Profil immunohistochimique, aspects morphologiques et pronostic des cancers du sein selon la classification moléculaire (étude de 151 cas)

TOURS-BU Médecine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Accumulation of Arachidonic Acid, Precursor of Pro-Inflammatory Eicosanoids, in Adipose Tissue of Obese Women: Association with Breast Cancer Aggressiveness Indicators

While obesity is linked to cancer risk, no studies have explored the consequences of body mass index (BMI) on fatty acid profiles in breast adipose tissue and on breast tumor aggressiveness indicators. Because of this, 261 breast adipose tissue samples of women with invasive breast carcinoma were analyzed. Fatty acid profile was established by gas chromatography. For normal-weight women, major changes in fatty acid profile occurs after menopause, with the enrichment of long-chain polyunsaturated fatty acids (LC-PUFAs) of both n-6 and n-3 series enrichment, but a stable LC-PUFAs n-6/n-3 ratio across age. BMI impact was analyzed by age subgroups to overcome the age effect. BMI increase is associated with LC-PUFAs n-6 accumulation, including arachidonic acid. Positive correlations between BMI and several LC-PUFAs n-6 were observed, as well as a strong imbalance in the LC-PUFAs n-6/n-3 ratio. Regarding cancer, axillary lymph nodes (p = 0.02) and inflammatory breast cancer (p = 0.08) are more frequently involved in obese women. Increased BMI induces an LC-PUFAs n-6 accumulation, including arachidonic acid, in adipose tissue. This may participate in the development of low-grade inflammation in obese women and breast tumor progression. These results suggest the value of lifestyle and LC-PUFAs n-3 potential, in the context of obesity and breast cancer secondary/tertiary prevention

Predictive factors of major deviation (>20 mm) between lesion sizes measured by magnetic resonance imaging and histology for invasive lobular breast cancer

International audienc

Lymphome intravasculaire : à propos de deux observations autopsiques et revue de la littérature

International audienceIntravacular large B-cell lymphoma (LIV) is a rare entity individualized in the WHO classification since 2001&nbsp;as a subtype of extranodal diffuse large B-cell lymphoma. We report two autopsic cases of LIV: a 77-year-old woman presenting with fever, dyspnea, antehypophyseal failure and a 54-year-old man presenting with fever, weight-loss, night-sweats and encephalopathy. They died respectively 10&nbsp;and 7&nbsp;months after the beginning of symptoms, without diagnosis. Neither infectious disease nor lymphomatous proliferation had been identified. From these two cases and our literature review, we insist on the importance of histopathological diagnosis on biopsy for this rare pathology which clinical diagnosis remains difficult.Les lymphomes intravasculaires à grandes cellules B (LIV) sont rares et individualisés dans la classification de l’OMS depuis 2001&nbsp;comme un sous-type de lymphome B diffus à grandes cellules extraganglionnairea. Nous rapportons deux cas de LIV de diagnostic autopsique. Il s’agissait d’une femme de 77&nbsp;ans ayant présenté fièvre, dyspnée, insuffisance antéhypophysaire et d’un homme de 54&nbsp;ans ayant présenté fièvre, amaigrissement, sueurs nocturnes et encéphalopathie. Ils sont décédés respectivement dix et sept mois après le début des symptômes, sans diagnostic. Les bilans infectieux étaient négatifs. Aucune prolifération lymphomateuse n’avait été mise en évidence. Évoquer et diagnostiquer cliniquement un LIV est difficile car il s’agit d’une pathologie rare dont les symptômes peuvent être très variables. À partir de ces deux observations et de la revue de la littérature, nous présentons l’intérêt des différentes biopsies dans la mise en évidence de la prolifération lymphomateuse.</p

Evolution of characteristics of women with endometrial cancer during a 40 years study period

International audienceObjectives: The aim of our work was to investigate changes in presentation and endometrial cancer (EC) types frequencies thorough a 40 years study period.Patients and methods: The patient group consisted of consecutive women undergoing surgery for endometrial cancer in our institution between 1975, and 2014. Clinical data included age, BMI (Kg/m2), histological data from surgical staging and survival data.Results: 842 patients with the final diagnosis of endometrial cancer were enrolled. BMI was overweight rising through study decades. Age of diagnosis was also in constant augmentation since 1975. Type II EC proportion was 9.2% in the seventies and 27.9% after 2000. Overall survival was stable over time. Women with BMI < 18 kg/m2 had lower overall survival when compared to women with other BMI categories (p < 0.0001).Discussion and conclusion: An analysis on a larger population of underweight women with EC is needed to identify specific factors. A trend to develop more type II EC can partly explain these results. We identified a clear trend of augmentation of type II EC, known to have a poor prognosis while necessitating specific surgical management. Histologic analysis standardisation, surgical strategy and amelioration of adjuvant treatments permitted to maintain a stable overall survival for the whole population despite this augmentation

Total Polyunsaturated Fatty Acid Level in Abdominal Adipose Tissue as an Independent Predictor of Recurrence-Free Survival in Women with Ovarian Cancer

Prognostic factors for epithelial ovarian cancers (EOCs) are in particular clinical factors such as pathology staging at diagnosis (FIGO stages), genetic mutation, or histological phenotypes. In the present study, FIGO stage, tumor residue after surgery, and body mass index were clinical predictors of recurrence-free survival (RFS). Nonetheless, a number of studies support a lipid metabolism disorder in ovarian cancer patients. The objective of this pilot study was to explore whether fatty acid composition of adipose reflecting the qualitative dietary intake and fatty acids metabolism may be associated with RFS. Forty-six women with EOCs and six with borderline ovarian tumors between March 2017 and January 2020 were included in this prospective study at Tours university teaching hospital (central France). The patients involved in the present study are part of the METERMUS trial (clinicaltrials.gov NCT03027479). Adipose tissue specimens from four abdominal locations (superficial and deep subcutaneous, visceral (pericolic), and omental) were collected during surgery or exploratory laparoscopy. A fatty acid profile of adipose tissue triglycerides was established by gas chromatography. Fatty acids composition was compared among the four locations using nonparametric Friedman’s ANOVA test for repeated measures. Median follow-up of EOC patients was 15 months and patients’ RFS was analyzed using Kaplan–Meier survival curves and log-rank test by separating patients into two groups according to median fatty acid levels. The content of long-chain saturated fatty acids (SFAs) was increased and that of long-chain polyunsaturated fatty acids (PUFAs) decreased in deep versus superficial subcutaneous adipose tissue in EOC patients. Nevertheless, the content of total SFAs was ~28%, monounsaturated fatty acids (MUFAs) ~55%, PUFAs n-6 ~11.5%, and PUFAs n-3 about 1.3%, whatever the adipose tissue. When EOC patients were separated into two groups by median fatty acid content, total PUFAs (n-6+n-3) levels, whatever the adipose tissue, were positively and independently associated with RFS. RFS was about two times longer in EOC patients with high versus low total PUFA content (median survival: 12 vs. 27 months, p = 0.01 to <0.0001 according to the tissue). Content of total PUFAs (n-6+n-3) in abdominal adipose tissue (visceral and subcutaneous) are new prognostic factors in EOC

Outcome of patients with breast cancer in the oldest old (≥80 years)

International audiencePurpose: In the present study, we present a large institutional study to determine the influence of age≥ 80 years on breast cancer presentation and prognosis.Methods: The study is a retrospective analysis of our prospectively maintained breast cancer database study using data from of women managed from January 2007 through December 2013. Clinicopathologic characteristics were correlated with outcomes according to age (<80 years and ≥ 80 years).Results: During the study period, 2083 women with invasive breast cancer were included of which 160 women aged ≥ 80 years (7.7 %). Overall survival was lower in the oldest old than in younger counterparts (p < 0.0001) as was distant metastasis free survival (p = 0.004). Differences in management included more radical surgeries and less chemotherapy and radiotherapy in case of age≥ 80 years. By multivariate analysis, age ≥ 80 years was an independent predictive factor of poor overall survival.Conclusion: In the present study, age ≥ 80 years was an independent predictive factor of poor overall survival

Low eicosapentaenoic acid and gamma-linolenic acid levels in breast adipose tissue are associated with inflammatory breast cancer

International audienceObjectiveSince it is thought that breast adipose tissue could influence breast cancer clinical presentation, we wanted to characterize specifically the relationship between breast adipose tissue fatty acid profile and Inflammatory Breast cancer (IBC).MethodsTwo hundred thirty-four women presenting with breast cancer were managed in our centre between January 2009 and December 2011. Breast adipose tissue specimens were collected during breast surgery. We established the biochemical profile of adipose tissue fatty acids (FA) by gas chromatography and assessed whether there were differences in function of the presence of breast inflammation or not.ResultsWe found that IBC was associated with decreased levels in breast adipose tissue of eicosapentaenoic acid (EPA), one of the two main polyunsaturated n-3 fatty acids (n-3 PUFA) of marine origin, but also with decreased levels of Gamma Linolenic acid (GLA). Inversely, an increase in palmitic acid levels was associated with IBC.ConclusionThese differences in lipid content may contribute to the occurrence of breast cancer inflammation

Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer

International audienceObjective The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality. Methods Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality. Results We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosa-pentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality. Discussion These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality

Evaluation of the two intraoperative examination methods for sentinel lymph node assessment: a multicentric and retrospective study on more than 2,000 nodes.

International audienceBACKGROUND: Intraoperative frozen section (FS) and imprint cytology (IC) are currently used to detect sentinel lymph node (SLN) metastasis, allowing for complete dissection when necessary. MATERIALS AND METHODS: A 2-year retrospective chart review was performed for patients who underwent SLN procedure in five French hospitals. The FS and IC results were compared to the definitive histology in order to calculate the sensitivity, specificity and false-negative rate. These results were studied from both the surgeon's and the pathologist's point of view. RESULTS: The comparison of the FS group (n=672) and IC group (n=576) showed a lack of sensitivity for both techniques, even if it was better for FS (59.3% vs. IC=33.3%). The false-negative rate (among patients with metastases) was very high in the two groups (FS=40.7% vs. IC=66.6%), leading to high re-intervention rates (FS=40.7% vs. IC=30.2%). False-negative nodes were more often small metastases and lobular carcinoma type. CONCLUSION: The interest in intraoperative examination is questionable. To avoid intraoperative examination failures, we think that complete staging of the disease before surgical treatment would be more relevant