5 research outputs found
The metastatic phenotype of inflammatory breast cancer is associated with ALDH1 positive cells
Discordance du phénotype immunohistochimique hormonal et du récepteur du facteur de croissance épidermique de type 2 [HER2] des métastases cérébrales de cancer du sein comparativement à leurs primitifs
International audienceINTRODUCTION: Phenotype changes between primary tumor and the corresponding brain metastases are recent reported data. Breast cancer, with biological markers predicting prognosis and guiding therapeutic strategy remains an interesting model to observe and evaluate theses changes. The objective of our study was to compare molecular features (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor type 2, [HER2]) between brain metastases and its primary tumor in patients presenting with pathologically confirmed breast cancer.MATERIAL AND METHODS: This retrospective study was based on the immunohistochemical analysis of the brain metastases paraffin embedded samples stored in our institutional tumor bank, after surgical resection. The level of expression of hormonal receptors and HER2 on brain metastases were centrally reviewed and compared to the expression status in primary breast cancer from medical records.RESULTS: Forty-four samples of brain metastases were available for analysis. Hormonal receptor modification status was observed in 11/44 brain metastases (25%) for ER and 6/44 (13.6%) for PR. A modification of HER2 overexpression was observed in brain metastases in 6/44 (13.6%). Molecular subtype modification was shown in 17 cases (38.6%). A significant difference was demonstrated between time to develop brain metastases in cases without status modification (HER2, ER and PR) (med=49.5months [7.8-236.4]) and in cases in which brain metastases status differs from primary tumor (med=27.5months [0-197.3]), (P=0.0244, IC95=3.09-51.62, Mann and Whitney test).CONCLUSION: the main interest of this study was to focus on the molecular feature changes between primary tumor and their brain metastases. Time to develop brain metastases was correlated to phenotypic changes in brain metastases.Introduction:La modification phĂ©notypique entre une tumeur primitive et sa mĂ©tastase cĂ©rĂ©brale correspondante est une donnĂ©e rĂ©cente. Le cancer du sein, de part ses biomarqueurs impactant le pronostic et la stratĂ©gie thĂ©rapeutique, constitue une pathologie dâintĂ©rĂȘt pour observer et Ă©valuer ce type de modification. Lâobjectif Ă©tait de comparer les caractĂ©ristiques molĂ©culaires (rĂ©cepteurs aux estrogĂšnes [RE], Ă la progestĂ©rone [PR], et rĂ©cepteur au facteur de croissance Ă©pidermique humain type 2 [HER2]) des mĂ©tastases cĂ©rĂ©brales et des tumeurs primitives correspondantes de patients porteurs dâun adĂ©nocarcinome mammaire.MatĂ©riels et mĂ©thodes:Cette Ă©tude rĂ©trospective, utilisait des Ă©chantillons tumoraux issus des mĂ©tastases cĂ©rĂ©brales rĂ©sĂ©quĂ©es, inclus en paraffine, conservĂ©s en tumorothĂšque. Le niveau dâexpression des rĂ©cepteurs hormonaux et de HER2, sur chaque couple primitif/mĂ©tastase cĂ©rĂ©brale correspondante Ă©tait analysĂ© par immunohistochimie.RĂ©sultats:Quarante-quatre Ă©chantillons de mĂ©tastases cĂ©rĂ©brales Ă©taient exploitables. La conversion des rĂ©cepteurs hormonaux a Ă©tĂ© observĂ©e pour 11/44 mĂ©tastases cĂ©rĂ©brales (25 %) pour RE et pour 6/44 cas (13,6 %) pour RP. Lâexpression de HER2 Ă©tait modifiĂ©e au sein de la mĂ©tastase cĂ©rĂ©brale dans 6/44 cas (13,6 %). Le changement de sous-type molĂ©culaire Ă©tait montrĂ© dans 17 cas (38,6 %). Il existait une diffĂ©rence significative pour le dĂ©lai de survenue de la mĂ©tastase cĂ©rĂ©brale entre le groupe ne prĂ©sentant pas de modification pour RE, RP ou HER2, (med = 49,5 mois [7,8â236,4]) et le groupe dont le phĂ©notype de la mĂ©tastase cĂ©rĂ©brale diffĂ©rait du primitif (med = 27,5 [0â197,3]), (p = 0,0244, IC95 = 3,09â51,62, test de Mann et Whitney).Conclusion:LâintĂ©rĂȘt de ce travail Ă©tait la mise en Ă©vidence de modification de signature molĂ©culaire entre la tumeur primitive et la mĂ©tastase cĂ©rĂ©brale correspondante. Le dĂ©lai de survenue de la mĂ©tastase cĂ©rĂ©brale apparaissait corrĂ©lĂ© Ă la modification de statut phĂ©notypique de la mĂ©tastase cĂ©rĂ©brale
Lymphovascular invasion has a significant prognostic impact in patients with early breast cancer, results from a large, national, multicenter, retrospective cohort study
International audienceBackground: We determined the prognostic impact of lymphovascular invasion (LVI) in a large, national, multicenter, retrospective cohort of patients with early breast cancer (BC) according to numerous factors.Patients and methods: We collected data on 17 322 early BC patients treated in 13 French cancer centers from 1991 to 2013. Survival functions were calculated using the Kaplan-Meier method and multivariate survival analyses were carried out using the Cox proportional hazards regression model adjusted for significant variables associated with LVI or not. Two propensity score-based matching approaches were used to balance differences in known prognostic variables associated with LVI status and to assess the impact of adjuvant chemotherapy (AC) in LVI-positive luminal A-like patients.Results: LVI was present in 24.3% (4205) of patients. LVI was significantly and independently associated with all clinical and pathological characteristics analyzed in the entire population and according to endocrine receptor (ER) status except for the time period in binary logistic regression. According to multivariate analyses including ER status, AC, grade, and tumor subtypes, the presence of LVI was significantly associated with a negative prognostic impact on overall (OS), disease-free (DFS), and metastasis-free survival (MFS) in all patients [hazard ratio (HR) = 1.345, HR = 1.312, and HR = 1.415, respectively; P < 0.0001], which was also observed in the propensity score-based analysis in addition to the association of AC with a significant increase in both OS and DFS in LVI-positive luminal A-like patients. LVI did not have a significant impact in either patients with ER-positive grade 3 tumors or those with AC-treated luminal A-like tumors.Conclusion: The presence of LVI has an independent negative prognostic impact on OS, DFS, and MFS in early BC patients, except in ER-positive grade 3 tumors and in those with luminal A-like tumors treated with AC. Therefore, LVI may indicate the existence of a subset of luminal A-like patients who may still benefit from adjuvant therapy