There continues to be large variation in margin policy and re-excision rates across units. Altering margin policies to follow either SSO-ASTRO or ABS guidelines would result in a modest reduction in the national re-excision rate. Most re-excisions are for involved margins rather than close margins.
Estrogen receptor (ER) action is modulated by posttranslational modifications. Although ER␣ phosphorylation correlates with patient outcome, ER is similarly phosphorylated but its significance in breast cancer has not been addressed. We investigated whether ER that is phosphorylated at serine 105 (S105-ER) is expressed in breast cancer and assessed potential clinical implications of this phosphorylation. Following antibody validation, S105-ER expression was studied in tissue microarrays comprising 108 tamoxifen-resistant and 351 tamoxifen-sensitive cases and analyzed against clinical data. S105-ER regulation in vitro was assessed by Western blot, flow cytometry, and immunofluorescence. Nuclear S105-ER was observed in breast carcinoma and was associated with better survival (Allred score >3), even in tamoxifen-resistant cases, and additionally correlated with ER1 and ER2 expression. Distinct S105-ER nuclear speckles were seen in some higher grade tumors. S105-ER levels increased in MCF-7 cells in response to 17-estradiol, the ER-specific agonist diarylpropionitrile , and the partial ER-agonist genistein. S105-ER nuclear speckles were also seen in MCF-7 cells and markedly increased in size and number at 24 hours following 17-estradiol and, in particular diarylpropionitrile, treatment. These speckles were coexpressed with ER1 and ER2. Presence of S105-ER in breast cancer and association with improved survival, even in endocrine resistant breast tumors suggest S105-ER might be a useful additional prognostic marker in this disease.
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Background: Estrogen receptor (ER) α predicts response to hormonal therapy in breast carcinoma. The role of ERβ is less well understood. ER activities can be modulated by post-translational modifications including phosphorylation and phosphorylated ERα has been correlated with patient outcome. We investigated whether ERβ phosphorylated at Serine 105 (P-S105-ERβ) is expressed in breast carcinoma and assessed its potential clinical implications.Material and Methods: Tissue microarrays comprising 427 breast tumours (23% grade 1, 43% grade 2, 34% grade 3) with median follow up 118 months and 106 endocrine resistant breast tumours (15% grade 1, 41% grade 2, 44% grade 3) with median follow up 71 months were used in this study. Expression of P-S105-ERβ was studied by immunohistochemistry and analysed against clinical data. Regulation of P-S105-ERβ in vitro was assessed by immunofluorescence and Western blotting.Results: Expression of P-S105-ERβ was mainly nuclear and could be abolished by phosphatase pre-incubation, indicating specificity. In the first cohort Allred scoring ranged from 0 to 8 (median 6). Nuclear speckling was observed in 45% of cases. P-S105-ERβ correlated with ERβ1 (Allred score ≥ 3) and was associated with better overall survival (OS) and disease free survival (DFS) (p=0.028 and p=0.027, respectively). In a multivariate Cox hazard analysis, P-S105-ERβ overexpression was a significant predictor of better survival independent of tumor grade, lymph node status, size or ERα. In the endocrine resistant cohort Allred scoring ranged from 0 to 8 (median of 4) and the overexpression of P-S105-ERβ was also associated with improved OS and DFS (p=0.044 and p=0.033, respectively). Nuclear speckling was present in only 11% of cases. The difference in expression of P-S105-ERβ and association with survival outcome between the two cohorts was statistically significant. P-S105-ERβ was expressed in MCF-7 cells and in response to 17β-estradiol (E2); levels were raised within 30 min, and sustained for 24 hours. ERβ1 expression was unaffected by this treatment. Nuclear speckling was also observed and was markedly increased at 24 hours following E2 but not Tamoxifen.Conclusion: This is the first time to our knowledge that the expression of P-S105-ERβ in breast carcinoma has been investigated. Its presence in breast carcinoma and association with improved survival suggest P-S105-ERβ might be a useful additional prognostic marker in breast cancer.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4141.
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