Biological characteristics of breast cancer at the primary tumour and the involved lymph nodes

Abstract

Diminished oestrogen receptor (ER) expression in the involved axillary lymph nodes (ALN) in breast cancer compared with the primary tumour has been reported in previous studies. We have assessed a wider spectrum of tumour markers (ER, progesterone receptor (PgR), p53, Ki-67 and HER-2/neu) and compared extent and staining intensities at the primary tumour and the involved ALN on specimens of 22 cases with invasive ductal breast cancer. At the involved ALN, both the quantity of positive staining cells and the staining intensities for ER and PgR were decreased (p < 0.001 and p = 0.003, respectively). In contrast, the quantity of positive staining cells (p < 0.004) and the staining intensities for Ki-67 were increased. The differences for HER-2/neu and p53 staining at both sites were insignificant. The immunohistochemical staining properties of both the primary tumour and the ALN metastases showed no correlation with the number of involved ALN (p > 0.05). This study suggested that ALN metastasis might indicate a more unfavourable expression pattern of ER, PgR and Ki-67 in invasive ductal breast cancer.

Prognostic Value of Ki-67 in Breast Cancer Patients with Positive Axillary Lymph Nodes: A Retrospective Cohort Study

“…In the present study, our results showed the Ki-67 expression was not related to the number of metastatic lymph nodes, in agreement with a previous report [31]. In addition, Ki-67 expression in axillary lymph nodes is significantly higher in lymph nodes than that in primary cancer in some cases [31], [32], which may be explained that cancer cells with potent proliferative capability are more likely to metastasize from the primary cancer to the axillary lymph nodes. Analysis of patients with divergent Ki-67 expression in primary versus metastatic lesions suggests that the prognostic value of Ki-67 (>10%) on survival was greater in the tumors located in the nodes than that in the primary lesion [24], [31].…”

Biological subtypes of breast cancer: Prognostic and therapeutic implications

“…The expression patterns of hormone receptors and Ki67 may especially show differences in the tumor cells at the lymph nodes and the primary lesion, probably due to tumor cell heterogeneity in parallel to increased tumor burden [77] . Although research results indicate that these multigene molecular assays can reclassify some breast cancer patients who are ranked as high risk using the traditional classification systems into low risk (i.e., reducing the number of patients who might unnecessarily undergo chemotherapy) and vice versa, available data are insufficient to challenge classical classification systems and to justify withholding chemotherapy for high risk patients if classified as low risk using multigene assays.…”

Parotid gland metastasis of a breast cancer

“…Dikicioglu et al [5] concluded that lymphatic metastasis presented a significative trend to reduce the expression of oestrogen and progesterone receptors and an increase in the expression of Ki-67, but there were no differences in the expression of HER-2 and p53.…”