Tumor Desmoplastic Stroma - Its Utility as A Prognostic Marker for Breast Carcinoma
Keywords:
Breast carcinoma, Tumor desmoplasia, Prognosis, Immunohistochemistry
Abstract
Background Breast cancer is the second most common malignancy in women, affecting more than 1 million worldwide annually and is the most frequent cause of cancer related deaths in women. Dynamic interactions between neoplastic epithelial cells and the surrounding stroma can select stromal cells that modulate tumor behavior. The interplay between a tumor and its environment is exemplified by the morphological changes observed in the stroma of human breast cancer. Hence in this study we tried to evaluate a grading system for tumor desmoplasia and its role as a prognostic marker for breast cancer. Methods This is a retrospective study including 102 primary invasive breast malignancy diagnosed at a tertiary care hospital between January 2015 to September 2017. The cases with prior chemotherapy and radiotherapy were excluded. In all the cases hematoxylin & eosin stained slides were retrieved and assessed for desmoplastic stromal categorization, tumor grade and axillary lymph nodal involvement. The status of immunohistochemistry for ER, PR &, Her2 neu were tabulated. The association of desmoplastic stroma was evaluated with other known prognostic factors. p value calculated, p < 0.05 considered significant. Results: There was statistically significant association of the type of desmoplastic stroma with the tumor grade, tumor size and metastatic axillary lymphnode. Conclusion: This emphasizes the role of stromal desmoplasia in tumor progression and prognosis. Hence we conclude that a special mention to be made on the type of desmoplasia in the histopathology report of all breast cancer.References
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3. Shekhar MP, Werdell J, Santner SJ, Pauley RJ, Tait L. Breast stroma plays a dominant regulatory role in breast epithelial growth and differentiation: implications for tumor development and progression. Cancer Res 2001;61:1320-6.
4. Bissell MJ, Barcellos-Hoff MH. Theinfluence of extracellular matrix on gene expression: is structure the message? J Cell Sci Suppl 1987;8:327-43.
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6. Mario Wernicke, Laura Cecilia Piñeiro, Daniela Caramutti, Vanesa G. Dorn, Maria Marta Lopez Raffo, Hector G. Guixa, Margarita Telenta, Ana Alcestes Morandi, Breast Cancer Stromal Myxoid Changes Are Associated with Tumor Invasion and Metastasis: A Central Role for Hyaluronan. The United States and Canadian Academy of Pathology, Inc. 2003:16:99
7. Ueno H, JonesAM,Wilkinson KH.Histological categorisation of fibrotic cancer stroma in advanced rectal cancer.Gut. 2004;53:581–586.
8. ME Maragoudakis et al. Basement Membrane Biosynthesis as a Target for Developing Inhibitors of Angiogenesis With Anti-Tumor Properties .Kidney Int.1993; 43 (1): 147-150.
9. Fang M, Yuan J, Peng C. Collagen as a double-edged sword in tumor progression. Tumor Biol. 2014; 35:2871–2882.
10. Mariam Shadan, Nazoora Khan, Mohammad Amanullah Khan2, Hena Ansari, Sufian Zaheer. Histological categorization of stromal desmoplasia in breast cancer and its diagnostic and prognostic utility SSRG International Journal of Medical Science (SSRG-IJMS) – Vol 4 Issue 6 – June 2017
11. Wyckoff JB, Wang Y, Lin EY. Direct visualization of macrophage-assisted tumor cell intravasation in mammary tumors. Cancer Res. 2007;67:2649–56.
12. Wernicke M, Piñeiro LC, Caramutti D. Breast cancer stromal myxoid changes are associated with tumor invasion and metastasis: A central role for Hyaluronan. Mod Pathol. 2003;16(2):99–107.
13. Liotta LA, Rao CN, Barsky SH. Tumor invasion and the extracellular matrix. Lab Invest. 1983;49:636–49.
14. W E Mesker, T J A Dekker, E M de Kruijf, C C Engels, G W van Pelt, V T H B M Smit and R A E M Tollenaar The prognostic significance of tumour-stroma ratio in oestrogen receptor-positive breast cancer. British Journal of Cancer (2015) 112, 1832–1833 | doi: 10.1038/bjc.2014.570
Published
2019-10-25
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