Fine needle aspirates (FNA) from 106 high-risk women and 25 low-risk women were evaluated for overexpression of estrogen receptor (ER), epidermal growth factor receptor (EGFR), mutant p53, and HER-2/neu by immunocytochemistry, and for aneuploidy by image analysis. Aspirates were also classified cytologically as normal, apocrine metaplasia, epithelial hyperplasia (EH), or dysplasia. High-risk women were those with a first-degree relative with breast cancer (76%), precancerous breast disease (26%), prior cancer of the contralateral breast (9%), or multiple abnormalities (I1 %). Low-risk women had none of the above risk factors, nor a prior breast biopsy or clinical evidence of fibrocystic disease. The median 10-year Gail risk for the high-risk group was 4%, compared to 0.7% for the low-risk group. There were significant differences (p < 0.01) between high-and low-risk women in the prevalences of hyperplasia (55% versus 12%), dysplasia (19% versus O%), aneuploidy (32% versus O%), overexpressed EGFR (32% versus 4%), and overexpressed p53 (29% versus 4%). The prevalence of multiple biomarker abnormalities was also greater in high-risk than in low-risk women (28% versus 0%; p < 0.01). Four percent (4%) of FNAs from high-risk women with normal cytology, 29% of aspirates with hyperplastic cytology, and 60% of those with dysplasia were associated with two or more biomarker abnormalities. The differences in the prevalence of multiple biomarker abnormalities among various cytologic categories were statistically significant (p = 0.02, normal versus EH; p = 0.02, EH versus dysplasia; p < 0.01, normal versus dysplasia). Further study of these tissue biomarkers as potential intermediate-term (5-10 year) predictors of breast cancer development is warranted. 0 1993 Wiley-Liss, Inc.Key words: Aneuploidy, biomarkers, breast cancer, dysplasia, epidermal growth factor receptor, estrogen receptor, fine needle aspirates, HER-2, high-risk, hyperplasia, p53We chose to study cytology, ploidy, and overexpression of estrogen receptor (ER), epidermal growth factor receptor (EGFR), p53, and HER-2/neu as potential tissue-derived predictors of later breast cancer development. Our rationale in Selecting these for study is that abnormalities Of all these variables are present in 240% of cases of
Background: UK screen detected breast cancers (SDBC) (aged 50-65 years) have an overall 97.2% 5 year relative survival compared to 77.6% for symptomatic cancers. Epithelial proliferation has been used to determine therapy in the St. Gallen guidelines (Ki67 ≥30% indicates the need for chemotherapy). Methods: To determine the value of Ki67 in post-menopausal breast cancer in women aged 50-65 years, we have studied Ki67 in 1270 women aged 50-65 years (mean 57 years) with either symptomatic cancers (n=412) or SDBC (n=858) with a 10 year follow up. Results: Ki67 predicted relapse and death in both symptomatic and SDBC. Mode of detection, size, grade, node status and oestrogen receptor (ER) were independently predictive of breast cancer mortality and Ki67 was not an independent variable. In small size ≤15mm ER positive SDBC (n=248) or symptomatic cancers (n=146), Ki67 was not prognostic (p=0.13 and 0.59 respectively). Twelve per cent of symptomatic and 2% of SDBC had died within 5 years. Mean Ki67 in SDBC was 21.4 (SD 10.3) and 34.2 (SD 16.2) in symptomatic cancers (p=≤0.001). ER positive cancers had lower Ki67 levels (p=0.002). For each 10 unit increase in Ki67, increases in distant relapse occurred (RR 1.43:95%CI;1.32-1.55). Ten Year Survival According to Ki67 and Mode of Presentation Discussion: Epithelial proliferation is prognostic in breast cancer but its value is predominantly in large size (≥15mm) symptomatic tumours and Ki67 alone cannot be used to determine therapy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-31.
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