Cytological Criteria for Predicting the Luminal Phenotype of Breast Carcinoma

Abstract

Background: Specific cytological criteria for the luminal phenotype of breast carcinoma, despite it being the most common and having a better prognosis as well as targeted therapies under study, remain to be established. Using fine-needle aspiration cytology (FNAC), we aimed to identify the luminal phenotype through the evaluation of cytological criteria recognized in routine practice. Methods: We correlated 169 FNACs of breast carcinomas with their tissue specimens, classified into phenotypes by immunohistochemistry (applying tissue microarray technology) as luminal A, luminal B, HER2 overexpression, and triple negative. All FNAC samples were blindly reviewed according to cellularity, cell cohesion, necrosis, nucleoli, and nuclear atypia. Fisher's exact test was used to test associations between the cytological criteria and phenotypes. Results: The following phenotypes were obtained - luminal A: 107 (63.3%), luminal B: 39 (23.1%), HER2 overexpression: 8 (4.7%), and triple negative: 15 (8.9%). The luminal phenotype showed mild/moderate cellularity (40.4%) (OR = 7.12, 95% CI: 1.61-31.52), inconspicuous, present nucleoli (55.5%) (OR = 8.31, 95% CI: 2.36-29.19), and mild/moderate nuclear atypia (44.5%) (OR = 8.42, 95% CI: 1.90-37.25). Conclusion: The criteria that might indicate the luminal phenotype of breast carcinoma in FNAC were mild/moderate cellularity, inconspicuous, present, and nonprominent nucleoli, and mild/moderate nuclear atypia.

Optoacoustic imaging of the breast: correlation with histopathology and histopathologic biomarkers

“…Nevertheless, the combination of functional and morphologic information provided by OA/US features was even more valuable to differentiate between breast cancer molecular subtypes, and the differences between molecular subtypes may justify these findings. LUMA tumors usually have low levels of proliferation-related genes, have mild/moderate cellularity, are usually of low histological grade, and have a better outcome when compared to LUMBs [23–25]. Compared to LUMAs, LUMB cancers are more often of higher histological grade and have higher proliferation rates, lower cellular cohesion, higher rates of necrosis, and a worse prognosis [23–25, 27, 28].…”

“…LUMA tumors usually have low levels of proliferation-related genes, have mild/moderate cellularity, are usually of low histological grade, and have a better outcome when compared to LUMBs [23–25]. Compared to LUMAs, LUMB cancers are more often of higher histological grade and have higher proliferation rates, lower cellular cohesion, higher rates of necrosis, and a worse prognosis [23–25, 27, 28]. Notably, malignant stromal cells—mostly tumor-associated fibroblasts—which are more frequently found in LUMBs than in LUMAs—can induce tumor cell proliferation and also promote angiogenesis [30, 31].…”

“…Our results showed that OA/US feature scores assigned to LUMB subtypes were not significantly different than those assigned to TNBCs. Although LUMB tumors present lower cellularity and lower grade and less extensive necrosis than TNBCs, these differences are not as pronounced when comparing LUMAs vs TNBC [23–25].…”

“…Another interesting finding was the significant difference between TNBC and HER2-enriched regarding total internal features. These two types of tumors are known to have many overlapping characteristics: both of them are usually high grade, have low cell cohesion, and present with more extensive necrosis [25, 31, 51]. However, TNBCs usually have higher cellularity and tubular and syncytial cluster scores when compared to HER2-enriched breast cancers [25, 31, 51, 52], which may also explain the significantly higher total internal feature scores found in TNBCs.…”

Photoacoustic imaging of breast cancer: a mini review of system design and image features

“…The four tumor subtypes, luminal A (LUMA), luminal B (LUMB), triple negative breast cancer (TNBC), and human epidermal growth factor receptor type 2 enhanced (HER2-E), and their characteristics [69][70][71][72] are presented in Table 3. Menezes et al 73 reviewed results from the Maestro trial, and Dogan et al 74 reviewed results from the Pioneer trial to investigate whether tumor subtypes could be differentiated based on PA/US features.…”