CLINICAL AND MORPHOLOGICAL FEATURES OF LUMINAL A SUBTYPE OF INVASIVE DUCTAL BREAST CANCER
Keywords:
clinical features, morphological structure, luminal A breast cancer, disease progression
Abstract
The aim of this article was to study clinical and morphological features of luminal A subtype of breast cancer to assess its relationship with disease progression. Methods: This study included 79 patients with luminal A subtype of breast cancer who treatment in 2017 at the Lviv State Oncological Regional Treatment and Diagnostic Center. The Luminal A subtype was identified by immunohistochemistry (IHC) as ER+, PR+/-, HER2- and Ki-67 less than 20 percent on surgically resected breast cancer tissue. Results: The mean age of patients was 60,41±12,25 (range, 32–85 years), 26 (32,9%) were under 55 years. Nottingham Histologic Grade distribution was as follows: G1 – 10 (12,66%), G2 – 56 (70,88%), and G3 – 13 (16,46%) cases. Clinical stage II – 35 (44,3%) and III – 31 (39,24%) was observed. Menopausal status was in 67,1% of cases. Morphological analysis of the tumor tissue showed that except alveolar structures, there were trabecular, solid, tubular structures and separately located groups of tumor cells. The stromal component of the tumor was weak or moderate, most tumors showed minimal or marked inflammatory infiltration and low proliferative activity. Conclusions: To predict the probability of lymphogenic metastasis should be considered: menstrual function, histologic grade, the presence of alveolar structures in the infiltrative component, the different types of structures in the infiltrative component, hyalinosis in the stroma of the tumor node and inflammatory infiltration of tumor.
References
1. Albert, J.M., Gonzalez-Angulo, A.M., Guray, M, et al. (2010). Estrogen/Progesterone Receptor negativity and HER2 positivity predict locoregional recurrence in patients with T1a, b N0 breast cancer. Int J Radiat Oncol.,77(5), 1296–02. DOI: 10.1016/j.ijrobp.2009.12.011
2. Allred, D.C. (2010). Issues and updates: evaluating estrogen receptor-α, progesterone receptor, and HER2 in breast cancer. Modern Pathology, 23, S52–S59. DOI https://doi.org/10.1038/modpathol.2010.55
3. Arvold, N.D., Taghian, A.G., Niemierko, A. et al. (2011). Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy. J Clin Oncol, 29(29), 3885–91. DOI: 10.1200/JCO.2011.36.1105
4. Bulletin of National Cancer Registry of Ukraine (English). (2020). Cancer in Ukraine, 2018-2019. Ukrainian cancer registry statistics, Vol.21 “Cancer in Ukraine”,2018-2019
5. Cheang, M.C.U., Chia, S.K., Voduc D. et al. (2009). Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst, 101, 736-50. DOI: 10.1093/jnci/djp082
6. Edge, Stephen B, Compton, Carolyn C. (2010). The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 17(6), 1471-4. doi: 10.1245/s10434-010-0985-4
7. Elston, C.W., Ellis, I.O. (1991). Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology, 19(5), 403-10. DOI: 10.1111/j.1365-2559. 1991.tb00229.x
8. Gabos, Z., Thoms, J., Ghosh, S., et al. (2010). The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer. Breast Cancer Res Treat, 124(1):187–94. DOI: 10.1007/s10549-010-1135-1
9. García Fernández, A., Chabrera, C., García Font, M., et al. (2014). Mortality and recurrence patterns of breast cancer patients diagnosed under a screening programme versus comparable non-screened breast cancer patients from the same population: analytical survey from 2002 to 2012. Tumor Biol, 35(3):1945–53. DOI: 10.1007/s13277-013-1260-7
10. Goldhirsch, A., Wood, W.C., Coates, A.S., Gelber, R.D., Thürlimann, B., Senn, H.J. et al. (2011). Strategies for subtypes – dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol, 22(8), 1736-47. DOI: 10.1093/annonc/mdr304
11. Guarneri, V., Conte, P.F. (2009). Metastatic breast cancer: therapeutic options according to molecular subtypes and prior adjuvant therapy. Oncologist, 14, 645-56. DOI: 10.1634/theoncologist.2009-0078
12. Haffty, B.G. (2002). Molecular and genetic markers in the local-regional management of breast cancer. Semin Radiat Oncol, 12(4), 329–40. https://doi.org/10.1053/srao.2002.35252
13. Hammond, M.E., Hayes, D.F., Dowsett, M., Allred, D.C. et al. (2010). American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone Receptors in Breast Cancer. Arch Pathol Lab Med, 134(6), 907-22. DOI: 10.1043/1543-2165-134.7. e48
14. Harbeck, N., Thomssen, C., and Gnant, M. (2013). St. Gallen 2013: Brief Preliminary Summary of the Consensus Discussion. Breast Care (Basel); 8(2), 102–09. doi: 10.1159/000351193
15. Jatoi, I., Anderson. WF., Jeong, J-H., Redmond, CK. (2011). Breast Cancer Adjuvant Therapy: Time to Consider Its Time-Dependent Effects. J Clin Oncol, 29(17), 2301–2304. DOI: 10.1200/JCO.2010.32.3550
16. Lakhani, S.R., Ellis, I.O., Schnitt, S.J. et al. (2012). World Health Organisation Classification of Tumors. WHO Classification of tumors of the breast. Lyon: IARC Press 2012. https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Tumours-Of-The-Breast-2012#
17. Metzger-Filho, O., Sun, Z., Viale, G. et al. (2013). Patterns of recurrence and outcome according to breast cancer subtypes in lymph node-negative disease: Results from international breast cancer study group trials VIII and IX. J Clin Oncol., 31(25), 3083–90. DOI: 10.1200/JCO.2012.46.1574
18. Millar, E.K.A., Graham, P.H., O’Toole, S.A. et al. (2009). Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol., 27(28), 4701–08. DOI: 10.1200/JCO.2008.21.7075
19. Nguyen, P.L., Taghian, A.G., Katz, M.S. et al. (2008). Breast Cancer Subtype Approximated by Estrogen Receptor, Progesterone Receptor, and HER-2 Is Associated with Local and Distant Recurrence After Breast-Conserving Therapy. J Clin Oncol., 26(14), 2373-78. DOI: 10.1200/JCO.2007.14.4287
20. Onitilo, A.A., Engel, J.M., Greenlee, R.T., Mukesh, B.N. (2009). Breast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res., 7(1-2), 4-13. DOI: 10.3121/cmr.2009.825
21. Parker, J.S., Mullins, M., Cheang, M.C. et al. (2009). Supervised risk predictor of breast cancer based on intrinsic subtypes. J Clin Oncol., 27, 1160-7. DOI: 10.1200/JCO.2008.18.1370
22. Perou, C.M., Sørlie, T., Eisen, M.B., van de Rijn, M. et al. (2000). Molecular portraits of human breast tumours. Nature, 406, 747-52. DOI: 10.1038/35021093
23. Puay Hoon Tan, Ian Ellis, Kimberly Allison. (2020). The 2019 World Health Organization classification of tumours of the breast. Histopathology, 77(2), 181-5. DOI: 10.1111/his.14091
24. Raica, M., Jung, I., Cimpean, A.M., Suciu, C., Muresan, A.C. (2009). From conventional pathologic diagnosis to the molecular classification of breast carcinoma: are we ready for the change? Rom J Morphol Embryol., 50(1), 5-13. https://rjme.ro/RJME/resources/files/500109005013.pdf
25. Sanpaolo, P., Barbieri, V., Genovesi, D. (2011). Prognostic value of breast cancer subtypes on breast cancer specific survival, distant metastases and local relapse rates in conservatively managed early-stage breast cancer: A retrospective clinical study. Eur J Surg Oncol., 37(10), 876-82. DOI: 10.1016/j.ejso.2011.07.001
26. Strehl, J.D., Wachter, D.L., Fasching, P.A., Beckmann, M.W., Hartmann A. (2011). Invasive breast cancer: recognition of molecular subtypes. Breast Care, 6, 258-64. DOI: 10.1159/000331339
27. Tavassoli, F.A., Devilee, P. (2003). World Health Organization: Tumours of the breast and female genital organs (IARC WHO Classification of Tumours): IARC Press, Lyon, France. DOI https://doi.org/10.1186/bcr788
28. Tsoutsou, P.G., Vozenin, M-C., Durham, A-D, Bourhis, J. (2017). How could breast cancer molecular features contribute to locoregional treatment decision making? Crit Rev Oncol Hematol., 110, 43–48. DOI: 10.1016/j.critrevonc.2016.12.006
29. van der Leij, F., Elkhuizen, P.H.M., Bartelink, H., van de Vijver, M.J. (2012). Predictive Factors for Local Recurrence in Breast Cancer. Semin Radiat Oncol., 22(2), 100–107. DOI: 10.1016/j.semradonc.2011.12.001
30. Voduc, K.D., Cheang, M.C.U., Tyldesley, S., Gelmon, K., Nielsen, T.O., Kennecke, H. (2010). Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol., 28(10), 1684–1691. DOI: 10.1200/JCO.2009.24.9284
31. WHO Classification of Tumors Editorial Board, ed. WHO classification of tumors, 5th edition – Breast tumors. Lyon: International Agency for Research on Cancer 2019 DOI: 10.1111/his.14091 WHO, 2021 Breast cancer now most common form of cancer: WHO taking action https://www.who.int/news/item/03-02-2021-breast-cancer-now-most-common-form-of-cancer-who-taking-action Yanagawa, M., Ikemot, K., Kawauchi, S. et al. (2012). Luminal A and luminal B (HER2 negative) subtypes of breast cancer consist of a mixture of tumors with different genotype. BMC Res Notes, 5, 376. https://doi.org/10.1186/1756-0500-5-376
32. Zaha, D.C., Lazăr, E., Lăzureanu, C. (2010). Clinicopathologic features and five years survival analysis in molecular subtypes of breast cancer. Rom J Morphol Embryol, 51(1), 85-9. PMID: 20191125. https://pubmed.ncbi.nlm.nih.gov/20191125
2. Allred, D.C. (2010). Issues and updates: evaluating estrogen receptor-α, progesterone receptor, and HER2 in breast cancer. Modern Pathology, 23, S52–S59. DOI https://doi.org/10.1038/modpathol.2010.55
3. Arvold, N.D., Taghian, A.G., Niemierko, A. et al. (2011). Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy. J Clin Oncol, 29(29), 3885–91. DOI: 10.1200/JCO.2011.36.1105
4. Bulletin of National Cancer Registry of Ukraine (English). (2020). Cancer in Ukraine, 2018-2019. Ukrainian cancer registry statistics, Vol.21 “Cancer in Ukraine”,2018-2019
5. Cheang, M.C.U., Chia, S.K., Voduc D. et al. (2009). Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst, 101, 736-50. DOI: 10.1093/jnci/djp082
6. Edge, Stephen B, Compton, Carolyn C. (2010). The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 17(6), 1471-4. doi: 10.1245/s10434-010-0985-4
7. Elston, C.W., Ellis, I.O. (1991). Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology, 19(5), 403-10. DOI: 10.1111/j.1365-2559. 1991.tb00229.x
8. Gabos, Z., Thoms, J., Ghosh, S., et al. (2010). The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer. Breast Cancer Res Treat, 124(1):187–94. DOI: 10.1007/s10549-010-1135-1
9. García Fernández, A., Chabrera, C., García Font, M., et al. (2014). Mortality and recurrence patterns of breast cancer patients diagnosed under a screening programme versus comparable non-screened breast cancer patients from the same population: analytical survey from 2002 to 2012. Tumor Biol, 35(3):1945–53. DOI: 10.1007/s13277-013-1260-7
10. Goldhirsch, A., Wood, W.C., Coates, A.S., Gelber, R.D., Thürlimann, B., Senn, H.J. et al. (2011). Strategies for subtypes – dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol, 22(8), 1736-47. DOI: 10.1093/annonc/mdr304
11. Guarneri, V., Conte, P.F. (2009). Metastatic breast cancer: therapeutic options according to molecular subtypes and prior adjuvant therapy. Oncologist, 14, 645-56. DOI: 10.1634/theoncologist.2009-0078
12. Haffty, B.G. (2002). Molecular and genetic markers in the local-regional management of breast cancer. Semin Radiat Oncol, 12(4), 329–40. https://doi.org/10.1053/srao.2002.35252
13. Hammond, M.E., Hayes, D.F., Dowsett, M., Allred, D.C. et al. (2010). American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone Receptors in Breast Cancer. Arch Pathol Lab Med, 134(6), 907-22. DOI: 10.1043/1543-2165-134.7. e48
14. Harbeck, N., Thomssen, C., and Gnant, M. (2013). St. Gallen 2013: Brief Preliminary Summary of the Consensus Discussion. Breast Care (Basel); 8(2), 102–09. doi: 10.1159/000351193
15. Jatoi, I., Anderson. WF., Jeong, J-H., Redmond, CK. (2011). Breast Cancer Adjuvant Therapy: Time to Consider Its Time-Dependent Effects. J Clin Oncol, 29(17), 2301–2304. DOI: 10.1200/JCO.2010.32.3550
16. Lakhani, S.R., Ellis, I.O., Schnitt, S.J. et al. (2012). World Health Organisation Classification of Tumors. WHO Classification of tumors of the breast. Lyon: IARC Press 2012. https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Tumours-Of-The-Breast-2012#
17. Metzger-Filho, O., Sun, Z., Viale, G. et al. (2013). Patterns of recurrence and outcome according to breast cancer subtypes in lymph node-negative disease: Results from international breast cancer study group trials VIII and IX. J Clin Oncol., 31(25), 3083–90. DOI: 10.1200/JCO.2012.46.1574
18. Millar, E.K.A., Graham, P.H., O’Toole, S.A. et al. (2009). Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol., 27(28), 4701–08. DOI: 10.1200/JCO.2008.21.7075
19. Nguyen, P.L., Taghian, A.G., Katz, M.S. et al. (2008). Breast Cancer Subtype Approximated by Estrogen Receptor, Progesterone Receptor, and HER-2 Is Associated with Local and Distant Recurrence After Breast-Conserving Therapy. J Clin Oncol., 26(14), 2373-78. DOI: 10.1200/JCO.2007.14.4287
20. Onitilo, A.A., Engel, J.M., Greenlee, R.T., Mukesh, B.N. (2009). Breast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res., 7(1-2), 4-13. DOI: 10.3121/cmr.2009.825
21. Parker, J.S., Mullins, M., Cheang, M.C. et al. (2009). Supervised risk predictor of breast cancer based on intrinsic subtypes. J Clin Oncol., 27, 1160-7. DOI: 10.1200/JCO.2008.18.1370
22. Perou, C.M., Sørlie, T., Eisen, M.B., van de Rijn, M. et al. (2000). Molecular portraits of human breast tumours. Nature, 406, 747-52. DOI: 10.1038/35021093
23. Puay Hoon Tan, Ian Ellis, Kimberly Allison. (2020). The 2019 World Health Organization classification of tumours of the breast. Histopathology, 77(2), 181-5. DOI: 10.1111/his.14091
24. Raica, M., Jung, I., Cimpean, A.M., Suciu, C., Muresan, A.C. (2009). From conventional pathologic diagnosis to the molecular classification of breast carcinoma: are we ready for the change? Rom J Morphol Embryol., 50(1), 5-13. https://rjme.ro/RJME/resources/files/500109005013.pdf
25. Sanpaolo, P., Barbieri, V., Genovesi, D. (2011). Prognostic value of breast cancer subtypes on breast cancer specific survival, distant metastases and local relapse rates in conservatively managed early-stage breast cancer: A retrospective clinical study. Eur J Surg Oncol., 37(10), 876-82. DOI: 10.1016/j.ejso.2011.07.001
26. Strehl, J.D., Wachter, D.L., Fasching, P.A., Beckmann, M.W., Hartmann A. (2011). Invasive breast cancer: recognition of molecular subtypes. Breast Care, 6, 258-64. DOI: 10.1159/000331339
27. Tavassoli, F.A., Devilee, P. (2003). World Health Organization: Tumours of the breast and female genital organs (IARC WHO Classification of Tumours): IARC Press, Lyon, France. DOI https://doi.org/10.1186/bcr788
28. Tsoutsou, P.G., Vozenin, M-C., Durham, A-D, Bourhis, J. (2017). How could breast cancer molecular features contribute to locoregional treatment decision making? Crit Rev Oncol Hematol., 110, 43–48. DOI: 10.1016/j.critrevonc.2016.12.006
29. van der Leij, F., Elkhuizen, P.H.M., Bartelink, H., van de Vijver, M.J. (2012). Predictive Factors for Local Recurrence in Breast Cancer. Semin Radiat Oncol., 22(2), 100–107. DOI: 10.1016/j.semradonc.2011.12.001
30. Voduc, K.D., Cheang, M.C.U., Tyldesley, S., Gelmon, K., Nielsen, T.O., Kennecke, H. (2010). Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol., 28(10), 1684–1691. DOI: 10.1200/JCO.2009.24.9284
31. WHO Classification of Tumors Editorial Board, ed. WHO classification of tumors, 5th edition – Breast tumors. Lyon: International Agency for Research on Cancer 2019 DOI: 10.1111/his.14091 WHO, 2021 Breast cancer now most common form of cancer: WHO taking action https://www.who.int/news/item/03-02-2021-breast-cancer-now-most-common-form-of-cancer-who-taking-action Yanagawa, M., Ikemot, K., Kawauchi, S. et al. (2012). Luminal A and luminal B (HER2 negative) subtypes of breast cancer consist of a mixture of tumors with different genotype. BMC Res Notes, 5, 376. https://doi.org/10.1186/1756-0500-5-376
32. Zaha, D.C., Lazăr, E., Lăzureanu, C. (2010). Clinicopathologic features and five years survival analysis in molecular subtypes of breast cancer. Rom J Morphol Embryol, 51(1), 85-9. PMID: 20191125. https://pubmed.ncbi.nlm.nih.gov/20191125
Abstract views: 203 PDF Downloads: 161
Published
2021-06-18
How to Cite
Volos, L., & Dudash, A. (2021). CLINICAL AND MORPHOLOGICAL FEATURES OF LUMINAL A SUBTYPE OF INVASIVE DUCTAL BREAST CANCER. Scientific Journal of Polonia University, 43(6), 293-306. https://doi.org/10.23856/4338
Section
HEALTH, ENVIRONMENT, DEVELOPMENT
