Risk stratification in early-stage estrogen receptor+/HER2-breast cancer patients: Comparative analysis of cost-effective methods

Prakash, Chandra; Gunda, Aparna; Attuluri, Arun Kumar; Madhav, Lekshmi; Ramkumar, Charusheila; Basavaraj, Chetana; Naidu, Nirupama; Bakre, Manjiri M.

doi:10.4103/jco.jco_12_17

Cited by 2 publications

(3 citation statements)

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“…In our work, zinc levels and intrinsic breast cancer subtypes were related to each other with an upwards trend for "high-risk-cancers" [10,57], while "luminal-like types" (HRpos./Her2neg.) had only mild zinc increases, zinc levels were considerably higher in Her2-positive and finally being highest in triple-negative breast cancers (TNBC).…”

Section: Discussionmentioning

confidence: 54%

Zinc distribution within breast cancer tissue of different intrinsic subtypes

Rüsch

Hirner

Schmitz

et al. 2020

Arch Gynecol Obstet

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Purpose To show feasibility of laser ablation inductively coupled mass spectrometry (LA-ICPMS) for analysis of zinc content and concentration in breast cancer tissue and to correlate this with validated prognostic and predictive markers, i.e. histological grading and expression of steroid receptors (estrogen receptor, ER; progesterone receptor, PR) and human epidermal growth-factor receptor 2 (Her2). Methods 28 samples of human invasive ductal breast cancer tissue were subclassified into groups of four different intrinsic subtypes according to the expression of ER, PR and Her2 by immunohistological staining and then analyzed for zinc content and distribution by LA-ICPMS applying a calibration technique based on spiked polyacrylamide gels. A correlation of zinc concentration with histological grading and molecular subtypes was analyzed. Results Consistent with results of a pilot-study LA-ICPMS was feasible to show zinc accumulation in cancerous tissue, even more adjacent healthy stroma was with proportional increase of zinc. Zinc levels were most elevated in triple-positive (TPBC) and in triple-negative (TNB) breast cancers. Conclusion LA-ICPMS was feasible to confirm a connection between zinc and grade of malignancy; furthermore, focusing on a correlation of zinc and intrinsic breast cancer subtypes, LA-ICPMS depicted an upwards trend of zinc for “high-risk-cancers” with highest levels in Her2-positive and in triple-negative (TNBC) disease. The currently uncommon alliance of clinicians and analytical chemists in basic research is most promising to exploit the full potential of diagnostic accuracy in the efforts to solve the enigma of breast cancer initiation and course of disease.

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Section: Discussionmentioning

confidence: 54%

Zinc distribution within breast cancer tissue of different intrinsic subtypes

Rüsch

Hirner

Schmitz

et al. 2020

Arch Gynecol Obstet

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Section: Methodsmentioning

confidence: 99%

“…Ki67: IHCs were performed at the OncoStem laboratory and graded by trained oncopathologists. 14,15 The Ki67 expression ≤5% was considered low risk, >5 < 30% intermediate, and ≥ 30% high risk. 2 CAB: IHC was performed on five consecutive sections for CAB biomarkers on an automated Ventana platform.…”

Section: Immunohistochemistrymentioning

confidence: 99%

The usefulness of CanAssist Breast over Ki67 in breast cancer recurrence risk assessment

Eshwaraiah¹,

Gunda²,

Kanakasetty

et al. 2023

Cancer Medicine

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Background: Assessment of Ki67 by immunohistochemistry (IHC) has limited utility in clinical practice owing to analytical validity issues. According to International Ki67 Working Group (IKWG) guidelines, treatment should be guided by a prognostic test in patients expressing intermediate Ki67 range, >5%-<30%. The objective of the study is to compare the prognostic performance of CanAssist Breast (CAB) with that of Ki67 across various Ki67 prognostic groups. Methods:The cohort had 1701 patients. Various risk groups were compared for the distant relapse-free interval (DRFi) derived from Kaplan-Meier survival analysis. As per IKWG, patients are categorized into three risk groups: low-risk (<5%), intermediate risk (>5%-<30%), and high-risk (>30%). CAB generates two risk groups, low and high risk based on a predefined cutoff.Results: In the total cohort, 76% of the patients were low risk (LR) by CAB as against 46% by Ki67 with a similar DRFi of 94%. In the node-negative sub-cohort, 87% were LR by CAB with a DRFi of 97% against 49% by Ki67 with a DRFi of 96%.In subgroups of patients with T1 or N1 or G2 tumors, Ki67-based risk stratification was not significant while it was significant by CAB. In the intermediate Ki67 (>5%-<30%) category up to 89% (N0 sub-cohort) were LR by CAB and the percentage of LR patients was 25% (p < 0.0001) higher compared to NPI or mAOL. In the low Ki67 (≤5%) group, up to 19% were segregated as high-risk by CAB with 86% DRFi suggesting the requirement of chemotherapy in these low Ki67 patients. Conclusion:CAB provided superior prognostic information in various Ki67 subgroups, especially in the intermediate Ki67 group.

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Risk stratification in early-stage estrogen receptor+/HER2-breast cancer patients: Comparative analysis of cost-effective methods

Cited by 2 publications

References 0 publications

Zinc distribution within breast cancer tissue of different intrinsic subtypes

Zinc distribution within breast cancer tissue of different intrinsic subtypes

The usefulness of CanAssist Breast over Ki67 in breast cancer recurrence risk assessment

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