, 95% CI = 1.07 to 2.97; P = .03). Tissue culture and mouse model studies indicated that this fibroblast phenotype is induced by DCIS cells in a cell contact-dependent manner. Epithelial Jagged1 and fibroblast Notch2 were identified through loss-of-function studies as key juxtacrine signaling components driving the formation of the poor prognosis-associated fibroblast phenotype. CONCLUSIONS A PDGFRα(low)/PDGFRβ(high) fibroblast subset was identified as a marker for high-risk DCIS. The Jagged-1/Notch2/PDGFR stroma-epithelial pathway was described as a novel signaling mechanism regulating this poor prognosis-associated fibroblast subset. In general terms, the study highlights epithelial-stromal crosstalk in DCIS and contributes to ongoing efforts to define clinically relevant fibroblast subsets and their etiology.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Animals
- Biomarkers, Tumor
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Cancer-Associated Fibroblasts/metabolism
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/mortality
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cell Communication
- Cell Line, Tumor
- Coculture Techniques
- Computational Biology/methods
- Disease Models, Animal
- Epithelial Cells/metabolism
- Female
- Gene Expression Profiling
- Humans
- Immunohistochemistry
- Mice
- Middle Aged
- Neoplasm Grading
- Prognosis
- Receptors, Platelet-Derived Growth Factor/genetics
- Receptors, Platelet-Derived Growth Factor/metabolism
- Stromal Cells/metabolism
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18
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Lazzeroni M, Puntoni M, Provinciali N, Webber TB, Briata IM, D'Amico M, Giuliano S, Siri G, Cagnacci S, DeCensi A. Estimating the magnitude of clinical benefit of systemic therapy in patients with DCIS or pre-invasive disease of the breast. Breast 2020; 48 Suppl 1:S39-S43. [PMID: 31839158 DOI: 10.1016/s0960-9776(19)31121-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The challenge of effective management of ductal carcinoma in situ (DCIS) and other pre-malignant disorders of the breast is to select patients who will not progress to invasive carcinoma from those at the highest risk who require radiotherapy and/or endocrine therapy to minimize the risk of a subsequent invasive recurrence. Although IBIS-II and NSABP-B35 DCIS phase III trials proved that tamoxifen 20 mg/day and anastrozole reduce the risk of ipsilateral and contralateral events, the toxicities of both drugs have hampered the drug uptake by high-risk women. We recently reported results of a 3-year placebo-controlled trial of low-dose (5 mg/d) tamoxifen in 500 women with intraepithelial neoplasia (70% DCIS). At a median follow-up of 5 years, women randomly assigned to low-dose tamoxifen had half the number of subsequent diagnoses of DCIS or invasive cancer compared with those randomly assigned to placebo but no increase in thromboembolic events or endometrial cancers. The 5-year number needed to treat was 22 (95% CI, 20-27). Our attention is now focused on prognostic and predictive markers to identify patients who can derive the greatest benefits from low dose tamoxifen, such as for instance the expression of 23 genes involved in cell cycle progression (CCP). In conclusion, we endorse an active treatment of DCIS as the standard of care.
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Affiliation(s)
- Matteo Lazzeroni
- Division of Cancer Prevention and Genetics, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Matteo Puntoni
- Clinical Trial Office, E.O. Ospedali Galliera, Genoa, Italy
| | | | | | | | - Mauro D'Amico
- Division of Medical Oncology, E.O. Ospedali Galliera, Genoa, Italy
| | - Silvia Giuliano
- Division of Medical Oncology, E.O. Ospedali Galliera, Genoa, Italy
| | - Giacomo Siri
- Clinical Trial Office, E.O. Ospedali Galliera, Genoa, Italy
| | - Sara Cagnacci
- Division of Cancer Prevention and Genetics, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Andrea DeCensi
- Division of Medical Oncology, E.O. Ospedali Galliera, Genoa, Italy; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom.
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19
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Hwang ES, Hyslop T, Hendrix LH, Duong S, Bedrosian I, Price E, Caudle A, Hieken T, Guenther J, Hudis CA, Winer E, Lyss AP, Dickson-Witmer D, Hoefer R, Ollila DW, Hardman T, Marks J, Chen YY, Krings G, Esserman L, Hylton N. Phase II Single-Arm Study of Preoperative Letrozole for Estrogen Receptor-Positive Postmenopausal Ductal Carcinoma In Situ: CALGB 40903 (Alliance). J Clin Oncol 2020; 38:1284-1292. [PMID: 32125937 PMCID: PMC7164489 DOI: 10.1200/jco.19.00510] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Primary endocrine therapy for ductal carcinoma in situ (DCIS) as a potential alternative to surgery has been understudied. This trial explored the feasibility of a short-term course of letrozole and sought to determine whether treatment results in measurable radiographic and biologic changes in estrogen receptor (ER)-positive DCIS. PATIENTS AND METHODS A phase II single-arm multicenter cooperative-group trial was conducted in postmenopausal patients diagnosed with ER-positive DCIS without invasion. Patients were treated with letrozole 2.5 mg per day for 6 months before surgery. Breast magnetic resonance imaging (MRI) was obtained at baseline, 3 months, and 6 months. The primary end point was change in 6-month MRI enhancement volume compared with baseline. RESULTS Overall, 79 patients were enrolled and 70 completed 6 months of letrozole. Of these, 67 patients had MRI data available for each timepoint. Baseline MRI volumes ranged from 0.004 to 26.3 cm3. Median reductions from baseline MRI volume (1.4 cm3) were 0.6 cm3 (61.0%) at 3 months (P < .001) and 0.8 cm3 (71.7%) at 6 months (P < .001). Consistent reductions were seen in median baseline ER H-score (228; median reduction, 15.0; P = .005), progesterone receptor H-score (15; median reduction, 85.0; P < .001), and Ki67 score (12%; median reduction, 6.3%; P = .007). Of the 59 patients who underwent surgery per study protocol, persistent DCIS remained in 50 patients (85%), invasive cancer was detected in six patients (10%), and no residual DCIS or invasive cancer was seen in nine patients (15%). CONCLUSIONS In a cohort of postmenopausal women with ER-positive DCIS, preoperative letrozole resulted in significant imaging and biomarker changes. These findings support future trials of extended endocrine therapy as primary nonoperative treatment of some DCIS.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/drug therapy
- Breast Neoplasms/metabolism
- Breast Neoplasms/surgery
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/drug therapy
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Cohort Studies
- Female
- Humans
- Letrozole/therapeutic use
- Magnetic Resonance Imaging
- Mammography
- Neoadjuvant Therapy
- Postmenopause
- Preoperative Care/methods
- Receptors, Estrogen/metabolism
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Affiliation(s)
| | - Terry Hyslop
- Duke Cancer Institute, Duke University, Durham, NC
- Alliance Statistics and Data Center, Duke University, Durham, NC
| | - Laura H. Hendrix
- Duke Cancer Institute, Duke University, Durham, NC
- Alliance Statistics and Data Center, Duke University, Durham, NC
| | - Stephanie Duong
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN
| | | | - Elissa Price
- University of California, San Francisco, San Francisco, CA
| | | | - Tina Hieken
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN
| | | | | | - Eric Winer
- Dana-Farber/Partners Cancer Care, Boston, MA
| | | | | | | | | | | | | | - Yunn-Yi Chen
- University of California, San Francisco, San Francisco, CA
| | - Gregor Krings
- University of California, San Francisco, San Francisco, CA
| | - Laura Esserman
- University of California, San Francisco, San Francisco, CA
| | - Nola Hylton
- University of California, San Francisco, San Francisco, CA
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20
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Liu Y, West R, Weber JD, Colditz GA. Race and risk of subsequent aggressive breast cancer following ductal carcinoma in situ. Cancer 2019; 125:3225-3233. [PMID: 31120565 PMCID: PMC6717007 DOI: 10.1002/cncr.32200] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/22/2019] [Accepted: 04/30/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND General populations of black women have a higher risk of developing breast cancer negative for both estrogen receptor (ER) and progesterone receptor (PR) in comparison with white counterparts. Racial differences remain unknown in the risk of developing aggressive invasive breast cancer (IBC) that is characterized by negativity for both ER and PR (ER-PR-) or higher 21-gene recurrence scores after ductal carcinoma in situ (DCIS). METHODS This study identified 163,892 women (10.5% black, 9.8% Asian, and 8.6% Hispanic) with incident DCIS between 1990 and 2015 from the Surveillance, Epidemiology, and End Results data sets. Cox proportional hazards regression was used to estimate hazards ratios (HRs) of subsequent IBC classified by the hormone receptor status and 21-gene recurrence scores. RESULTS During a median follow-up of 90 months, 8333 women developed IBC. In comparison with white women, the adjusted HR of subsequent ER-PR- breast cancer was 1.86 (95% confidence interval [CI], 1.57-2.20) for black women (absolute 10-year difference, 2.2%) and 1.40 (95% CI, 1.14-1.71) for Asian women (absolute 10-year difference, 0.4%); this was stronger than the associations for ER+ and/or PR+ subtypes (Pheterogeneity = .0004). The 21-gene recurrence scores of subsequent early-stage, ER+ IBCs varied by race/ethnicity (Pheterogeneity = .057); black women were more likely than white women to have a recurrence score of 26 or higher (HR, 1.38; 95% CI, 1.00-1.92). No significant difference was observed in the risks of subsequent IBC subtypes for Hispanic women. CONCLUSIONS Black and Asian women with DCIS had higher risks of developing biologically aggressive IBC than white counterparts. This should be considered in treatment decisions for black and Asian patients with DCIS.
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MESH Headings
- Adult
- Black or African American/statistics & numerical data
- Aged
- Aged, 80 and over
- Asian/statistics & numerical data
- Breast Neoplasms/ethnology
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Intraductal, Noninfiltrating/epidemiology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Female
- Hispanic or Latino/statistics & numerical data
- Humans
- Incidence
- Male
- Middle Aged
- Neoplasm Invasiveness
- Neoplasms, Second Primary/ethnology
- Neoplasms, Second Primary/metabolism
- Neoplasms, Second Primary/pathology
- Proportional Hazards Models
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Risk
- SEER Program
- United States/epidemiology
- White People/statistics & numerical data
- Young Adult
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Affiliation(s)
- Ying Liu
- Division of Public Health Sciences, Department of SurgeryWashington University School of MedicineSt. LouisMissouri
- Alvin J. Siteman Cancer CenterBarnes‐Jewish Hospital and Washington University School of MedicineSt. LouisMissouri
| | - Robert West
- Department of PathologyStanford University School of MedicineStanfordCalifornia
| | - Jason D. Weber
- Alvin J. Siteman Cancer CenterBarnes‐Jewish Hospital and Washington University School of MedicineSt. LouisMissouri
- Division of Molecular Oncology, Department of MedicineWashington University School of MedicineSt. LouisMissouri
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of SurgeryWashington University School of MedicineSt. LouisMissouri
- Alvin J. Siteman Cancer CenterBarnes‐Jewish Hospital and Washington University School of MedicineSt. LouisMissouri
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21
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Rosa M, Agosto-Arroyo E. Core needle biopsy of benign, borderline and in-situ problematic lesions of the breast: Diagnosis, differential diagnosis and immunohistochemistry. Ann Diagn Pathol 2019; 43:151407. [PMID: 31634810 DOI: 10.1016/j.anndiagpath.2019.151407] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/22/2019] [Accepted: 09/02/2019] [Indexed: 12/11/2022]
Abstract
Core needle biopsy (CNB) is the most common sampling technique for the histologic evaluation of breast abnormalities. Diagnosing benign proliferative, borderline and some in-situ lesions in CNB is challenging and subject to a significant degree of interobserver variability. In addition, due to the inherent limitations of CNB, "upgrading" to a more significant pathology at excision is an important consideration for some lesions. Pathologists carry a major responsibility in patient diagnosis, risk stratification and management. Familiarity with the histologic features and the clinical significance of these common and problematic lesions encountered in CNB is necessary for adequate treatment and patient follow-up. This review will focus on benign, atypical and in-situ epithelial proliferations, papillary lesions, radial sclerosing lesions, adenosis and cellular fibroepithelial lesions. Highlights of histologic features, useful strategies for accurate diagnosis, basic immunohistochemistry and management will be presented.
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Affiliation(s)
- Marilin Rosa
- Department of Anatomic Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States of America.
| | - Emmanuel Agosto-Arroyo
- Department of Anatomic Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States of America.
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22
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Yetkin G, Celayir MF, Tanik C, Citgez B, Uludag M, Mihmanli M. Male breast cancer: A 10 year retrospective case series in a tertiary care hospital. J PAK MED ASSOC 2019; 69:1209-1212. [PMID: 31431782] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Male breast cancer is a rare disease and it differs from breast cancer in women by some characteristics. The incidence of the disease has increased in the last 25 years. The records of male patients who underwent surgery for breast cancer between 2007 and 2017 were retrospectively reviewed in a tertiary care hospital in Istanbul, Turkey. The patients' ages, background, family history, clinical features, histopathological features of the tumour, its stage, the treatment and the survival were investigated. SPSS 15.0 for Windows programme was used for statistical analysis.Survival analysis was performed with Kaplan-Meier method.Determinants were analysed by univariate Cox regression analysis. A total of 15 patients were evaluated in our study. Fourteen patients had invasive ductal carcinoma and one patient had intraductal papillary carcinoma. The median followup period of the patients was 36 months The axillary lymph node metastasis positivity rate (number of metastatic lymph nodes/number of lymph nodes dissected) was statistically significantly higher in patients who died than in patients who survived.In univariate Cox regression analysis, the effects of age, tumour size, estrogen, progesterone, the presence of HER2/neu receptor and axillary metastasis on survival were not determined. We believe that raising awareness on male breast cancer in the community, genetic testing and screening mammography in high-risk patients will be useful in early diagnosis of the disease and improvement of its prognosis.
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MESH Headings
- Aged
- Antineoplastic Agents, Hormonal/therapeutic use
- Axilla
- Breast Neoplasms, Male/metabolism
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Chemotherapy, Adjuvant
- Humans
- Lymph Node Excision
- Lymph Nodes/pathology
- Male
- Mastectomy
- Mastectomy, Modified Radical
- Middle Aged
- Neoplasm Staging
- Prognosis
- Proportional Hazards Models
- Radiotherapy, Adjuvant
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Sentinel Lymph Node Biopsy
- Survival Rate
- Tertiary Care Centers
- Tumor Burden
- Turkey
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Affiliation(s)
- Gurkan Yetkin
- General Surgery Clinic, University of Health Sciences, Sisli Hamidiye Etfal Education & Research Hospital, Turkey
| | - Mustafa Fevzi Celayir
- General Surgery Clinic, University of Health Sciences, Sisli Hamidiye Etfal Education & Research Hospital, Turkey
| | - Canan Tanik
- Pathology Clinic, University of Health Sciences, Sisli Hamidiye Etfal Education & Research Hospital, Turkey
| | - Bulent Citgez
- General Surgery Clinic, University of Health Sciences, Sisli Hamidiye Etfal Education & Research Hospital, Turkey
| | - Mehmet Uludag
- General Surgery Clinic, University of Health Sciences, Sisli Hamidiye Etfal Education & Research Hospital, Turkey
| | - Mehmet Mihmanli
- General Surgery Clinic, University of Health Sciences, Sisli Hamidiye Etfal Education & Research Hospital, Turkey
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23
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Shah RB, Shore KT, Yoon J, Mendrinos S, McKenney JK, Tian W. PTEN loss in prostatic adenocarcinoma correlates with specific adverse histologic features (intraductal carcinoma, cribriform Gleason pattern 4 and stromogenic carcinoma). Prostate 2019; 79:1267-1273. [PMID: 31111513 DOI: 10.1002/pros.23831] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 03/29/2019] [Accepted: 04/24/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The loss of PTEN tumor suppressor gene is one of the most common somatic genetic aberrations in prostate cancer (PCa) and is frequently associated with high-risk disease. Deletion or mutation of at least one PTEN allele has been reported to occur in 20% to 40% of localized PCa and up to 60% of metastases. The goal of this study was to determine if somatic alteration detected by PTEN immunohistochemical loss of expression is associated with specific histologic features. METHODS Two hundred sixty prostate core needle biopsies with PCa were assessed for PTEN loss using an analytically validated immunohistochemical assay. Blinded to PTEN status, each tumor was assessed for the Grade Group (GG) and the presence or absence of nine epithelial features. Presence of stromogenic PCa was also assessed and defined as grade 3 reactive tumor stroma as previously described: the presence of carcinoma associated stromal response with epithelial to stroma ratio of greater than 50% reactive stroma. RESULTS Eight-eight (34%) cases exhibited PTEN loss while 172 (66%) had intact PTEN. PTEN loss was significantly (P < 0.05) associated with increasing GG, poorly formed glands (74% of total cases with loss vs 49% of intact), and three well-validated unfavorable pathological features: intraductal carcinoma of the prostate (IDC-P) (69% of total cases with loss vs 12% of intact), cribriform Gleason pattern 4 (38% of total cases with loss vs 10% of intact) and stromogenic PCa (23% of total cases with loss vs 6% of intact). IDC-P had the highest relative risk (4.993, 95% confidence interval, 3.451-7.223, P < 0.001) for PTEN loss. At least one of these three unfavorable pathological features were present in 67% of PCa exhibiting PTEN loss, while only 11% of PCa exhibited PTEN loss when none of these three unfavorable pathological features were present. CONCLUSIONS PCa with PTEN loss demonstrates a strong correlation with known unfavorable histologic features, particularly IDC-P. This is the first study showing the association of PTEN loss with stromogenic PCa.
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Affiliation(s)
- Rajal B Shah
- Division of Urologic Pathology, Inform Diagnostics, Irving, Texas
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Karen T Shore
- Weiss School of Natural Sciences, Rice University, Houston, Texas
| | - Jiyoon Yoon
- Division of Urologic Pathology, Inform Diagnostics, Irving, Texas
| | - Savvas Mendrinos
- Division of Urologic Pathology, Inform Diagnostics, Irving, Texas
| | - Jesse K McKenney
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, The Cleveland Clinic, Cleveland, Ohio
| | - Wei Tian
- Division of Urologic Pathology, Inform Diagnostics, Irving, Texas
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24
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Nie L, Pan X, Zhang M, Yin X, Gong J, Chen X, Xu M, Zhou Q, Chen N. The expression profile and heterogeneity analysis of ERG in 633 consecutive prostate cancers from a single center. Prostate 2019; 79:819-825. [PMID: 30900303 DOI: 10.1002/pros.23785] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/20/2019] [Accepted: 02/14/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Overexpression of ERG protein resulting from TMPRSS2:ERG rearrangement is highly specific for prostate cancer (PCa). However, the biological function of this fusion protein and its relationship with clinicopathological features still remain controversial. METHOD In this study, we evaluated ERG protein expression/gene rearrangement and heterogeneity by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in a cohort of 633 consecutive PCa initially diagnosed by core-needle biopsy in the West China Hospital. RESULT Overall, ERG protein expression was detected in 16.7% (106 of 633) cases, and frequently observed in PCa patients less than 60 years of age (31.9% vs 15.5%, P = 0.004) and in PCa with Gleason score less than 8 (20.0% vs 13.4%, P = 0.027), but infrequently observed in cases with intraductal carcinoma of the prostate (IDC-P) (10.0% vs 18.6%, P = 0.012). Follow-up analysis found that patients who progressed to castration-resistant prostate cancer (CRPC) have a lower frequency of ERG protein expression at initial biopsies compared to androgen deprivation therapy (ADT)-sensitive cases (14.1% vs 23.5%, P = 0.042), but Kaplan-Meier curve showed that ERG protein expression was not an independent prognostic marker. Of all the 106 ERG-positive cases, eight cases (7.5%) exhibited heterogeneous expression of ERG protein, in which ERG was only positive in tumors with Gleason pattern 3, but negative in Gleason pattern 4. The FISH analysis was consistent with IHC in six of these cases. In the other two cases, ERG rearrangement was detected in tumors with both Gleason pattern 3 and 4 by FISH, despite the negative protein expression in Gleason pattern 4. In case 1, a repeated biopsy was performed when the disease progressed to CRPC, and no ERG-positive cells were identified neither by IHC nor FISH. CONCLUSION This was by far the largest series of ERG expression and heterogeneity analysis in Chinese PCa. The ERG rearrangement seemed to be frequently expressed in patients with relatively younger age and lower Gleason score and infrequently expressed in PCa with the IDC-P. PCa with positive ERG were less frequently to progress to CRPC, but there was no prognostic significance of ERG expression. In heterogeneous cases, ERG protein was detectable only in tumors with Gleason pattern 3 but not in pattern 4. Tumor cells with positive ERG expression/rearrangement seemed easily response to ADT.
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MESH Headings
- Biopsy, Large-Core Needle/methods
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cohort Studies
- Gene Expression
- Gene Rearrangement
- Genetic Heterogeneity
- Humans
- Image-Guided Biopsy/methods
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Male
- Middle Aged
- Neoplasm Grading
- Prognosis
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/metabolism
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms, Castration-Resistant/genetics
- Prostatic Neoplasms, Castration-Resistant/metabolism
- Prostatic Neoplasms, Castration-Resistant/pathology
- Serine Endopeptidases/genetics
- Serine Endopeptidases/metabolism
- Transcriptional Regulator ERG/biosynthesis
- Transcriptional Regulator ERG/genetics
- Tumor Burden
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Affiliation(s)
- Ling Nie
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Xiuyi Pan
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Mengni Zhang
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Xiaoxue Yin
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Jing Gong
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Xueqin Chen
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Miao Xu
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Qiao Zhou
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Ni Chen
- State Key Laboratory of Biotherapy, Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
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25
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Vermeulen MA, van Deurzen CHM, Doebar SC, de Leng WWJ, Martens JWM, van Diest PJ, Moelans CB. Promoter hypermethylation in ductal carcinoma in situ of the male breast. Endocr Relat Cancer 2019; 26:575-584. [PMID: 30921768 DOI: 10.1530/erc-18-0485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/26/2019] [Indexed: 12/26/2022]
Abstract
Ductal carcinoma in situ (DCIS) of the male breast is very rare and has hardly been studied molecularly. In males, we compared methylation status of 25 breast cancer-related genes in pure DCIS (n = 18) and invasive breast carcinoma (IBC) with adjacent DCIS (DCIS-AIC) (n = 44) using methylation-specific multiplex ligation-dependent probe amplification. Results were compared to female breast cancer (BC). There were no significant differences in methylation features between male pure DCIS, DCIS-AIC and IBC after correction for multiple comparisons. In paired analysis of IBC and adjacent DCIS, CADM1 showed a significantly higher absolute methylation percentage in DCIS (P = 0.002). In cluster analysis, two clusters stood out with respectively infrequent and frequent methylation (GATA5, KLLN, PAX6, PAX5, CDH13, MSH6 and WT1 were frequently methylated). Compared to female DCIS, methylation was in general much less common in male DCIS, especially for VHL, ESR1, CDKN2A, CD44, CHFR, BRCA2, RB1 and STK11. In contrast, THBS1 and GATA5 were more frequently methylated in male DCIS. In conclusion, there is frequent methylation of GATA5, KLLN, PAX6, PAX5, CDH13, MSH6 and WT1 in male DCIS. Since there was little change in the methylation status for the studied genes from pure male DCIS to DCIS-AIC and IBC, methylation of these seven genes is more likely to occur early in male breast carcinogenesis. Based on the current markers male DCIS seems to be an epigenetically more advanced precursor of male BC, although in comparison to its female counterpart it appears that fewer loci harbor methylation, pointing to differences between male and female breast carcinogenesis with regard to the studied loci.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms, Male/genetics
- Breast Neoplasms, Male/metabolism
- Breast Neoplasms, Male/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- DNA Methylation
- Female
- Follow-Up Studies
- Gene Expression Regulation, Neoplastic
- Humans
- Inflammatory Breast Neoplasms/genetics
- Inflammatory Breast Neoplasms/metabolism
- Inflammatory Breast Neoplasms/pathology
- Male
- Middle Aged
- Prognosis
- Promoter Regions, Genetic
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
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Affiliation(s)
- Marijn A Vermeulen
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Carolien H M van Deurzen
- Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- BOOG Study Center/Dutch Breast Cancer Research Group, Amsterdam, The Netherlands
| | - Shusma C Doebar
- Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wendy W J de Leng
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - John W M Martens
- BOOG Study Center/Dutch Breast Cancer Research Group, Amsterdam, The Netherlands
- Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cathy B Moelans
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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26
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Yang M, Xu Z, Zhang QZ, Wang K, Ji XY, Xu J, Zhang JY, Niu G. A breast one-patient panel of heterogeneous genomes reveals genetic alterations driving DCIS into invasive lesions. Future Oncol 2019; 15:1565-1576. [PMID: 30888194 DOI: 10.2217/fon-2018-0555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: Utilize breast cancer samples in the same patient to indicate breast cancer development. Patients & methods: We performed whole-exome analysis of spatially independent ductal carcinoma in situ (DCIS) and invasive ductal carcinoma samples from the same breast. Results: In VEGF pathway, we observed two genes disrupted in DCIS, while another four (including ACTN2) mutated in invasive ductal carcinoma. When looked up TCGA database, we identified seven breast cancer patients with ACTN2 somatic mutations and observed a dramatic decrease in the overall survival time in ACTN2 mutant patients (p = 0.0182). A further finding in the TCGA database shows that breast cancer patients with ≥2 mutated genes in VEGF pathways showed worse prognosis (p = 0.0013). Conclusion: TCGA database and special case could inform each other to reveal DCIS developmental rules.
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Affiliation(s)
- Mei Yang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, PR China
| | - Zhe Xu
- Department of Ophthalmology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
- Department of Ophthalmology, General hospital of southern theatre command, Guangzhou 510010, PR China
| | - Qiang-Zu Zhang
- Phil Rivers Technology, Beijing 10095, PR China
- Department of Cancer Genomics, LemonData Biotech (Shenzhen) Ltd, Shenzhen 518000, PR China
| | - Kun Wang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, PR China
| | - Xiao-Yang Ji
- Phil Rivers Technology, Beijing 10095, PR China
- College of Animal Science, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Juan Xu
- Breast Disease Center, Guangdong Women & Children Hospital, Guangzhou 511400, PR China
| | - Jiang-Yu Zhang
- Pathology Department, Guangdong Women & Children Hospital, Guangzhou 511400, PR China
| | - Gang Niu
- Phil Rivers Technology, Beijing 10095, PR China
- Department of Cancer Genomics, LemonData Biotech (Shenzhen) Ltd, Shenzhen 518000, PR China
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27
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Szynglarewicz B, Kasprzak P, Donizy P, Biecek P, Halon A, Matkowski R. Biological Aggressiveness of Subclinical No-Mass Ductal Carcinoma In Situ (DCIS) Can Be Reflected by the Expression Profiles of Epithelial-Mesenchymal Transition Triggers. Int J Mol Sci 2018; 19:ijms19123941. [PMID: 30544617 PMCID: PMC6320898 DOI: 10.3390/ijms19123941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 12/21/2022] Open
Abstract
Epithelial-mesenchymal transitions (EMTs) have been recently implicated in the process of cancer progression. The aim of this study was to assess how the preoperative expression patterns of EMT biomarkers correlate with the risk of postoperative invasion in ductal carcinoma in situ (DCIS) found on stereotactic breast biopsies. N-cadherin, Snail1, and secreted protein acidic and rich in cysteine (SPARC) immunoreactivity was observed in 8%, 62%, and 38% of tumors, respectively. Snail1 and SPARC expressions were significantly related to N-cadherin expression and to each other. The postoperative upgrading rate was associated with a positive preoperative expression of all biomarkers. Significance of Snail1 and SPARC persisted in multivariate analysis, but the impact of SPARC on invasion was more significant. When these two EMT triggers were considered together, the risk of invasion did not significantly differ between the subtypes of DCIS with single positive expression (SPARC−/Snail1+ vs. SPARC+/Snail1−). However, it was significantly lower in single-positive DCIS when compared to lesions of a double-positive profile (SPARC+/Snail1+). Moreover, there were no cases in the double-negative DCIS (SPARC−/Snail1−), with foci of infiltrating cancer found postoperatively in residual postbiopsy lesions. In contrast, DCIS with a combined high SPARC and Snail1 expression (intermediate or strong) had an invasive component in 66–100% of tumors.
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Affiliation(s)
- Bartlomiej Szynglarewicz
- Breast Unit, Department of Surgical Oncology, Lower Silesia Oncology Center, 53-413 Wroclaw, Poland.
- Department of Oncology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, 53-413 Wroclaw, Poland.
| | - Piotr Kasprzak
- Department of Breast Imaging, Lower Silesia Oncology Center, 53-413 Wroclaw, Poland.
| | - Piotr Donizy
- Department of Pathomorphology and Oncological Cytology, 53-413 Wroclaw Medical University, Wroclaw, Poland.
| | - Przemyslaw Biecek
- Faculty of Mathematics and Information Science, Warsaw University of Technology 00-662 Warsaw, Poland.
| | - Agnieszka Halon
- Department of Pathomorphology and Oncological Cytology, 53-413 Wroclaw Medical University, Wroclaw, Poland.
| | - Rafal Matkowski
- Breast Unit, Department of Surgical Oncology, Lower Silesia Oncology Center, 53-413 Wroclaw, Poland.
- Department of Oncology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, 53-413 Wroclaw, Poland.
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28
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Nelson AC, Machado HL, Schwertfeger KL. Breaking through to the Other Side: Microenvironment Contributions to DCIS Initiation and Progression. J Mammary Gland Biol Neoplasia 2018; 23:207-221. [PMID: 30168075 PMCID: PMC6237657 DOI: 10.1007/s10911-018-9409-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/22/2018] [Indexed: 01/08/2023] Open
Abstract
Refinements in early detection, surgical and radiation therapy, and hormone receptor-targeted treatments have improved the survival rates for breast cancer patients. However, the ability to reliably identify which non-invasive lesions and localized tumors have the ability to progress and/or metastasize remains a major unmet need in the field. The current diagnostic and therapeutic strategies focus on intrinsic alterations within carcinoma cells that are closely associated with proliferation. However, substantial accumulating evidence has indicated that permissive changes in the stromal tissues surrounding the carcinoma play an integral role in breast cancer tumor initiation and progression. Numerous studies have suggested that the stromal environment surrounding ductal carcinoma in situ (DCIS) lesions actively contributes to enhancing tumor cell invasion and immune escape. This review will describe the current state of knowledge regarding the mechanisms through which the microenvironment interacts with DCIS lesions focusing on recent studies that describe the contributions of myoepithelial cells, fibroblasts and immune cells to invasion and subsequent progression. These mechanisms will be considered in the context of developing biomarkers for identifying lesions that will progress to invasive carcinoma and/or developing approaches for therapeutic intervention.
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Affiliation(s)
- Andrew C Nelson
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, 2231 6th St SE, Minneapolis, MN, 55455, USA
| | - Heather L Machado
- Department of Biochemistry and Molecular Biology, Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kathryn L Schwertfeger
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
- Masonic Cancer Center, University of Minnesota, 2231 6th St SE, Minneapolis, MN, 55455, USA.
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA.
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29
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Wan ZB, Gao HY, Wei L, Zhang AQ, Zhang JY, Wang Y, Wang DD, Zhang Y. Expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67 in ductal carcinoma in situ (DCIS) and DCIS with microinvasion. Medicine (Baltimore) 2018; 97:e13055. [PMID: 30383678 PMCID: PMC6221707 DOI: 10.1097/md.0000000000013055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Ductal carcinoma in situ (DCIS) represents a heterogeneous disease in its histologic appearance and biological potential. Some women treated for DCIS subsequently develop invasive breast cancer. DCIS with microinvasion is considered as the interim stage in the progression from DCIS to invasive breast cancer. Analysis of the differences between DCIS and DCIS with microinvasion may aid in understanding the characteristic of DCIS with microinvasion and identifying biological factors determining progression of DCIS to invasive disease.Retrospective analysis of 219 cases between 2012 and 2018 was performed in our institution. The pathological results and axillary lymph nodes status were collected. Analysis of the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 in pure DCIS (164 cases), and DCIS with microinvasion (55 cases) using immunohistochemistry.DCIS with microinvasion had a higher nuclear grade (P < .001) and was more likely to have sentinel lymph node biopsy (SLNB) positivity (P = .039) than DCIS. Expression of ER, PR were significantly higher in DCIS compared with DCIS with microinvasion (P < .001, P < .001). While the expression of HER-2 in DCIS with microinvasion (56.4%) was significantly higher than in DCIS (36.6%, P = .01). Furthermore, DCIS with microinvasion was significantly more likely to have aggressive subtype (Triple-negative and HER2-enriched tumors, P = .005).Our results indicated that DCIS with microinvasion was different from pure DCIS in clinicopathologic characteristics and molecular alterations. It displayed a more aggressive biological nature than pure DCIS. It may be a distinct entity.
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Affiliation(s)
- Zhi-Bin Wan
- Department of Pathology, Guangdong Women and Children Hospital of Guangzhou Medical University
| | - Hong-Yi Gao
- Department of Pathology, Guangdong Women and Children Hospital
| | - Lian Wei
- School of Public Health, Guangzhou Medical University
| | - An-Qin Zhang
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Jiang-Yu Zhang
- Department of Pathology, Guangdong Women and Children Hospital
| | - Yi Wang
- Department of Pathology, Guangdong Women and Children Hospital
| | - Dong-Dong Wang
- Department of Pathology, Guangdong Women and Children Hospital
| | - Yan Zhang
- Department of Pathology, Guangdong Women and Children Hospital
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30
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Lee JH, Kim HM, Koo JS. Differential Expression of Cancer-Associated Fibroblast-Related Proteins in Ductal Carcinoma in situ According to Molecular Subtype and Stromal Histology. Pathobiology 2018; 85:311-321. [PMID: 30223270 DOI: 10.1159/000492392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/23/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study is to investigate the expression of cancer-associated fibroblast (CAF)-related proteins and their implication in ductal carcinoma in situ (DCIS). METHODS We constructed a tissue microarray of 223 cases of DCIS and examined immunohistochemical staining for the 7 CAF-related proteins. We classified DCIS into luminal type, human epidermal growth factor receptor-2 (HER-2) type, and triple negative breast cancer (TNBC) according to the immunohistochemical results for estrogen receptor, progesterone receptor, and HER-2. We also classified DCIS into desmoplastic, normal-like, and inflammatory type according to stromal histology. RESULTS There were significant differences in the expression of S100A4, podoplanin, prolyl 4-hydroxylase subunit alpha 3, NG2, and PDGFRα in stromal cells of DCIS when classified according to molecular subtype. The expression rate of all CAF-related proteins in stromal cells was higher in the HER-2 type and TNBC than in the luminal type (p < 0.001). When classified according to stromal subtype, there were significant differences in the expression of all CAF-related proteins in stromal cells, with the inflammatory stromal type showing higher expression of CAF-related proteins than other stromal types. CONCLUSION The expression of CAF-related proteins in stromal cells of DCIS varies according to molecular subtype and stromal type.
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MESH Headings
- Biomarkers, Tumor/metabolism
- Cancer-Associated Fibroblasts/metabolism
- Cancer-Associated Fibroblasts/pathology
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Female
- Gene Expression Regulation, Neoplastic/genetics
- Humans
- Middle Aged
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/genetics
- Receptors, Progesterone/metabolism
- Triple Negative Breast Neoplasms/genetics
- Triple Negative Breast Neoplasms/metabolism
- Triple Negative Breast Neoplasms/pathology
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Solanki R, Agrawal N, Ansari M, Jain S, Jindal A. COX-2 Expression in Breast Carcinoma with Correlation to Clinicopathological Parameters. Asian Pac J Cancer Prev 2018; 19:1971-1975. [PMID: 30051683 PMCID: PMC6165637 DOI: 10.22034/apjcp.2018.19.7.1971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/13/2018] [Indexed: 11/27/2022] Open
Abstract
Objective: Breast carcinoma is the most common malignant tumor and the leading cause of carcinoma deaths in women. Its etiology is multifactorial, implicating reproductive factors, hormonal imbalances and genetic predispositions. Studies have shown that Cycloxygenase-2 (COX-2) plays an important role in the carcinogenesis and increased expression has been regarded as a poor prognostic factor. The objective of our study is 1. To study COX-2 expression in normal breast tissue, DCIS and invasive breast cancer. 2. To determine COX-2 expression with clinicopathological prognostic parameters. Methods: Radical mastectomy specimens were studied for COX-2 expression by immunohistochemistry in 50 patients diagnosed as breast carcinoma. COX-2 expression is quantified as IHS Score and separately calculated for normal breast epithelium near the tumor, DCIS and invasive areas. Relationship between COX-2 expression with various clinicopathological parameters was evaluated. Result: The results of our study suggest an association of the expression of COX-2 to the factors associated with poor prognosis in breast cancer, such as larger tumor size, positive lymph node status, higher T stage and N stage and lymphovascular invasion. There was a higher COX-2 expression in the DCIS component as compared to the invasive ductal carcinoma component and the adjoining breast epithelium. Conclusion: Our study established the role of COX-2 in carcinogenesis and its association with adverse prognostic factors.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cyclooxygenase 2/metabolism
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Prognosis
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Altundag K. Is it rational to extend the duration of preventive endocrine treatment in hormone receptor positive ductal carcinoma in situ? J BUON 2018; 23:835. [PMID: 30003760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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33
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Gu Z, Gao D, Al-Zubaydi F, Li S, Singh Y, Rivera K, Holloway J, Szekely Z, Love S, Sinko PJ. The effect of size and polymer architecture of doxorubicin-poly(ethylene) glycol conjugate nanocarriers on breast duct retention, potency and toxicity. Eur J Pharm Sci 2018; 121:118-125. [PMID: 29698706 DOI: 10.1016/j.ejps.2018.04.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 04/22/2018] [Indexed: 11/17/2022]
Abstract
Although systemic administration of chemotherapeutic agents is routinely used for treating invasive breast cancer, the only therapeutic options for ductal carcinoma in situ (DCIS) are surgery and radiation. Treating DCIS by delivering drugs locally to the affected milk duct offers significant advantages over systemic administration, including reduced systemic and breast toxicities, as well as a greatly reduced need for surgery and radiation. In this study, mammary gland retention and toxicity of intraductally administered poly(ethylene) glycol-doxorubicin (PEG-DOX) polymeric conjugate nanocarriers of varying molecular sizes and architectures were investigated. Nanocarriers were formed by conjugating one or more copies of doxorubicin to PEG polymers, of varying molecular weights (5, 10, 20, and 40 kDa) and architectures (linear, four-arm and eight-arm). Cytotoxicity against MCF7 cells, a human breast cancer cell line, was assessed, and IC50 values were calculated. The nanocarriers were intraductally administered into the mammary glands of female retired breeder Sprague-Dawley rats. Whole body images were captured using in vivo optical imaging, and changes in ductal structure as well local inflammation were monitored. Fluorescence intensities were monitored, over time, to evaluate nanocarrier mammary gland retention half-lives (t1/2). The IC50 values of PEG-DOX nanocarriers against MCF7 cells were 40 kDa PEG-(DOX)4 (1.23 μM) < 5 kDa PEG-DOX (1.76 μM) < 40 kDa PEG-(DOX)8 (3.49 μM) < 10 kDa PEG-DOX (3.86 μM) < 20 kDa PEG-DOX (8.96 μM) < 40 kDa PEG-DOX (18.11 μM), whereas the IC50 of free DOX was only 0.14 μM. The t1/2 of linear 5, 20, and 40 kDa nanocarriers were 2.2 ± 0.3, 3.6 ± 0.6, and 13.1 ± 3.4 h, whereas the retention t1/2 of 4- and 8-arm 40 kDa nanocarriers were 14.9 ± 5.6 h and 11.9 ± 2.9 h, respectively. The retention t1/2 of free doxorubicin was 2.0 ± 0.4 h, which was significantly shorter than that of the linear and branched 40 kDa PEG-DOX nanocarriers. Increased molecular weight and decreased branching both demonstrated a strong correlation to enhanced mammary gland retention. Intraductally administered free doxorubicin resulted in ductal damage, severe inflammation and generation of atypical cell neoplasms, whereas PEG-DOX nanocarriers induced only minor and transient inflammation (i.e., damaged epithelial cells and detached cellular debris). The 40 kDa 4-arm PEG-DOX nanocarrier demonstrated the longest ductal retention half-life, the lowest IC50 (i.e., most potent), and minimal ductal damage and inflammation. The current results suggest that PEG-DOX nanocarriers with prolonged ductal retention may present the best option for intraductal treatment of DCIS, due to their low local toxicity and potential for sustained therapeutic effect.
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Affiliation(s)
- Zichao Gu
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Dayuan Gao
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Firas Al-Zubaydi
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Shike Li
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Yashveer Singh
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Department of Chemistry, Center for Biomedical Engineering (CBME), Indian Institute of Technology Ropar, Nangal Road, Rupnagar, Punjab 140001, India.
| | - Kristia Rivera
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Jennifer Holloway
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Zoltan Szekely
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA.
| | - Susan Love
- Dr. Susan Love Research Foundation, 16133 Ventura Suite 1000, Encino, CA 91436, USA.
| | - Patrick J Sinko
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA.
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Kassardjian A, Shintaku PI, Moatamed NA. Expression of immune checkpoint regulators, cytotoxic T lymphocyte antigen 4 (CTLA-4) and programmed death-ligand 1 (PD-L1), in female breast carcinomas. PLoS One 2018; 13:e0195958. [PMID: 29672601 PMCID: PMC5909602 DOI: 10.1371/journal.pone.0195958] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 04/03/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Immune checkpoint regulators, cytotoxic T lymphocyte antigen 4 (CTLA-4) and the programmed cell death protein-1/programmed death-ligand 1 (PD-1/PD-L1) have emerged as promising new targets for cancer therapeutics. While tumor expression of PD-L1 has been shown to have objective responses to anti-PD-L1 immunotherapies, the clinical implications of CTLA-4 expression in tumor cells or immune cells in the tumor microenvironment is still controversial. We investigated the expression of CTLA-4 and PD-L1 in human breast tumors and provided a scoring system for the systematic evaluation of CTLA-4 staining. METHODS Immunohistochemical staining for PD-L1 and CTLA-4 expression was performed on a tissue microarray of 102 cores, which included normal and neoplastic breast tissues. Neoplastic cores were divided into four groups: Ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and invasive tubular carcinoma (ITC). PD-L1 and CTLA-4 expressions were scored based on a system which accounted for the percentage and intensity of positivity and results provided in conjunction with available clinical and demographic data. RESULTS Overall, CTLA-4 was over-expressed in 49 of 93 (52.7%) breast tumors. Subcategorically, CTLA-4 was positive in 3 of 8 (37.5%) ductal carcinoma in situ, 40 of 73 (55%) of invasive ductal carcinomas, 4 of 10 (40%) of invasive lobular carcinomas and 2 of 2 (100%) of invasive tubular carcinomas. All 6 normal breast tissues were interpreted as negative for CTLA-4 staining. Only 4.1% of the invasive ductal carcinomas were positive for PD-L1 reactivity and the remaining carcinomas stained negative. CONCLUSIONS This study shows a significant overexpression of CTLA-4 in >50% of breast carcinomas with no such overexpression of CTLA-4 in benign breast tissues. PDL-1 staining is seen in only a small number of invasive ductal carcinomas (4.1%). These findings suggest the need for further investigation of anti-CTLA-4 and anti-PD-L1 immunotherapies and their efficacy in the treatment of breast carcinomas with overexpression of these immune modulators. In addition, the proposed scoring system will facilitate a more systematic correlation between tumor reactivity and clinical outcome which can be applied to all intracytoplasmic tumor markers.
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MESH Headings
- Adult
- B7-H1 Antigen/genetics
- B7-H1 Antigen/metabolism
- Biomarkers, Tumor
- Breast Neoplasms/genetics
- Breast Neoplasms/immunology
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- CTLA-4 Antigen/genetics
- CTLA-4 Antigen/metabolism
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/immunology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Female
- Gene Expression
- Humans
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
- Tissue Array Analysis
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Affiliation(s)
- Ari Kassardjian
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Peter I. Shintaku
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Neda A. Moatamed
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
- * E-mail:
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35
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Codegone ML, Di Carlo R, Muccioli G, Bussolati G. Histology and Cytometrics in Human Breast Cancers Assayed for the Presence of Prolactin Receptors. Tumori 2018; 67:549-52. [PMID: 6278686 DOI: 10.1177/030089168106700606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Histology and cytometrics were evaluated in 50 cases of human breast infiltrating carcinomas (44 ductal, 6 lobular) assayed for the presence of prolactin receptors (PR). The tumors were considered PR positive when the level of specific binding reached or exceeded 0.5 %. Twenty-six ductal infiltrating carcinomas and 4 lobular ones were PR positive. No strict correlation was found between PR and degree of histologic differentiation (expressed in grades) or menopausal status. Better differentiated (grade I) ductal carcinomas were, however, mostly PR negative. Evaluation of the mean nuclear diameter (MND) and of the maximal epithelial cellularity (MEC) revealed that in ductal carcinomas a high level of PR (> 3 % specific binding) was significantly correlated with a high MND. It is concluded that, contrary to that observed in estrogen receptor-positive tumors, PR-positive human ductal carcinomas are more likely to have large nuclei, i.e., cytologically anaplastic, whereas better differentiated (grade I) carcinomas are generally PR negative.
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36
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Pietribiasi F, Gugliotta P, Racca S, Di Carlo F, Bussolati G. A Combined Histological, Immunocytochemical and Biochemical Approach in the Evaluation of Estrogen Receptors in Breast Carcinomas. Int J Biol Markers 2018; 1:9-14. [PMID: 2826620 DOI: 10.1177/172460088600100103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Correlation of structural and functional data might lead to better identification of hormone-dependent tumors. Sixty breast cancer specimens, sent to the biochemistry laboratory for estrogen receptor (ER) analysis, were studied here by a combined morpho-functional approach. Histological examination of needle biopsies on frozen tissue blocks showed that 12 cases (10%) were free of tumor cells; these cases mostly proved ER negative. On the other 48 cases, an immunocytochemical reaction was performed on the biopsy sections with a monoclonal antibody directed against p 29, an estrogen receptor related antigen. The staining values for p 29 and the biochemical ER findings were significantly correlated. A combined histological, immunocytochemical study seems to offer advantages in the selection of patients for hormonal therapy.
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Affiliation(s)
- F Pietribiasi
- Department of Biomedical Sciences and Human Oncology, University of Turin
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37
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Kindermann G, Paterok E, Weishaar J, Egger H, Rummel W, Kleissl HP, Ober KG. Early Detection of Ductal Breast Cancer: The Diagnostic Procedure for Pathological Discharge from the Nipple. Tumori 2018; 65:555-62. [PMID: 229600 DOI: 10.1177/030089167906500506] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pathologic discharge from the nipple may be the only symptom of an early stage of carcinoma. Galactography is then the diagnostic method of choice to locate intraductal, nonpalpable lesions. The technique of galactography, the adequate surgical approach of pathologic galactographs (milk-duct segment resection), and the appropriate histological work-up of the surgical specimen are demonstrated. We report on 1918 galactographies in 1363 women with pathological discharge. In only 427 cases was a milk duct segment resection necessary (31.4%). In 8.5%, we found invasive intraductal cancer and in 2.9% ductal carcinomata in situ. Only 1 patient with breast cancer had axillary metastases. Extensive intraductal solid, papillary or adenomatous proliferations were found in 11.9% of the patients with excision. In 46.7% of the patients, papillomas were excised, a definitive treatment for this process. The supposition for success in the early diagnosis of cancer is close teamwork among the radiology, surgery and pathology services: the diagnostic result depends upon this. We attribute our yield of exact diagnosis to a very sophisticated histological work-up. We believe that this is necessary to avoid diagnostic failures.
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Kunitake JAMR, Choi S, Nguyen KX, Lee MM, He F, Sudilovsky D, Morris PG, Jochelson MS, Hudis CA, Muller DA, Fratzl P, Fischbach C, Masic A, Estroff LA. Correlative imaging reveals physiochemical heterogeneity of microcalcifications in human breast carcinomas. J Struct Biol 2018; 202:25-34. [PMID: 29221896 PMCID: PMC5835408 DOI: 10.1016/j.jsb.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/02/2017] [Indexed: 02/02/2023]
Abstract
Microcalcifications (MCs) are routinely used to detect breast cancer in mammography. Little is known, however, about their materials properties and associated organic matrix, or their correlation to breast cancer prognosis. We combine histopathology, Raman microscopy, and electron microscopy to image MCs within snap-frozen human breast tissue and generate micron-scale resolution correlative maps of crystalline phase, trace metals, particle morphology, and organic matrix chemical signatures within high grade ductal carcinoma in situ (DCIS) and invasive cancer. We reveal the heterogeneity of mineral-matrix pairings, including punctate apatitic particles (<2 µm) with associated trace elements (e.g., F, Na, and unexpectedly Al) distributed within the necrotic cores of DCIS, and both apatite and spheroidal whitlockite particles in invasive cancer within a matrix containing spectroscopic signatures of collagen, non-collagen proteins, cholesterol, carotenoids, and DNA. Among the three DCIS samples, we identify key similarities in MC morphology and distribution, supporting a dystrophic mineralization pathway. This multimodal methodology lays the groundwork for establishing MC heterogeneity in the context of breast cancer biology, and could dramatically improve current prognostic models.
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Affiliation(s)
- Jennie A M R Kunitake
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Siyoung Choi
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Kayla X Nguyen
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY 14853, USA
| | - Meredith M Lee
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Frank He
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Daniel Sudilovsky
- Department of Pathology and Laboratory Medicine, Cayuga Medical Center at Ithaca, Ithaca, NY 14850, USA; Department of Pathology, Upstate Medical University, SUNY, Binghamton, NY 13904, USA
| | - Patrick G Morris
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center/Evelyn H. Lauder Breast and Imaging Center, New York, NY 10065, USA
| | - Maxine S Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center/Evelyn H. Lauder Breast and Imaging Center, New York, NY 10065, USA
| | - Clifford A Hudis
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center/Evelyn H. Lauder Breast and Imaging Center, New York, NY 10065, USA
| | - David A Muller
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY 14853, USA; Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY 14853, USA
| | - Peter Fratzl
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Research Campus Potsdam-Golm, 14424 Potsdam, Germany
| | - Claudia Fischbach
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA; Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY 14853, USA.
| | - Admir Masic
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Lara A Estroff
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY 14853, USA; Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY 14853, USA.
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Contegiacomo A, Mariani Costantini R, Muraro R, Battista P, Valli C, Frati L, Calderopoli R, Zilembo N, Falco I, Petrella G. Cell Kinetics and Tumor-Associated Antigen Expression in Human Mammary Carcinomas. Int J Biol Markers 2018; 6:159-66. [PMID: 1665163 DOI: 10.1177/172460089100600304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Twenty-six primary breast carcinomas were studied to evaluate cell proliferation as assessed by thymidine labeling index (TLI), and antigenic phenotype, as defined by immunohistochemistry using eight monoclonal antibodies (MAbs) to tumor-associated antigens (TAAs). The majority of tumors had low TLI values. Reactivity to MAbs B72.3, CC49, CC83 (anti TAG 72), COL-12 (anti CEA) and MOv2 (against a tumor-associated mucoprotein) was restricted to < 50% of the tumors studied, while MAbs B1.1 (anti CEA), MBrl and MBr8 (to tumor-associated carbohydrates) reacted with > 50% of the cases. Correlations between expression of TAAs and proliferative activity showed that the tumors could be divided into three groups, two characterized by either high proliferative activity and absence of antigenic expression or low proliferative activity and strong antigenic expression, and the third showing no relation between these two biological features. We defined two antigenic phenotypes associated with specific cellular kinetics: one characterized by negative immunoreaction with MAbs, CC49, CC83 and COL-12 and high proliferative activity; the other characterized by intense immunoreactivity with these antibodies and low proliferative activity. The data suggest that cell proliferation and antigenic phenotype may define biologic subsets of breast carcinomas
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Affiliation(s)
- A Contegiacomo
- Department of Experimental Medicine, La Sapienza University of Roma, Italy
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40
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Ghaffarizadeh A, Heiland R, Friedman SH, Mumenthaler SM, Macklin P. PhysiCell: An open source physics-based cell simulator for 3-D multicellular systems. PLoS Comput Biol 2018; 14:e1005991. [PMID: 29474446 PMCID: PMC5841829 DOI: 10.1371/journal.pcbi.1005991] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 03/07/2018] [Accepted: 01/19/2018] [Indexed: 02/07/2023] Open
Abstract
Many multicellular systems problems can only be understood by studying how cells move, grow, divide, interact, and die. Tissue-scale dynamics emerge from systems of many interacting cells as they respond to and influence their microenvironment. The ideal "virtual laboratory" for such multicellular systems simulates both the biochemical microenvironment (the "stage") and many mechanically and biochemically interacting cells (the "players" upon the stage). PhysiCell-physics-based multicellular simulator-is an open source agent-based simulator that provides both the stage and the players for studying many interacting cells in dynamic tissue microenvironments. It builds upon a multi-substrate biotransport solver to link cell phenotype to multiple diffusing substrates and signaling factors. It includes biologically-driven sub-models for cell cycling, apoptosis, necrosis, solid and fluid volume changes, mechanics, and motility "out of the box." The C++ code has minimal dependencies, making it simple to maintain and deploy across platforms. PhysiCell has been parallelized with OpenMP, and its performance scales linearly with the number of cells. Simulations up to 105-106 cells are feasible on quad-core desktop workstations; larger simulations are attainable on single HPC compute nodes. We demonstrate PhysiCell by simulating the impact of necrotic core biomechanics, 3-D geometry, and stochasticity on the dynamics of hanging drop tumor spheroids and ductal carcinoma in situ (DCIS) of the breast. We demonstrate stochastic motility, chemical and contact-based interaction of multiple cell types, and the extensibility of PhysiCell with examples in synthetic multicellular systems (a "cellular cargo delivery" system, with application to anti-cancer treatments), cancer heterogeneity, and cancer immunology. PhysiCell is a powerful multicellular systems simulator that will be continually improved with new capabilities and performance improvements. It also represents a significant independent code base for replicating results from other simulation platforms. The PhysiCell source code, examples, documentation, and support are available under the BSD license at http://PhysiCell.MathCancer.org and http://PhysiCell.sf.net.
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Affiliation(s)
- Ahmadreza Ghaffarizadeh
- Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Randy Heiland
- Intelligent Systems Engineering, Indiana University, Bloomington, Indiana, United States of America
| | - Samuel H. Friedman
- Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, California, United States of America
- Opto-Knowledge Systems, Inc., Torrance, California, United States of America
| | - Shannon M. Mumenthaler
- Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Paul Macklin
- Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, California, United States of America
- Intelligent Systems Engineering, Indiana University, Bloomington, Indiana, United States of America
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Conklin MW, Gangnon RE, Sprague BL, Van Gemert L, Hampton JM, Eliceiri KW, Bredfeldt JS, Liu Y, Surachaicharn N, Newcomb PA, Friedl A, Keely PJ, Trentham-Dietz A. Collagen Alignment as a Predictor of Recurrence after Ductal Carcinoma In Situ. Cancer Epidemiol Biomarkers Prev 2018; 27:138-145. [PMID: 29141852 PMCID: PMC5809285 DOI: 10.1158/1055-9965.epi-17-0720] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/26/2017] [Accepted: 11/01/2017] [Indexed: 12/29/2022] Open
Abstract
Background: Collagen fibers surrounding breast ducts may influence breast cancer progression. Syndecan-1 interacts with constituents in the extracellular matrix, including collagen fibers, and may contribute to cancer cell migration. Thus, the orientation of collagen fibers surrounding ductal carcinoma in situ (DCIS) lesions and stromal syndecan-1 expression may predict recurrence.Methods: We evaluated collagen fiber alignment and syndecan-1 expression in 227 women diagnosed with DCIS in 1995 to 2006 followed through 2014 (median, 14.5 years; range, 0.7-17.6). Stromal collagen alignment was evaluated from diagnostic tissue slides using second harmonic generation microscopy and fiber analysis software. Univariate analysis was conducted using χ2 tests and ANOVA. The association between collagen alignment z-scores, syndecan-1 staining intensity, and time to recurrence was evaluated using HRs and 95% confidence intervals (CIs).Results: Greater fiber angles surrounding DCIS lesions, but not syndecan-1 staining intensity, were related to positive HER2 (P = 0.002) status, comedo necrosis (P = 0.03), and negative estrogen receptor (P = 0.002) and progesterone receptor (P = 0.02) status. Fiber angle distributions surrounding lesions included more angles closer to 90 degrees than normal ducts (P = 0.06). Collagen alignment z-scores for DCIS lesions were positively related to recurrence (HR = 1.25; 95% CI, 0.84-1.87 for an interquartile range increase in average fiber angles).Conclusions: Although collagen alignment and stromal syndecan-1 expression did not predict recurrence, collagen fibers perpendicular to the duct perimeter were more frequent in DCIS lesions with features typical of poor prognosis.Impact: Follow-up studies are warranted to examine whether additional features of the collagen matrix may more strongly predict patient outcomes. Cancer Epidemiol Biomarkers Prev; 27(2); 138-45. ©2017 AACR.
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Affiliation(s)
- Matthew W Conklin
- Department of Cell and Regenerative Biology, University of Wisconsin-Madison, Madison, Wisconsin
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ronald E Gangnon
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Brian L Sprague
- Department of Surgery, University of Vermont, Burlington, Vermont
| | - Lisa Van Gemert
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - John M Hampton
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kevin W Eliceiri
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jeremy S Bredfeldt
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Yuming Liu
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Nuntida Surachaicharn
- Department of Cell and Regenerative Biology, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Andreas Friedl
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Amy Trentham-Dietz
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
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42
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Soon PS, Provan PJ, Kim E, Pathmanathan N, Graham D, Clarke CL, Balleine RL. Profiling differential microRNA expression between in situ, infiltrative and lympho-vascular space invasive breast cancer: a pilot study. Clin Exp Metastasis 2017; 35:3-13. [PMID: 29214365 DOI: 10.1007/s10585-017-9868-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/30/2017] [Indexed: 12/12/2022]
Abstract
Ductal carcinoma in situ (DCIS), invasive breast cancer (IBC) and lympho-vascular invasion (LVI) represent distinct stages in breast cancer progression with different clinical implications. Altered microRNA (miRNA) expression may play a role in mediating the progression of DCIS to IBC and LVI. The aim of this pilot study was to investigate whether differential miRNA expression could play a role in breast cancer progression. Cancer cells from DCIS, IBC and LVI were microdissected from formalin fixed paraffin embedded (FFPE) tissue of five breast cancer samples. MiRNA profiling of extracted RNA was performed using the TaqMan® Array Human MicroRNA Cards A and B v3.0. Candidate miRNAs and gene targets were validated by qPCR. 3D culture of MCF10A, MCF10DCIS.com and T47D cells were used as models for normal, DCIS and IBC. Immunohistochemistry of candidate genes was performed on FFPE 3D cell cultures as well as on tissue microarray which included cores of DCIS and IBC samples. MiR-150, miR-126 and miR-155 were found to be more highly expressed in IBC and LVI compared to DCIS. Gene targets of these miRNAs, RhoA, PEG10 and MYB, were found to be more highly expressed in DCIS compared to IBC by qPCR and in MCF10A and MCF10DCIS.com cells compared to T47D cells by immunohistochemistry. There was no difference in intensity of staining of RhoA by immunohistochemistry in DCIS versus IBC samples on tissue microarray. In this pilot study, we found evidence to support a potential role for variation in miRNA levels in the transition from DCIS to IBC.
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MESH Headings
- Adult
- Aged
- Axilla
- Blood Vessels/pathology
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Cell Line, Tumor
- Disease Progression
- Female
- Formaldehyde
- Gene Expression Profiling
- Humans
- Lymph Node Excision
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymph Nodes/surgery
- Lymphatic Metastasis/genetics
- MicroRNAs/genetics
- Middle Aged
- Neoplasm Invasiveness/genetics
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Paraffin Embedding
- Pilot Projects
- Reproducibility of Results
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- Patsy S Soon
- South Western Sydney Clinical School, Bankstown Hospital, University of New South Wales, Bankstown, NSW, 2200, Australia.
- Breast Cancer, Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, NSW, 2170, Australia.
- Department of Surgery, Bankstown Hospital, Bankstown, NSW, 2200, Australia.
- Cancer Genetics, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
- Level 3, Staff Specialist Suite, Bankstown Hospital, Eldridge Rd, Bankstown, NSW, 2200, Australia.
| | - Pamela J Provan
- Translational Oncology, Sydney West Cancer Network, The Crown Princess Mary Cancer Centre Westmead Hospital, Westmead, NSW, 2145, Australia
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
| | - Edward Kim
- Cancer Genetics, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Nirmala Pathmanathan
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Dinny Graham
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
| | - Christine L Clarke
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
| | - Rosemary L Balleine
- Translational Oncology, Sydney West Cancer Network, The Crown Princess Mary Cancer Centre Westmead Hospital, Westmead, NSW, 2145, Australia
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
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Xie F, Hosany S, Zhong S, Jiang Y, Zhang F, Lin L, Wang X, Gao S, Hu X. MicroRNA-193a inhibits breast cancer proliferation and metastasis by downregulating WT1. PLoS One 2017; 12:e0185565. [PMID: 29016617 PMCID: PMC5634539 DOI: 10.1371/journal.pone.0185565] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 09/14/2017] [Indexed: 01/22/2023] Open
Abstract
In many cancers, microRNA-193a (miR-193a) is a suppressor miRNA, but its underlying anti-oncogenic activity in breast cancer is not known. In this study, we found decreased miR-193a (specifically, miR-193a-5p) expression not only in breast cancer cell lines but also in breast cancer tissues as compared with the adjacent non-tumor tissues. Ectopic miR-193a overexpression inhibited the proliferation, colony formation, migration, and invasion of MDA-MB-231 and BT549 cells. miR-193a reduced Wilms’ tumor 1 (WT1) expression and repressed luciferase reporter activity by binding WT1 coding region sequences; mutation of the predicted miR-193a binding site abolished this effect. miR-193a and WT1 expression were significantly inversely correlated in breast cancer tissues. Importantly, the anti-cancer activity induced by miR-193a was partially reversed by WT1 overexpression, indicating an important role for WT1 in such activity related to miR-193a. Our results reveal that miR-193a-WT1 interaction plays an important role in breast cancer metastasis, and suggest that restoring miR-193a expression is a therapeutic strategy in breast cancer.
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MESH Headings
- Adult
- Aged
- Base Sequence
- Binding Sites
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cell Line, Tumor
- Cell Movement
- Cell Proliferation
- Female
- Gene Expression Regulation, Neoplastic
- Genes, Reporter
- Humans
- Luciferases/genetics
- Luciferases/metabolism
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Middle Aged
- Mutation
- Neoplasm Metastasis
- Signal Transduction
- WT1 Proteins/genetics
- WT1 Proteins/metabolism
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Affiliation(s)
- FeiYan Xie
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Sumayyah Hosany
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Shen Zhong
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Yang Jiang
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Fen Zhang
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - LiLi Lin
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - XiaoBo Wang
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - ShenMeng Gao
- Laboratory of Internal Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
- * E-mail: (SMG); (XQH)
| | - XiaoQu Hu
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
- * E-mail: (SMG); (XQH)
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44
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Monti D, Sotgia F, Whitaker-Menezes D, Tuluc M, Birbe R, Berger A, Lazar M, Cotzia P, Draganova-Tacheva R, Lin Z, Domingo-Vidal M, Newberg A, Lisanti MP, Martinez-Outschoorn U. Pilot study demonstrating metabolic and anti-proliferative effects of in vivo anti-oxidant supplementation with N-Acetylcysteine in Breast Cancer. Semin Oncol 2017; 44:226-232. [PMID: 29248134 PMCID: PMC5737796 DOI: 10.1053/j.seminoncol.2017.10.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/05/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND High oxidative stress as defined by hydroxyl and peroxyl activity is often found in the stroma of human breast cancers. Oxidative stress induces stromal catabolism, which promotes cancer aggressiveness. Stromal cells exposed to oxidative stress release catabolites such as lactate, which are up-taken by cancer cells to support mitochondrial oxidative phosphorylation. The transfer of catabolites between stromal and cancer cells leads to metabolic heterogeneity between these cells and increased cancer cell proliferation and reduced apoptosis in preclinical models. N-Acetylcysteine (NAC) is an antioxidant that reduces oxidative stress and reverses stromal catabolism and stromal-carcinoma cell metabolic heterogeneity, resulting in reduced proliferation and increased apoptosis of cancer cells in experimental models of breast cancer. The purpose of this clinical trial was to determine if NAC could reduce markers of stromal-cancer metabolic heterogeneity and markers of cancer cell aggressiveness in human breast cancer. METHODS Subjects with newly diagnosed stage 0 and I breast cancer who were not going to receive neoadjuvant therapy prior to surgical resection were treated with NAC before definitive surgery to assess intra-tumoral metabolic markers. NAC was administered once a week intravenously at a dose of 150 mg/kg and 600 mg twice daily orally on the days not receiving intravenous NAC. Histochemistry for the stromal metabolic markers monocarboxylate transporter 4 (MCT4) and caveolin-1 (CAV1) and the Ki67 proliferation assay and TUNEL apoptosis assay in carcinoma cells were performed in pre- and post-NAC specimens. RESULTS The range of days on NAC was 14-27 and the mean was 19 days. Post-treatment biopsies showed significant decrease in stromal MCT4 and reduced Ki67 in carcinoma cells. NAC did not significantly change stromal CAV1 and carcinoma TUNEL staining. NAC was well tolerated. CONCLUSIONS NAC as a single agent reduces MCT4 stromal expression, which is a marker of glycolysis in breast cancer with reduced carcinoma cell proliferation. This study suggests that modulating metabolism in the tumor microenvironment has the potential to impact breast cancer proliferation.
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MESH Headings
- Acetylcysteine/therapeutic use
- Adult
- Apoptosis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/drug therapy
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Papillary/drug therapy
- Carcinoma, Papillary/metabolism
- Carcinoma, Papillary/pathology
- Caveolin 1/metabolism
- Cell Proliferation
- Female
- Free Radical Scavengers/therapeutic use
- Humans
- Immunohistochemistry
- In Situ Nick-End Labeling
- Ki-67 Antigen/metabolism
- Mastectomy
- Middle Aged
- Monocarboxylic Acid Transporters/metabolism
- Muscle Proteins/metabolism
- Neoadjuvant Therapy
- Neoplasm Staging
- Pilot Projects
- Stromal Cells/metabolism
- Treatment Outcome
- Tumor Microenvironment
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Affiliation(s)
- Daniel Monti
- Marcus Institute of Integrative Health at Thomas Jefferson University, Philadelphia, PA
| | - Federica Sotgia
- School of Environment and Life Sciences, University of Salford, Manchester, UK
| | | | - Madalina Tuluc
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA
| | - Ruth Birbe
- Department of Pathology, Cooper University Hospital, Camden, NJ
| | - Adam Berger
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Melissa Lazar
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Paolo Cotzia
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Zhao Lin
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | | | - Andrew Newberg
- Marcus Institute of Integrative Health at Thomas Jefferson University, Philadelphia, PA
| | - Michael P Lisanti
- School of Environment and Life Sciences, University of Salford, Manchester, UK
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45
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Zellmer VR, Schnepp PM, Fracci SL, Tan X, Howe EN, Zhang S. Tumor-induced Stromal STAT1 Accelerates Breast Cancer via Deregulating Tissue Homeostasis. Mol Cancer Res 2017; 15:585-597. [PMID: 28108623 DOI: 10.1158/1541-7786.mcr-16-0312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/13/2016] [Accepted: 01/03/2017] [Indexed: 12/21/2022]
Abstract
The tumor microenvironment (TME), the dynamic tissue space in which the tumor exists, plays a significant role in tumor initiation, and is a key contributor in cancer progression; however, little is known about tumor-induced changes in the adjacent tissue stroma. Herein, tumor-induced changes in the TME were explored at the morphologic and molecular level to further understand cancer progression. Tumor-adjacent mammary glands (TAG) displayed altered branching morphology, expansion of myofibroblasts, and increased mammosphere formation, broadly suggesting a tumor-induced field effect. FACS analysis of TAGs demonstrated an increased number of Lin-CD24+/CD49+ enriched mammary gland stem cells (MaSC), suggesting deregulated tissue homeostasis in TAGs. Comparative transcriptome analysis of TAGs and contralateral control glands coupled with meta-analysis on differentially expressed genes with two breast cancer stromal patient microarray datasets identified shared upregulation of STAT1. Knockdown of STAT1 in cancer-associated fibroblast (CAF) cocultured with human breast cancer cells altered cancer cell proliferation, indicating a role for STAT1 as a stromal contributor of tumorigenesis. Furthermore, depletion of STAT1 in CAFs significantly reduced periductal reactive fibrosis and delayed early breast cancer progression in vivo Finally, cotreatment with fludarabine, a FDA-approved STAT1 activation inhibitor and DNA synthesis inhibitor, in combination with doxorubicin, showed enhanced therapeutic efficacy in treating mouse mammary gland tumors. Taken together, these results demonstrate that stromal STAT1 expression promotes tumor progression and is a potential therapeutic target for breast cancer.Implications: Tumors induce stromal STAT1-dependent cytokine secretion that promotes tumor cell proliferation and can be targeted using clinically-approved inhibitors of STAT1. Mol Cancer Res; 15(5); 585-97. ©2017 AACR.
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Affiliation(s)
- Victoria R Zellmer
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana
| | - Patricia M Schnepp
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana
| | - Sarah L Fracci
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | - Xuejuan Tan
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana
| | - Erin N Howe
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana
| | - Siyuan Zhang
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana.
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana
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46
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Campbell MJ, Baehner F, O'Meara T, Ojukwu E, Han B, Mukhtar R, Tandon V, Endicott M, Zhu Z, Wong J, Krings G, Au A, Gray JW, Esserman L. Characterizing the immune microenvironment in high-risk ductal carcinoma in situ of the breast. Breast Cancer Res Treat 2016; 161:17-28. [PMID: 27785654 DOI: 10.1007/s10549-016-4036-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 10/21/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE The recent increase in the incidence of ductal carcinoma in situ (DCIS) has sparked debate over the classification and treatment of this disease. Although DCIS is considered a precursor lesion to invasive breast cancer, some DCIS may have more or less risk than is realized. In this study, we characterized the immune microenvironment in DCIS to determine if immune infiltrates are predictive of recurrence. METHODS Fifty-two cases of high-grade DCIS (HG-DCIS), enriched for large lesions and a history of recurrence, were age matched with 65 cases of non-high-grade DCIS (nHG-DCIS). Immune infiltrates were characterized by single- or dual-color staining of FFPE sections for the following antigens: CD4, CD8, CD20, FoxP3, CD68, CD115, Mac387, MRC1, HLA-DR, and PCNA. Nuance multispectral imaging software was used for image acquisition. Protocols for automated image analysis were developed using CellProfiler. Immune cell populations associated with risk of recurrence were identified using classification and regression tree analysis. RESULTS HG-DCIS had significantly higher percentages of FoxP3+ cells, CD68+ and CD68+PCNA+ macrophages, HLA-DR+ cells, CD4+ T cells, CD20+ B cells, and total tumor infiltrating lymphocytes compared to nHG-DCIS. A classification tree, generated from 16 immune cell populations and 8 clinical parameters, identified three immune cell populations associated with risk of recurrence: CD8+HLADR+ T cells, CD8+HLADR- T cells, and CD115+ cells. CONCLUSION These findings suggest that the tumor immune microenvironment is an important factor in identifying DCIS cases with the highest risk for recurrence and that manipulating the immune microenvironment may be an efficacious strategy to alter or prevent disease progression.
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MESH Headings
- Adult
- Aged
- Biomarkers
- Breast Neoplasms/immunology
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/therapy
- Carcinoma, Intraductal, Noninfiltrating/immunology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/mortality
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Combined Modality Therapy
- Female
- Humans
- Lymphocyte Count
- Lymphocyte Subsets/immunology
- Lymphocyte Subsets/metabolism
- Lymphocyte Subsets/pathology
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/metabolism
- Lymphocytes, Tumor-Infiltrating/pathology
- Macrophages/immunology
- Macrophages/metabolism
- Macrophages/pathology
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Patient Outcome Assessment
- Prognosis
- Tumor Burden
- Tumor Microenvironment/immunology
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Affiliation(s)
- Michael J Campbell
- Department of Surgery, University of California, 2340 Sutter St, N321, San Francisco, CA, 94115, USA.
| | - Frederick Baehner
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Tess O'Meara
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
| | - Ekene Ojukwu
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
| | - Booyeon Han
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
| | - Rita Mukhtar
- Department of Surgery, University of California, 2340 Sutter St, N321, San Francisco, CA, 94115, USA
| | - Vickram Tandon
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
| | - Max Endicott
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
| | - Zelos Zhu
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
| | - Jasmine Wong
- Department of Surgery, University of California, 2340 Sutter St, N321, San Francisco, CA, 94115, USA
| | - Gregor Krings
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Alfred Au
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Joe W Gray
- Oregon Health and Science University, Portland, OR, USA
| | - Laura Esserman
- Department of Surgery, University of California, 2340 Sutter St, N321, San Francisco, CA, 94115, USA
- Mt Zion Carol Franc Buck Breast Care Center, University of California, San Francisco, CA, USA
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Vide J, César A, Rodrigues Pereira P, Azevdo F. Pigmented lesion of the nipple - a clinicopathological challenge. Dermatol Online J 2016; 22:13030/qt1qv340vp. [PMID: 28329595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 10/18/2016] [Indexed: 06/06/2023] Open
Abstract
Differential diagnoses of pigmented lesions of the nipple include melanocytic nevus, melanosis of the nipple, seborrheic keratosis, pigmented basal cell carcinoma, melanoma and Paget disease. The histologic exam with appropriate immunohistochemistry is a fundamental tool to achieve a correct diagnosis. We present a patient with a pigmented lesion of her right nipple revealing mammary Paget disease and elucidate diagnostic obstacles and prognostic importance of early breast cancer detection.
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Affiliation(s)
- Júlia Vide
- Serviço de Dermatologia e Venereologia, Centro Hospitalar de São João EPE, Porto, Portugal.
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48
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Bechert C, Kim JY, Tramm T, Tavassoli FA. Co-expression of p16 and p53 characterizes aggressive subtypes of ductal intraepithelial neoplasia. Virchows Arch 2016; 469:659-667. [PMID: 27664050 DOI: 10.1007/s00428-016-2024-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 08/12/2016] [Accepted: 09/14/2016] [Indexed: 12/21/2022]
Abstract
In the USA alone, approximately 61,000 new diagnoses of ductal intraepithelial neoplasia 1c-3 (DIN) are made each year. Around 10-20 % of the patients develop a recurrence, about 50 % of which are invasive. Prior studies have shown that invasive breast carcinomas positive for p16 or p53 have a higher frequency of recurrence and a more aggressive course; however, the co-expression of these markers across the entire spectrum of DIN and its potential correlation with grade of the lesions has not been studied previously. Immunohistochemical staining for p16 and p53 was evaluated on 262 DIN lesions from 211 cases diagnosed between 1991 and 2008. The lesions ranged from DIN1b (atypical intraductal hyperplasia) to DIN3 (DCIS, grade 3) and included 45 cases with associated invasive carcinoma. Frequency of staining for both p16 and p53 increased with increasing grade of DIN. Strong co-expression was found exclusively in higher grade DIN lesions (DIN2 and DIN3) particularly those associated with periductal stromal fibrosis and lymphocytic infiltrate. Strong co-expression was seen in 8 of 12 DIN3 lesions (67 %) associated with invasive carcinoma. In conclusion, co-expression of p16 and p53 increases with advancing grade of DIN and is maximal in high grade DIN lesions associated with invasive carcinoma, indicating a more aggressive phenotype. A distinctive variant of DIN with periductal fibrosis and lymphocytic infiltrate invariably falls into the high-grade category, based on either morphology or marker expression. Co-expression of p16/p53 may be of help in distinguishing between high-grade and low-grade DIN lesions.
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MESH Headings
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Cyclin-Dependent Kinase Inhibitor p16/metabolism
- Female
- Humans
- Hyperplasia/pathology
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Precancerous Conditions/pathology
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Charles Bechert
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, USA
| | - Jee-Yeon Kim
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, USA
- Department of Pathology, School of Medicine, Pusan National University, Busan, South Korea
| | - Trine Tramm
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, USA.
- Department of Pathology, Aarhus University Hospital, Nørrebrogade 44, Building 18, 8000, Aarhus C, Denmark.
| | - Fattaneh A Tavassoli
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, USA
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49
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Bezić J, Karaman I, Kunac N. Fibroadenoma with "immature-like" type of usual ductal hyperplasia. Breast Dis 2016; 36:157-160. [PMID: 27589503 DOI: 10.3233/bd-160233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We herein report a case of the breast fibroadenoma with foci of so-called immature variant of the conventional ductal hyperplasia. This type of usual ductal hyperplasia is histologically characterised by encircling intraductal proliferation of large cells with pale to amphophilic cytoplasm and large nuclei which vary in shape and in staining quality of the chromatin. We showed here, using the cytokeratin immunohistochemistry, that the proliferating cells were not of immature but rather mature immunohistochemical phenotype. Because of the presented discordance between immature histology and mature immunohistological profile we suggest that this rare type of usual ductal hyperplasia should be called "immature-like".
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50
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Abstract
Due to an increasing number of breast cancer diagnoses in younger women anecdotally noted at our institution, we conceived of this study %was to retrospectively review the records of women diagnosed with breast cancer under the age of 40 for potentially alterable versus unalterable risk factors in their history. Between 2007 and 2013, there were 52 patients less than 40 years of age with breast cancer at our institution: 79% (41/52) presented with a clinical abnormality (palpable mass, nipple discharge or inversion) and 21% (11/52) were asymptomatic but diagnosed on early screening mammograms. Seventy-five percent (39/52) of the cancers had an invasive component and 87% (45/52) were intermediate to high grade. Sixty percent (31/52) of subjects had stage 0 or I disease, but 40% (21/52) had later stage disease (stage II or greater). The vast majority of the cancers were ER+ (82%) and PR+ (78%). Fifty-six percent (28/50; 2 unknown) of the subjects had a documented history of hormonal contraception. Fifty-three percent (27/51; 1 unknown) of had no family history of breast cancer whatsoever, and 80% (41/51) had no family history of breast cancer in a first degree relative. Six were positive for BRCA 1, 2, or a variant (6/52 = 12%).
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MESH Headings
- Adult
- Asymptomatic Diseases
- Breast Neoplasms/diagnosis
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Contraceptives, Oral, Hormonal/therapeutic use
- Early Detection of Cancer
- Female
- Genes, BRCA1
- Genes, BRCA2
- Humans
- Mammography
- Menarche
- Neoplasm Grading
- Neoplasm Staging
- Phyllodes Tumor/diagnosis
- Phyllodes Tumor/genetics
- Phyllodes Tumor/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Reproductive History
- Reproductive Techniques, Assisted/statistics & numerical data
- Retrospective Studies
- Risk Factors
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