Personalizing Breast Cancer Staging by the Inclusion of ER, PR, and HER2

Bagaria, Sanjay P.; Ray, Partha S.; Sim, Myung Shin; Ye, Xing; Shamonki, Jaime; Cui, Xiaojiang; Giuliano, Armando E.

doi:10.1001/jamasurg.2013.3181

Cited by 83 publications

(75 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The tumor represents a combination of histomorphological features and these features do not exist in isolation from one another. Recent studies demonstrate that use of histomorphological characteristics of the tumor improves the prognostic accuracy of breast cancer staging [40]. We could not, however, incorporate PR and HER2 receptor statuses in this classification as it resulted in significant decrease in sample size and loss in statistical power, especially since the primary aim of our analysis was to investigate differences in associations by menopausal status and hormone use.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes

Yaghjyan

Tamimi

Bertrand

et al. 2017

Breast Cancer Res Treat

View full text Add to dashboard Cite

Purpose We examined the associations of mammographic breast density with breast cancer risk by tumor aggressiveness and by menopausal status and current postmenopausal hormone therapy. Methods This study included 2596 invasive breast cancer cases and 4059 controls selected from participants of four nested case—control studies within four established cohorts: the Mayo Mammography Health Study, the Nurses’ Health Study, Nurses’ Health Study II, and San Francisco Mammography Registry. Percent breast density (PD), absolute dense (DA), and non-dense areas (NDA) were assessed from digitized film-screen mammograms using a computer-assisted threshold technique and standardized across studies. We used polytomous logistic regression to quantify the associations of breast density with breast cancer risk by tumor aggressiveness (defined as presence of at least two of the following tumor characteristics: size ≥2 cm, grade 2/3, ER-negative status, or positive nodes), stratified by menopausal status and current hormone therapy. Results Overall, the positive association of PD and borderline inverse association of NDA with breast cancer risk was stronger in aggressive vs. non-aggressive tumors (≥51 vs. 11–25% OR 2.50, 95% CI 1.94–3.22 vs. OR 2.03, 95% CI 1.70–2.43, p-heterogeneity = 0.03; NDA 4th vs. 2nd quartile OR 0.54, 95% CI 0.41–0.70 vs. OR 0.71, 95% CI 0.59–0.85, p-heterogeneity = 0.07). However, there were no differences in the association of DA with breast cancer by aggressive status. In the stratified analysis, there was also evidence of a stronger association of PD and NDA with aggressive tumors among postmenopausal women and, in particular, current estrogen+progesterone users (≥51 vs. 11–25% OR 3.24, 95% CI 1.75–6.00 vs. OR 1.93, 95% CI 1.25–2.98, p-heterogeneity = 0.01; NDA 4th vs. 2nd quartile OR 0.43, 95% CI 0.21–0.85 vs. OR 0.56, 95% CI 0.35–0.89, p-heterogeneity = 0.01), even though the interaction was not significant. Conclusion Our findings suggest that associations of mammographic density with breast cancer risk differ by tumor aggressiveness. While there was no strong evidence that these associations differed by menopausal status or hormone therapy, they did appear more prominent among current estrogen+progesterone users.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Recent studies demonstrate that use of histomorphological characteristics of the tumor improves the prognostic accuracy of breast cancer staging [40]. In our analysis, tumors were defined as aggressive if they had at least two of the following criteria: size 2 cm and greater, differentiation grade 2 or 3, ER-negative status, and positive nodes.…”

Section: Methodsmentioning

confidence: 99%

Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes

Yaghjyan

Tamimi

Bertrand

et al. 2017

Breast Cancer Res Treat

View full text Add to dashboard Cite

show abstract

“…With a shift to smaller tumours due to screening programs, tumour staging per se has only limited prognostic power 13, 14 with recent studies suggesting that a refinement of the current staging system through inclusion of molecular profiles might prove beneficial 15, 16. The Elston–Ellis modification 17, 18 of the Scarff–Bloom–Richardson grading system 19 is widely used to estimate outcomes but the semi‐quantitative evaluation of morphological features rather than quantitative assessment of genetic parameters appears to introduce a considerable bias leaving grading results alone with a comparably limited impact on clinical decision making 13, 14, 20.…”

Section: Introductionmentioning

confidence: 99%

Classical pathology and mutational load of breast cancer – integration of two worlds

Budczies

Bockmayr

Denkert

et al. 2015

The Journal of Pathology CR

View full text Add to dashboard Cite

Breast cancer is a complex molecular disease comprising several biological subtypes. However, daily routine diagnosis is still based on a small set of well‐characterized clinico‐pathological variables. Here, we try to link the two worlds of surgical pathology and multilayered molecular profiling by analyzing the relationships between clinico‐pathological phenotypes and mutational loads of breast cancer. We evaluated the number of mutated genes with somatic non‐silent mutations in different subgroups of breast cancer based on clinico‐pathological, including immunohistochemical and tumour characteristics. The analysis was performed for a cohort of 687 primary breast cancer patients with mutational profiling, gene expression and clinico‐pathological data available from The Cancer Genome Atlas (TCGA) project. The number of mutated genes was strongly positively associated with higher tumour grade (p = 1.4e−14) and with the different immunohistochemical and PAM50 molecular subtypes of breast cancer (p = 1.4e−10 and p = 4.3e−10, respectively). We observed significant associations (|R| > 0.4) between the abundance of mutated genes and expression levels of genes related to proliferation in the overall cohort and hormone receptor positive cohort, including the Recurrence Score gene signature (e.g., MYBL2 and BIRC5). Specific mutated genes (TP53, NCOR1, NF1, PTPRD and RB1) were highly significantly associated with high loads of mutated genes. Multivariate analysis for overall survival (OS) revealed a worse survival for patients with high numbers of mutated genes (hazard ratio = 4.6, 95% CI: 1.0 – 20.0, p = 0.044). Here, we report a strong association of the number of mutated genes with immunohistochemical and PAM50 subtypes and tumour grade in breast cancer. We provide evidence that specific levels of the mutational load underlie different morphological and biological phenotypes, which collectively constitute the current basis of pathological diagnosis. Our study is a step towards genomics‐informed breast pathology and will provide a basis for future studies in this field bridging the gap between morphology, tumour biology and medical oncology.

show abstract

“…Triple-negative breast cancer profile is classified as normal breast-like if basal cytokeratins and the epidermal growth factor receptor are lacking, and as basal-cell-like cancers when basal cytokeratines (cytokeratin 5 and 6 and/or cytokeratin 14) are expressed [10]. Triple negative tumors represent 8–15% of all breast cancer cases and 10–15% of basal-like tumors [11]. Triple-negative and basal-like breast cancers are often associated with high proliferation, high grade, young age (<38 years), lack of BRCA1 protein expression and aggressive clinical behavior (lymph node and distant metastases occurrence) [12].…”

Section: Introductionmentioning

confidence: 99%

MicroRNAs Expression in Triple Negative vs Non Triple Negative Breast Cancer in Tunisia: Interaction with Clinical Outcome

et al. 2014

View full text Add to dashboard Cite

IntroductionMicroRNAs are small, non coding regulatory molecules containing approximately 21 to 25 nucleotides. They function as controllers of expression at post transcriptional levels of most human protein-coding genes and play an essential role in cell signaling pathways. The objective of the present study is to evaluate the expression profile of the following micro-RNAs: miR-10b, miR-17, miR-21, miR-34a, miR-146a, miR-148a and miR-182, and to determine their possible interaction in triple-negative and non triple-negative primary breast cancers based on clinical outcome.Methods60 triple-negative and non triple-negative breast cancer cases, along with their corresponding normal samples were investigated in relation to the expression of the seven studied miRNAs using qPCR Syber Green.ResultsWe observed that miR-21, miR-146a and miR-182 were significantly over expressed in triple negative breast cancer. Moreover, miR-10b, miR-21 and miR-182 were significantly associated to lymph node metastases occurrence in triple negative breast carcinoma while only miR-10b was associated with grade III in non triple negative breast cancer cases. Almost all the analyzed microRNAs were strongly associated with patients’ genico-obstetric history in non triple negative breast cancer cases except for miR-34a. All the studied microRNAs were strongly correlated with the use of the contraceptive pills in non triple negative breast cancer groups. The additive effect of hormonal factors in triple negative breast cancer cases showed an association with all the studied miRs except for miR-34 and miR-146a.ConclusionThe studied microRNAs are strongly influenced by environmental factors especially with hormonal patients’ history. Moreover, miR-10b, miR-21 and miR-182 could be defined as biomarkers in breast cancer to predict both lymph node metastases and grade III occurrence.

show abstract

Personalizing Breast Cancer Staging by the Inclusion of ER, PR, and HER2

Abstract: The internationally recognized and easily reproducible examination of ER, PR, and HER2 status exemplifies how nonanatomic factors can improve the prognostic accuracy of breast cancer staging.

Cited by 83 publications

References 27 publications

Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes

Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes

Classical pathology and mutational load of breast cancer – integration of two worlds

MicroRNAs Expression in Triple Negative vs Non Triple Negative Breast Cancer in Tunisia: Interaction with Clinical Outcome

Contact Info

Product

Resources

About