Modern therapies and iatrogenic changes in breast pathology

Provenzano, Elena; Pinder, Sarah

doi:10.1111/his.13098

Cited by 10 publications

(24 citation statements)

References 110 publications

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“…In rare cases, recurrence adenosquamous carcinoma of breast is invasive ductal carcinoma with ER and PR expression, [ 12 ] it could be that adjuvant chemotherapy alters the hormone receptor status. [ 13 ] In addition, it was reported that hormone receptors can regulate the expression of CD44v, which is considered having correlation with cellular differentiation in breast cancer. [ 14 ] The expression of CD44v is mainly restricted to myoepithelial cells in normal breast tissues.…”

Section: Discussionmentioning

confidence: 99%

Expression of hormone receptors in low-grade adenosquamous carcinoma of the breast

Wu¹,

Zhang²,

Wang

et al. 2017

Medicine

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Rationale:Low-grade adenosquamous carcinoma (LGASC) is a rare subtype of metaplastic breast carcinoma which is generally recognized as a characteristic subgroup of triple-negative breast cancers previously. However, in this study, we reported for the first time a case of LGASC with hormone receptors expression.Patient concerns:Pathological analysis of breast tumor specimen obtained by a 42-year-old female patient was performed. Morphologically, it composed of glandular structures with scattered squamous differentiation accompanied by haphazard arrangement of spindle cell stroma. Immunohistochemically, all myoepithelial and squamous differentiation markers showed typical LGASC positive or negative staining pattern. Interestingly, we found that normally aberrant hormone receptors were reactivated in this case. To our knowledge, this is the first report of a hormone receptor-positive LGASC. Apart from this, in the extended resection sample, we found scattered squamous metaplasia and florid adenosquamous proliferation (ASP). Meanwhile, it was positive for CD44 variant isoforms (CD44v), which is a breast cancer stem cell (CSC) marker, and expressed in LGASC, squamous metaplasia, and ASP.Diagnosis:LGASC with hormone receptors expression.Interventions:The breast-extended local excision and axillary lymph node dissection were performed.Outcomes:The patient was free of local recurrence and distant metastasis 6 months after surgical resection.Lessons:We herein report the first case of LGASC with immunoreactivity for hormone receptors, expanding its profile of immunophenotypes. CD44v may play an important role in the transition of LGASC precursor lesions into malignant processes, which may serve as a therapeutic target in LGASC.

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Section: Discussionmentioning

confidence: 99%

Expression of hormone receptors in low-grade adenosquamous carcinoma of the breast

Wu¹,

Zhang²,

Wang

et al. 2017

Medicine

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“…Although BIA-ALCL is of T-cell lineage, the neoplastic cells are usually negative for CD7 and often lack other pan-T-cell antigens, such as CD2, CD3, and CD5. 23,71 The B-cell markers CD20 and CD79a and the plasma-cell marker CD138 are negative. Unlike a subset of systemic ALCL, BIA-ALCL is consistently Alk-1 negative.…”

Section: Histopathologymentioning

confidence: 99%

“…Some neoplastic cells may resemble the "hallmark" cells described in systemic anaplastic large cell lymphoma (ALCL), which have kidney-shaped nuclei and paranuclear eosinophilia on hematoxylin-eosin-stained sections. 71 Neoplastic cells can be present individually in aspirated fluid, as small nests within fibrinoid and necrotic material adherent to the inner surface of a capsule or as sheets within a mass lesion. 19,25,72 Often there is an associated inflammatory cell infiltrate, including small lymphocytes, histiocytes, and eosinophils.…”

Section: Histopathologymentioning

confidence: 99%

Breast Implant–Associated Anaplastic Large-Cell Lymphoma: Current Understanding and Recommendations for Management

et al. 2020

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Worldwide, millions of women live with breast implants. Therefore, it is important that physicians be aware of an uncommon but possibly serious complication arising from breast implants: breast implant–associated anaplastic large cell lymphoma (BIA-ALCL). Breast implant–associated anaplastic large-cell lymphoma most commonly presents as a delayed fluid collection around a textured breast implant or as a mass in the capsule surrounding the implant. The exact pathogenesis of the disease remains unclear. The neoplastic cells of BIA-ALCL show strong uniform staining for CD30 and are consistently negative for activin receptor-like kinase 1. Patients with confirmed cases should be referred to a lymphoma specialist or breast medical oncologist for a complete oncologic evaluation before any surgical intervention. For disease confined to the fluid accumulation or capsule, or both, surgical removal of the implant and complete capsulectomy is the preferred treatment. Postoperative chemotherapy or radiation, or both, are not considered necessary for patients with limited-stage disease and are reserved for advanced disease stages. Generally, BIA-ALCL is a local disease that follows an indolent course and has an excellent prognosis. Although complete remission of disease has occurred in patients with BIA-ALCL, median overall survival is reduced. As of March 2018, approximately 529 unique, confirmed BIA-ALCL cases had been reported in 23 countries. To date, 16 patients have died from BIA-ALCL, and all had extracapsular involvement. The aim of this article is to summarize the diagnosis, evaluation, and management of BIA-ALCL, based on established guidelines, for all practitioners who may care for patients with breast implants.

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“…Several types of antitumor agents, including hormone therapy, chemotherapy, and radiotherapy have been investigated in preclinical research ( 21 , 22 , 24 – 28 ), and a safety and feasibility clinical trial was successfully conducted with Doxil administered by the i.duc route ( 22 ). The results are promising overall, but problems still exist, such as suboptimal antitumor efficiency of endocrine agents ( 26 ) and long-term effects of DNA-damaging agents such as chemotherapy and radiotherapy ( 49 ). Treatment using biological agents such as antibodies or antibody-targeted protein toxins may circumvent these problems.…”

Section: Discussionmentioning

confidence: 99%

Intraductal administration of transferrin receptor-targeted immunotoxin clears ductal carcinoma in situ in mouse models of breast cancer—a preclinical study

Wang

Kumar

Ding

et al. 2022

Proc. Natl. Acad. Sci. U.S.A.

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The human transferrin receptor (TFR) is overexpressed in most breast cancers, including preneoplastic ductal carcinoma in situ (DCIS). HB21(Fv)-PE40 is a single-chain immunotoxin (IT) engineered by fusing the variable region of a monoclonal antibody (HB21) against a TFR with a 40 kDa fragment of Pseudomonas exotoxin (PE). In humans, the administration of other TFR-targeted immunotoxins intrathecally led to inflammation and vascular leakage. We proposed that for treatment of DCIS, intraductal (i.duc) injection of HB21(Fv)-PE40 could avoid systemic toxicity while retaining its potent antitumor effects on visible and occult tumors in the entire ductal tree. Pharmacokinetic studies in mice showed that, in contrast to intravenous injection, IT was undetectable by enzyme-linked immunosorbent assay in blood following i.duc injection of up to 3.0 μg HB21(Fv)-PE40. We demonstrated the antitumor efficacy of HB21(Fv)-PE40 in two mammary-in-duct (MIND) models, MCF7 and SUM225, grown in NOD/SCID/gamma mice. Tumors were undetectable by In Vivo Imaging System (IVIS) imaging in intraductally treated mice within 1 wk of initiation of the regimen (IT once weekly/3 wk, 1.5 μg/teat). MCF7 tumor–bearing mice remained tumor free for up to 60 d of observation with i.duc IT, whereas the HB21 antibody alone or intraperitoneal IT treatment had minimal/no antitumor effects. These and similar findings in the SUM225 MIND model were substantiated by analysis of mammary gland whole mounts, histology, and immunohistochemistry for the proteins Ki67, CD31, CD71 (TFR), and Ku80. This study provides a strong preclinical foundation for conducting feasibility and safety trials in patients with stage 0 breast cancer.

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Modern therapies and iatrogenic changes in breast pathology

Cited by 10 publications

References 110 publications

Expression of hormone receptors in low-grade adenosquamous carcinoma of the breast

Expression of hormone receptors in low-grade adenosquamous carcinoma of the breast

Breast Implant–Associated Anaplastic Large-Cell Lymphoma: Current Understanding and Recommendations for Management

Intraductal administration of transferrin receptor-targeted immunotoxin clears ductal carcinoma in situ in mouse models of breast cancer—a preclinical study

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