Immunohistochemically defined subtypes and outcome in occult breast carcinoma with axillary presentation

Abstract

The aim of this study is to evaluate the outcome of occult breast cancer (OBC) in patients with axillary presentation overall and according to the immunohistochemically defined tumour subtypes. We reviewed information on 15,490 consecutive primary breast cancer patients, who underwent surgery at the European institute of oncology between September 1997 and December 2008. Patients with OBC were compared with an equal number of patients with small invasive breast carcinomas (pT1) observed at the same institution during the same period, matched for year of surgery, age, nodal status and biological features. Eighty patients with OBC (study group) and 80 patients with early breast cancer (control group) were identified. There was no significant difference in the disease-free survival (5 years DFS 66 vs. 68% P = 0.91) and the overall survival (5 years OS 80 and 86% P = 0.99) between the OBC and control groups. A statistically significant worse outcome was observed within the group of OBC for patients with more than four involved lymph nodes and with triple negative tumours. The outcome of OBC patients is comparable with that of matched patients with small sized breast cancer. High risk of relapse and death was observed in OBC patients with triple negative tumours and extensive nodal involvement.

Triple-negative invasive breast cancer on dynamic contrast-enhanced and diffusion-weighted MR imaging: comparison with other breast cancer subtypes

“…In addition to the traditional parameters such as tumour size, grade, and lymph node status, several molecular markers are employed in routine patient care [2,3]. An immunohistochemical profile based on the extent of the expression of the oestrogen receptor (ER), the progesterone receptor (PR) and the human epidermal growth factor receptor 2 (HER2) is the most frequently used molecular marker, and identifies subgroups of breast cancer patients with different outcomes and responsiveness to systemic therapies [4]. Recently, analyses of gene expression profiles with cDNA microarray technology have segregated breast cancers into several subtypes with common molecular features: luminal A and B (both ER-positive), normal breast-like, basal-like and HER2-positive (all ERnegative), and these subtypes differ in prognosis and survival [4][5][6][7][8].…”

Comparison of hormonal receptor and HER2 status between ultrasound-guided 14-gauge core needle biopsy and surgery in breast cancer patients

“…An immunohistochemical profile based on the extent of the expression of the estrogen receptor (ER), the progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) is the most frequently used molecular marker, and identifies subgroups of breast cancer patients with different outcomes and responsiveness to systemic therapies [1]. Immunohistochemistry can provide prognostic and predictive information for specific therapies.…”

Immunohistochemical Subtypes of Breast Cancer: Correlation with Clinicopathological and Radiological Factors

“…Therefore, the examination of IHC subtypes using breast cancer tissue is actively performed. IHC determinations of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 statuses are used to define these subtypes (4-6). With DNA microarray-expression profiling techniques, we can use a hierarchical clustering method to identify four distinct molecular subtypes: 1) luminal A (ER- and/or PR-positive, HER2-negative); 2) luminal B (ER- and/or PR-positive, HER2-positive or Ki67 > 14%); 3) HER2-enriched (HER2 amplified, ER- and PR-negative); and 4) triple-negative (TN) (ER-, PR-, and HER2-negative) subtypes.…”

“…With DNA microarray-expression profiling techniques, we can use a hierarchical clustering method to identify four distinct molecular subtypes: 1) luminal A (ER- and/or PR-positive, HER2-negative); 2) luminal B (ER- and/or PR-positive, HER2-positive or Ki67 > 14%); 3) HER2-enriched (HER2 amplified, ER- and PR-negative); and 4) triple-negative (TN) (ER-, PR-, and HER2-negative) subtypes. Prognosis and survival are different according to these subtypes (6). Luminal tumors are associated with the most favorable prognoses, while HER2-overexpressing and triple-negative tumors are associated with the worst prognosis (2, 7).…”