The 2019 World Health Organization classification of tumours of the breast

Tan, Puay Hoon; Ellis, Ian O.; Allison, Kimberly H.; Brogi, Edi; Fox, Stephen B.; Lakhani, Sunil R.; Lazar, Alexander J.; Morris, Elizabeth A.; Şahin, Ayşegül; Salgado, Roberto; Sapino, Anna; Sasano, Hironobu; Schnitt, Stuart J.; Sotiriou, Christos; Diest, Paul van; White, Valerie A.; Lokuhetty, Dilani; Cree, Ian A.

doi:10.1111/his.14091

Cited by 532 publications

(491 citation statements)

References 3 publications

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“…Initial diagnoses were confirmed on hematoxylin/eosin (H&E) stained sections. Patient characteristics (in accordance with the WHO 2012 and 2019 classification of BCa [ 41 ]) are presented in Table 1 . Statuses of ER and PR were determined according to the Allred scoring system [ 42 ].…”

Section: Methodsmentioning

confidence: 99%

Hormonal Receptor Status Determines Prognostic Significance of FGFR2 in Invasive Breast Carcinoma

Braun

Piasecka

Tomasik

et al. 2020

Cancers

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Interaction between fibroblast growth factor receptor 2 (FGFR2) and estrogen/progesterone receptors (ER/PR) affects resistance to anti-ER therapies, however the prognostic value of FGFR2 in breast cancer (BCa) remains largely unexplored. We have recently showed in vitro that FGFR2-mediated signaling alters PR activity and response to anti-ER treatment. Herein, prognostic significance of FGFR2 in BCa was evaluated in relation to both ER/PR protein status and a molecular signature designed to reflect PR transcriptional activity. FGFR2 was examined in 353 BCa cases using immunohistochemistry and Nanostring-based RNA quantification. FGFR2 expression was higher in ER+PR+ and ER+PR- compared to ER−PR− cases (p < 0.001). Low FGFR2 was associated with higher grade (p < 0.001), higher Ki67 proliferation index (p < 0.001), and worse overall and disease-free survival (HR = 2.34 (95% CI: 1.26–4.34), p = 0.007 and HR = 2.22 (95% CI: 1.25–3.93), p = 0.006, respectively). The poor prognostic value of low FGFR2 was apparent in ER+PR+, but not in ER+PR− patients, and it did not depend on the expression level of PR-dependent genes. Despite the functional link between FGFR2 and ER/PR revealed by preclinical studies, the data showed a link between FGFR2 expression and poor prognosis in BCa patients.

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Section: Methodsmentioning

confidence: 99%

Hormonal Receptor Status Determines Prognostic Significance of FGFR2 in Invasive Breast Carcinoma

Braun

Piasecka

Tomasik

et al. 2020

Cancers

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“…Epithelial rat mammary gland cells underwent a stepwise transformation into malignant ones through an increase of structures called terminal end buds, important targets associated with rat mammary carcinogenesis ( 22 , 33 ), these studies indicated that malathion alone induced changes exclusively at the duct level, increasing in size and number of cells per mm 2 with time. Such ducts defined as ductal in the proliferation stage, since one notable finding was that as time progressed those structures were transformed into mammary gland tumors that revealed a similarity to ductal carcinomas in comparison with controls, as reported by the World Health Organization ( 34 ).…”

Section: Experimental Induced Rat Mammary Gland Cancer Modelmentioning

confidence: 60%

Markers of epithelial-mesenchymal transition in an experimental breast cancer model induced by organophosphorous pesticides and estrogen (Review)

et al. 2020

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Breast cancer is a major health problem and accounted for 11.6% of all new cancer cases and 6.6% of all cancer deaths among women worldwide in 2018. However, its etiology has remained elusive. According to epidemiological studies, environmental factors are influencing the increase in the incidence of breast cancer risk. Components such as chemicals, including pesticides, are agents that produce deleterious effects on wildlife and humans. Among them, the organophosphorus pesticides, such as malathion, have largely been considered in this etiology. The epithelial-mesenchymal transition serves a key role in tumor progression and it is proposed that malathion is closely associated with the origin of this transition, among other causes. Moreover, proteins participating in this process are primordial in the transformation of a normal cell to a malignant tumor cell. The aim of the current study was to evaluate markers that indicated oncogenic properties. The results indicated greater expression levels of proteins associated with the epithelial-to-mesenchymal transition, including E-cadherin, Vimentin, Axl, and Slug in the rat mammary glands treated with malathion alone and combined with estrogen. Atropine was demonstrated to counteract the malathion effect as a muscarinic antagonist. The understanding of the use of markers in experimental models is crucial to identify different stages in the cancer process. The alteration of these markers may serve as a predicting factor that can be used to indicate whether a person has altered ducts or lobules in breast tissue within biopsies of individuals exposed to OPs or other environmental substances. Contents 1. Introduction 2. Data collection methods 3. Experimental induced rat mammary gland cancer model 4. Epithelial-to-mesenchymal transition (EMT) 5. Main findings 6. Conclusions and future perspectives

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“…Based on the code information in SEER, we divided tumor location into three groups (outer quadrant and axillary tail, inner quadrant, and others). Histology was categorized into five groups according to the latest classification of the World Health Organization ( 18 ): no special type (NST); invasive lobular carcinoma (ILC); favorable (tubular/mucinous/papillary); metaplastic; and others (histological types other than the above four types).…”

Section: Methodsmentioning

confidence: 99%

Predicting Survival Benefit of Sparing Sentinel Lymph Node Biopsy in Low-Risk Elderly Patients With Early Breast Cancer: A Population-Based Analysis

Wen

et al. 2020

Front. Oncol.

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The application of sentinel lymph node biopsy (SLNB) in elderly patients with early breast cancer remains somewhat controversial. This study aimed to establish individualized nomograms to predict survival outcomes of elderly patients with and without SLNB and find out which patients could avoid SLNB. Methods: A total of 39,962 ≥70-year-old patients diagnosed with T1-T2 breast cancer in 2010-2015 were included from the Surveillance, Epidemiology, and End Results (SEER) program and were divided into the training set (n = 29,971) and the validation set (n = 9,991). Axillary surgery was not specified in the SEER database, and we defined removing one to five lymph nodes as SLNB. Survival analysis was performed using the Kaplan-Meier plot and log-rank test. Multivariate Cox analysis was utilized to identify risk factors for overall survival (OS) and breast-cancer-specific survival (BCSS). Nomograms and a risk stratification model were constructed. Results: In the training set, patients with SLNB had better OS (adjusted HR 0.57, P < 0.001) and BCSS (adjusted HR 0.55, P < 0.001) than patients without SLNB. Multivariate COX analysis identified age, marital status, grade, subtype, T stage, and radiation as independent risk factors for OS and BCSS in both SLNB and non-SLNB groups (all P < 0.05). They were subsequently incorporated to establish nomograms to predict 3-and 5-year OS and BCSS for patients with or without SLNB. The concordance index ranged from 0.687 to 0.820, and calibration curves in the internal set and external set all demonstrated sufficient accuracies and good predictive capabilities. Further, we generated a risk stratification model which indicated that SLNB improved OS and BCSS in high-risk group (OS: HR 0.49, P < 0.001; BCSS: HR 0.54, P < 0.001), but not in the low-risk group (all P > 0.05). Conclusion: Well-validated nomograms and a risk stratification model were constructed to evaluate survival benefit from SLNB in elderly patients with early-stage breast cancer. Xu et al. SLNB in Elderly Breast Cancer SLNB was important for patients in the high-risk group but could be omitted in the low-risk group without sacrificing survival. This study could assist clinicians and elderly patients to weigh the risk-benefit of SLNB and make individualized decisions. We look forward to more powerful evidence from prospective trials.

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The 2019 World Health Organization classification of tumours of the breast

Cited by 532 publications

References 3 publications

Hormonal Receptor Status Determines Prognostic Significance of FGFR2 in Invasive Breast Carcinoma

Hormonal Receptor Status Determines Prognostic Significance of FGFR2 in Invasive Breast Carcinoma

Markers of epithelial-mesenchymal transition in an experimental breast cancer model induced by organophosphorous pesticides and estrogen (Review)

Predicting Survival Benefit of Sparing Sentinel Lymph Node Biopsy in Low-Risk Elderly Patients With Early Breast Cancer: A Population-Based Analysis

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