A comparative study of clinicopathological characteristics and expression of basal markers (CK5/6 & EGFR) in triple negative and non triple negative breast carcinomas in Kashmir valley.
Keywords:
Cytokeratin, EGFR, Triple negative breast neoplasms.
Abstract
BACKGROUND: The aim of this study was to compare the clinicopathological characteristics of Triple Negative Breast Carcinomas with Non Triple Negative Breast Carcinomas(NTNBC).Evaluation of expression of Epidermal Growth Factor Receptor (EGFR), CK5/6 in TNBC and their comparison with NTNBC was done. METHODS: 25 TNBC and 35 NTNBC were selected.The clinicopathological parameters of these two groups were compared. Each group was further immunostained for basal markers(CK5/6 and EGFR).The expression of markers in these two groups was studied and compared with each other.RESULTS : The mean age of TNBC and NTNBC were 47 and 49 years respectively. The majority (48%) of cases from TNBC as well as NTNBC (45%)were in size range of 2-5 cm(T2 stage). IDC-NOS was predominant histological type seen in 92% of TNBC and 100% NTNBC.TNBCs had a significantly higher tumor grade than NTNBC at presentation. LVI was seen in 40% TNBC cases and 42% NTNBC cases. Majority (52%) of TNBC cases were node negative while majority (37.14%) of NTNBC cases belonged to N1 stage. IIA was the most common stage in 36% TNBC cases . In NTNBC, majority of the cases (34%) belonged to Stage IIIA.Expression of basal markers was significantly associated with triple negative breast cancers.CONCLUSION: TNBCs had a significantly higher tumor grade than NTNBCs at presentation. Expression of basal markers was significantly associated with TNBCs. Since EGFR was significantly associated with triple negative phenotype,TNBC could potentially benefit from EGFR targeted therapeutic strategies. DOI: 10.21276/AABS.2017.1339References
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30. Albergaria A, Ricardo S,Milanezi F, Carneiro V,Amendoeira I, Vieira D et al. Nottingham Prognostic Index in Triple-Negative Breast Cancer: a reliable prognostic tool?.BMC Cancer.2011; 11:299.
31. Tawfik O, Davis K, Kimler BF. Clinicopathological Characteristics of Triple-Negative Invasive Mammary Carcinomas in African-American versus Caucasian Women.Ann Clin Lab Sci . 2010 ; 40(4 ):315-323
32. Hashmi AA, Edhi MM, Naqvi H, Faridi N, Khurshid A , Khan. Clinicopathologic features of triple negative breast cancers: an experience from Pakistan. Diagnostic Pathology.2014;9:43.
33. Pintens S, Neven P, Drijkoningen M ,Van Belle V, Moerman P, Christiaens MR et al:Triple negative breast cancer: a study from the point of view of basal CK5/6 and HER-1: J Clin Pathol. 2009;62(7):624-8.
34. Choccalingam C, Rao L, Rao S. Clinico-Pathological Characteristics of Triple Negative and Non Triple Negative High Grade Breast Carcinomas with and Without Basal Marker (CK5/6 and EGFR) Expression at a Rural Tertiary Hospital in India. Breast Cancer (Auckl). 2012; 6: 21–29.
35. Rakha EA, Reis-Filho JS , Ellis IO. Basal-Like Breast Cancer: A Critical Review. Journal of clinical oncology. 2008; 26: 2568-2581.
36. Abulkhair O, Moghraby JS, Badri M. Clinicopathologic features and prognosis of triple-negative breast cancer in patients 40 years of age and younger in Saudi Arabia. Hematology/Oncology and Stem Cell Therapy.2012;5(2):101-6.
2. Badve S, Dabbas DJ, Schnitt SJ, Baehner FL, Decker T, Eusebi V et al. Basal-like and triple negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. Mod Pathol. 2011; 24:157-67.
3. Elston EW, Ellis IO. Method for grading breast cancer. J Clin Pathol. 1993; 46: 189–190.
4. Sobin LH, Gospodarowicz MK, Wittekind CH. UICC: TNM classification of malignant tumors.7 ed. Oxford: Wiley-Blackwell; 2009.
5. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001; 98:10869–10874.
6. Sasa M, Bando Y, Takahashi M, Hirose T, Nagao T.Screening for basal marker expression is necessary for decision of therapeutic strategy for triple-negative breast cancer. J Surg Oncol.. 2008 Jan 1;97(1):30-4.
7. Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA et al. Molecular portraits of human breast tumours. Nature. 2000; 406:747-752.
8. Bhanvadia V, Goyal P. Basal-like breast cancer: The road less traveled.. Annals Of Pathology And Laboratory Medicine, 2014;1(1), 5-7.
9. Jones C, Nonni AV, Fulford L, Ryder K, Merrett S, Reis-Filho JS et al: CGH analysis of ductal carcinoma of the breast with basaloid/myoepithelial cell differentiation. Br J Cancer.2001;85:422-427.
10. Potemski P, Kusinska R, Watala C, Pluciennik E, Bednarek AK, Kordek R.Prognostic relevance of basal cytokeratin expression in operable breast cancer. Oncology.2005; 69:478-485.
11. Kim MJ, Ro JY, Ahn SH, Kim HH,Kim SB,Gong G . Clinicopathologic significance of the basal-like subtype of breast cancer: A comparison with hormone receptor and HER-2/neu-overexpressing phenotypes. Hum Pathol. 2006;37:1217-1226.
12. Fulford LG, Reis-Filho JS, Ryder K, Jones C, Gillett CE, Hanby A et al.Basal-like grade III invasive ductal carcinoma of the breast: Patterns of metastasis and long-term survival. Breast Cancer Res.2007;9:R4.
13. van de Rijn M, Perou CM, Tibshirani R, Haas P, Kallioniemi O, Kononen J et al.Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. Am J Pathol. 2002;161:1991-1996.
14. Rakha EA, Putti TC, Abd El-Rehim DM Paish C, Green AR,Powe DG et al. Morphological and immunophenotypic analysis of breast carcinomas with basal and myoepithelial differentiation. J Pathol. 2006;208:495-506.
15. Chang HY, Nuyten DS, Sneddon JB, Hasty T, Tibshirani R,Sorlie T et al. Robustness, scalability, and integration of a wound-response gene expression signature in predicting breast cancer survival. Proc Natl Acad Sci U S A. 2005 ;102:3738-3743
16. Reis-Filho JS, Milanezi F, Steele D, savage K, Simpson PT, Nesland JM et al. Metaplastic breast carcinomas are basal-like tumours. Histopathology. 2006;49:10-21.
17. Jacquemier J, Padovani L, Rabayrol L, Lakhani S, Penault-Llorca F, Denoux Y et al. Typical medullary breast carcinomas have a basal/myoepithelial phenotype. J Pathol. 2005;207:260-268.
18. Rosai and Ackerman. Surgical Pathology. 10 ed, India: Elsevier; c2011; p1712
19. Cheang MC, Voduc D, Bajdik C, Leung S, McKinney S, Chia SK et al. Basal-Like Breast Cancer Defined by Five Biomarkers Has Superior Prognostic Value than Triple-Negative Phenotype.Clin Cancer Res. 2008;14:1368.
20. Thike AA, Cheok PY, Jara-Lazaro AR, Tan B, Tan P, Tan PH. Triple-negative breast cancer: clinicopathological characteristics and relationship with basal-like breast cancer; Modern Pathology . 2010; 23:123–133.
21. Pillai SK, Tay A, Nair S, Leong CE .Triple-negative breast cancer is associated with EGFR, CK5/6 and c-KIT expression. BMC Clinical Pathology. 2012;12:18.
22. Rao C, Shetty J, Prasad KH. Immunohistochemical profile and morphology in triple - negative breast cancers. J Clin Diagn Res.2013 Jul;7(7):1361-5.
23. Lakshmaiah KC, Das U, Suresh TM, Lokanatha D, Babu GK, Jacob LA et al. A Study of Triple Negative Breast Cancer at a Tertiary Cancer Care Center in Southern India.Ann Med Health Sci Res. 2014 Nov-Dec; 4(6):933–937
24. Suresh P, Batra U, and Doval DC .Epidemiological and clinical profile of triple negative breast cancer at a cancer hospital in North India. Indian J Med Paediatr Oncol. 2013;34(2):89–95.
25. Yuan N, Meng M, Liu C. Clinical characteristics and prognostic analysis of triple-negative breast cancer patients. Mol Clin Oncol. 2014 Ma;2(2):245–251.
26. Gaopande VL, Joshi SS, Kulkarni MM, Dwivedi SS. A clinicopathologic study of triple negative breast cancer .J Sci Soc.: 2015 ;42(1):12-15
27. Qiu J, Xue X, Hu C. Comparison of Clinicopathological Features and Prognosis in Triple-Negative and Non-Triple Negative Breast Cancer. J Cancer. 2016;7(2):167-173
28. Li CY, Zhang S, Zhang XB, Zhang J. Clinicopathological and Prognostic Characteristics of Triple-Negative Breast Cancer (TNBC) in Chinese patients: A Retrospective study. APJCP. 2013;14(6): 3779-84.
29. Nabi MG, Ahangar A, Wahid MA, Kuchay S . Clinicopathological comparison of triple negative breast cancers with non-triple negative breast cancers in a hospital in North India. Niger J Clin Pract.2015; 18(3):381-6.
30. Albergaria A, Ricardo S,Milanezi F, Carneiro V,Amendoeira I, Vieira D et al. Nottingham Prognostic Index in Triple-Negative Breast Cancer: a reliable prognostic tool?.BMC Cancer.2011; 11:299.
31. Tawfik O, Davis K, Kimler BF. Clinicopathological Characteristics of Triple-Negative Invasive Mammary Carcinomas in African-American versus Caucasian Women.Ann Clin Lab Sci . 2010 ; 40(4 ):315-323
32. Hashmi AA, Edhi MM, Naqvi H, Faridi N, Khurshid A , Khan. Clinicopathologic features of triple negative breast cancers: an experience from Pakistan. Diagnostic Pathology.2014;9:43.
33. Pintens S, Neven P, Drijkoningen M ,Van Belle V, Moerman P, Christiaens MR et al:Triple negative breast cancer: a study from the point of view of basal CK5/6 and HER-1: J Clin Pathol. 2009;62(7):624-8.
34. Choccalingam C, Rao L, Rao S. Clinico-Pathological Characteristics of Triple Negative and Non Triple Negative High Grade Breast Carcinomas with and Without Basal Marker (CK5/6 and EGFR) Expression at a Rural Tertiary Hospital in India. Breast Cancer (Auckl). 2012; 6: 21–29.
35. Rakha EA, Reis-Filho JS , Ellis IO. Basal-Like Breast Cancer: A Critical Review. Journal of clinical oncology. 2008; 26: 2568-2581.
36. Abulkhair O, Moghraby JS, Badri M. Clinicopathologic features and prognosis of triple-negative breast cancer in patients 40 years of age and younger in Saudi Arabia. Hematology/Oncology and Stem Cell Therapy.2012;5(2):101-6.
Published
2017-02-25
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