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Original Article
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International Academy of Cytology standardized reporting of breast fine-needle aspiration cytology with cyto-histopathological correlation of breast carcinoma
Shweta Pai
J Pathol Transl Med. 2024;58(5):241-248.   Published online September 13, 2024
DOI: https://doi.org/10.4132/jptm.2024.07.14
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  • 407 Download
AbstractAbstract PDF
Background
The International Academy of Cytology (IAC) has developed a standardized approach for reporting the findings of breast fine-needle aspiration cytology (FNAC). Accordingly, there are five chief categories of breast lesions, C1 (insufficient material), C2 (benign), C3 (atypical), C4 (suspicious), and C5 (malignant). The prognostication and management of breast carcinoma can be performed readily on the basis of this classification system. The aim of this study was to classify various breast lesions into one of the above-named categories and to further grade the C5 lesions specifically using the Robinson system. The latter grades were then correlated with modified Scarff-Bloom-Richardson (SBR) grades.
Methods
This retrospective study was undertaken in the pathology department of a hospital located in the urban part of the city of Bangalore. All FNAC procedures performed on breast lumps spanning the year 2020 were included in the study.
Results
A total of 205 breast lesions was classified according to the IAC guidelines into C1 (6 cases, 2.9%), C2 (151 cases, 73.7%), C3 (13 cases, 6.3%), C4 (5 cases, 2.5%), and C5 (30 cases, 14.6%) groups. The C5 cases were further graded using Robinson’s system. The latter showed a significant correlation with the SBR system (concordance=83.3%, Spearman correlation=0.746, Kendall’s tau-b=0.736, kappa=0.661, standard error=0.095, p≤.001).
Conclusions
A standardized approach for FNAC reporting of breast lesions, as advocated for by the IAC, improves the quality and clarity of the reports and assures diagnostic reproducibility on a global scale. Further, the cytological grading of C5 lesions provides reliable cyto-prognostic scores that can help assess a tumor’s aggressiveness and predict its histological grade.
Case Study
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Metastatic choroidal melanoma in the breast: a case report and review of the literature
Loay Abudalu, Vinisha Malhotra, Nabila Nasir, Sami Titi
J Pathol Transl Med. 2023;57(4):238-241.   Published online July 11, 2023
DOI: https://doi.org/10.4132/jptm.2023.06.07
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  • 128 Download
AbstractAbstract PDF
The breast is an unusual site for metastases, accounting for less than 2% of malignant breast lesions but include those from malignant melanomas, carcinomas, sarcomas, and lymphomas from various organs. We diagnosed a very rare case of metastatic choroidal melanoma for a 67-year-old female who presented with a right breast lump and who had been previously diagnosed with choroidal melanoma-monosomy 3 in 2017. To the best of our knowledge, only five such cases have been published so far, with one in a male patient.
Original Articles
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Fatty acid synthetase expression in triple-negative breast cancer
Jin Hee Park, Hye Seung Han, So Dug Lim, Wook Youn Kim, Kyoung Sik Park, Young Bum Yoo, Seung Eun Lee, Wan-Seop Kim
J Pathol Transl Med. 2022;56(2):73-80.   Published online January 21, 2022
DOI: https://doi.org/10.4132/jptm.2021.10.27
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  • 204 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Background
Triple-negative breast cancer (TNBC) has a relatively poor prognosis. Research has identified potential metabolic targets, including fatty acid metabolism, in TNBC. The absence of effective target therapies for TNBC led to exploration of the role of fatty acid synthetase (FASN) as a potential target for TNBC therapy. Here, we analyzed the expression of FASN, a representative lipid metabolism–related protein, and investigated the association between FASN expression and Ki-67 and the programmed death ligand 1 (PD-L1) biomarkers in TNBC.
Methods
Immunohistochemical expression of FASN was analyzed in 166 patients with TNBC. For analytical purposes, patients with 0–1+ FASN staining were grouped as low-grade FASN and patients with 2–3+ FASN staining as high-grade FASN.
Results
FASN expression was observed in 47.1% of TNBC patients. Low and high expression of FASN was identified in 75.9% and 24.1%, respectively, and no statistically significant difference was found in T category, N category, American Joint Committee on Cancer stage, or recurrence rate between the low and high-FASN expression groups. Ki-67 proliferation level was significantly different between the low and high-FASN expression groups. FASN expression was significantly related to Ki-67 as the level increased. There was no significant difference in PD-L1 positivity between the low- and high-FASN expression groups.
Conclusions
We identified FASN expression in 166 TNBC patients. The Ki-67 proliferation index was positively correlated with FASN level, indicating higher proliferation activity as FASN increases. However, there was no statistical association with PD-L1 SP142, the currently FDA-approved assay, or FASN expression level.

Citations

Citations to this article as recorded by  
  • Lipid metabolism involved in progression and drug resistance of breast cancer
    Wenxiang Fu, Aijun Sun, Huijuan Dai
    Genes & Diseases.2025; 12(4): 101376.     CrossRef
  • Unveiling the impact of lipid metabolism on triple-negative breast cancer growth and treatment options
    Xin-xian Cai, Zhe-zhong Zhang, Xiao-xiao Yang, Wen-rui Shen, Liu-wei Yuan, Xi Ding, Ying Yu, Wen-yu Cai
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Protein biomarkers for diagnosis of breast cancer
    Emeka Eze Joshua Iweala, Doris Nnenna Amuji, Faith Chinasaokwu Nnaji
    Scientific African.2024; 25: e02308.     CrossRef
  • Microarray analysis points to LMNB1 and JUN as potential target genes for predicting metastasis promotion by etoposide in colorectal cancer
    Jiafei Liu, Hongjie Yang, Peng Li, Yuanda Zhou, Zhichun Zhang, Qingsheng Zeng, Xipeng Zhang, Yi Sun
    Scientific Reports.2024;[Epub]     CrossRef
  • The signature of extracellular vesicles in hypoxic breast cancer and their therapeutic engineering
    Baiheng Zhu, Kehao Xiang, Tanghua Li, Xin Li, Fujun Shi
    Cell Communication and Signaling.2024;[Epub]     CrossRef
  • NFYA promotes malignant behavior of triple-negative breast cancer in mice through the regulation of lipid metabolism
    Nobuhiro Okada, Chihiro Ueki, Masahiro Shimazaki, Goki Tsujimoto, Susumu Kohno, Hayato Muranaka, Kiyotsugu Yoshikawa, Chiaki Takahashi
    Communications Biology.2023;[Epub]     CrossRef
  • Role of EGFR and FASN in breast cancer progression
    Suchi Chaturvedi, Mainak Biswas, Sushabhan Sadhukhan, Avinash Sonawane
    Journal of Cell Communication and Signaling.2023; 17(4): 1249.     CrossRef
  • Bioinformatics Method Was Used to Analyze the Highly Expressed Gene FAM83A of Breast Cancer in Young Women
    Yongzhe Tang, Hao Wang, Qi He, Yuanyuan Chen, Jie Wang, Fahd Abd Algalil
    Applied Bionics and Biomechanics.2022; 2022: 1.     CrossRef
  • NCAPH promotes proliferation as well as motility of breast cancer cells by activating the PI3K/AKT pathway
    Ting Zhang, Peng Li, Wanying Guo, Qipeng Liu, Weiqiang Qiao, Miao Deng
    Physiology International.2022;[Epub]     CrossRef
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Potential of AKT2 expression as a predictor of lymph-node metastasis in invasive breast carcinoma of no special type
Primariadewi Rustamadji, Elvan Wiyarta, Kristina Anna Bethania, Kusmardi Kusmardi
J Pathol Transl Med. 2021;55(4):271-278.   Published online June 14, 2021
DOI: https://doi.org/10.4132/jptm.2021.04.26
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  • 3 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Background
Invasive breast carcinoma of no special type (IBC-NST) is the most common type of breast cancer and mainly causes regional lymph-node metastasis (LNM). We investigated the potential for AKT2 expression as a predictive biomarker for LNM in IBC-NST.
Methods
Forty-eight paraffin blocks containing IBC-NST primary tumors were divided into two groups based on presence or absence of LNM. Age, tumor grade, tumor size, lymphovascular invasion (LVI), and AKT expression were assessed. AKT2 expression was assessed based on immunohistochemical staining, while other data were collected from archives.
Results
Multiple logistic regression results showed that AKT2 expression and LVI were significantly associated with LNM (odds ratio [OR], 5.32; 95% confidence interval [CI], 1.42 to 19.93 and OR, 4.46; 95% CI, 1.17 to 16.97, respectively). AKT2 expression was able to discriminate against LNM (area under the receiver operating characteristic, 0.799 ± 0.063; 95% CI, 0.676 to 0.921) at an H-score cutoff of 104.62 (83.3% sensitivity, 62.5% specificity).
Conclusions
AKT2 expression has potential as a predictor of LNM in IBC-NST. The H-score cutoff for AKT2 expression can be used as a classification guide in future studies.

Citations

Citations to this article as recorded by  
  • Association of Src with Nottingham Prognostic Index in Breast Cancer: Implications for Breast Cancer Prognostication
    Primariadewi Rustamadji, Elvan Wiyarta
    Journal of Nature and Science of Medicine.2024; 7(2): 90.     CrossRef
  • CD4+ Tumor-infiltrating Lymphocytes in Neoadjuvant Chemotherapy-treated Invasive Breast Cancer of No Special Type
    Primariadewi Rustamadji, Elvan Wiyarta, Meike Pramono, Sinta Chaira Maulanisa
    Journal of Nature and Science of Medicine.2024; 7(3): 179.     CrossRef
  • Potential of AKNA as a Predictive Biomarker for Ovarian Cancer and Its Relationship to Tumor Grading
    P Rustamadji, E Wiyarta, M Miftahuzzakiyah, D Sukmawati, DA Suryandari, R Kodariah
    Nigerian Journal of Clinical Practice.2024; 27(9): 1089.     CrossRef
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    Primariadewi Rustamadji, Elvan Wiyarta, Ineke Anggreani
    Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 1440.     CrossRef
  • Effect of Omega-3-Rich Fish Oil on TNF-  Expression in Mice's Colonic Tissue Induced with Azoxymethane (AOM) and Dextran Sodium Sulphate (DSS)
    Elvan Wiyarta, Kusmardi Kusmardi, Yurnadi Hanafi Midoen
    Research Journal of Pharmacy and Technology.2022; : 3179.     CrossRef
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    Kusmardi Kusmardi, Elvan Wiyarta, Numlil Khaira Rusdi, Andi Muh. Maulana, Ari Estuningtyas, Hadi Sunaryo
    F1000Research.2021; 10: 902.     CrossRef
  • CD44 Variant Exon 6 Isoform Expression as a Potential Predictor of Lymph Node Metastasis in Invasive Breast Carcinoma of No Special Type
    Primariadewi Rustamadji, Elvan Wiyarta, Kristina A. Bethania, Rakesh Sathish Nair
    International Journal of Breast Cancer.2021; 2021: 1.     CrossRef
  • Correlation between CD 34 and CD 68 expression in placental malaria with maternal anemia
    Primariadewi Rustamadji, Muhammad Takbir, Puspita Eka Wuyung, Kusmardi Kusmardi, Elvan Wiyarta
    Tropical Parasitology.2021; 11(2): 92.     CrossRef
Reviews
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Standardized pathology report for breast cancer
Soo Youn Cho, So Yeon Park, Young Kyung Bae, Jee Yeon Kim, Eun Kyung Kim, Woo Gyeong Kim, Youngmee Kwon, Ahwon Lee, Hee Jin Lee, Ji Shin Lee, Jee Young Park, Gyungyub Gong, Hye Kyoung Yoon
J Pathol Transl Med. 2021;55(1):1-15.   Published online January 11, 2021
DOI: https://doi.org/10.4132/jptm.2020.11.20
  • 15,839 View
  • 724 Download
  • 8 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.

Citations

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  • Adenoid Cystic Carcinoma of Breast Associated With an Incidental Radial Scar: A Cyto‐Histopathology Correlation
    Rallapalli Rajyalakshmi, Valasapalli Rajani, Tanuku Sreedhar, Kollabathula Arpitha
    Diagnostic Cytopathology.2026;[Epub]     CrossRef
  • Navigating discrepancies: The assessment of residual lymphovascular invasion in breast carcinoma after neoadjuvant treatment
    Anikó Kovács, Åsa Rundgren-Sellei, Gunilla Rask, Annette Bauer, Anna Bodén, Johannes van Brakel, Eugenia Colón-Cervantes, Anna Ehinger, Johan Hartman, Balazs Acs
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    Human Pathology.2024; 145: 1.     CrossRef
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Imaging features of breast cancer molecular subtypes: state of the art
Nariya Cho
J Pathol Transl Med. 2021;55(1):16-25.   Published online November 9, 2020
DOI: https://doi.org/10.4132/jptm.2020.09.03
  • 54,797 View
  • 402 Download
  • 25 Web of Science
  • 25 Crossref
AbstractAbstract PDF
Characterization of breast cancer molecular subtypes has been the standard of care for breast cancer management. We aimed to provide a review of imaging features of breast cancer molecular subtypes for the field of precision medicine. We also provide an update on the recent progress in precision medicine for breast cancer, implications for imaging, and recent observations in longitudinal functional imaging with radiomics.

Citations

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    J.N. Akhundova
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Article image
Clinicopathological characteristics of BRCA-associated breast cancer in Asian patients
Eun-Kyu Kim, So Yeon Park, Sung-Won Kim
J Pathol Transl Med. 2020;54(4):265-275.   Published online May 14, 2020
DOI: https://doi.org/10.4132/jptm.2020.04.07
  • 11,899 View
  • 267 Download
  • 16 Web of Science
  • 14 Crossref
AbstractAbstract PDF
BRCA1/2 germline mutations account for the majority of hereditary breast cancers. Since the identification of the BRCA genes, several attempts have been made to define the clinicopathological characteristics of BRCA-associated breast cancer in comparison with sporadic breast cancer. Asians constitute 60% of the world population, and although the incidence of breast cancer in Asia remains low compared to the West, breast cancer is the most prevalent female cancer in the region. The epidemiological aspects of breast cancer are different between Asians and Caucasians. Asian patients present with breast cancer at a younger age than Western patients. The contributions of BRCA1/2 mutations to breast cancer incidence are expected to differ between Asians and Caucasians, and the different genetic backgrounds among races are likely to influence the breast cancer phenotypes. However, most large-scale studies on the clinicopathological characteristics of BRCA-associated breast cancer have been on Western patients, while studies on Asian populations were small and sporadic. In this review, we provide an overview of the clinical and pathological characteristics of BRCA-associated breast cancer, incorporating findings on Asian patients.

Citations

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    International Journal of General Medicine.2021; Volume 14: 7371.     CrossRef
Original Articles
Article image
Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho
J Pathol Transl Med. 2020;54(1):95-102.   Published online November 13, 2019
DOI: https://doi.org/10.4132/jptm.2019.10.24
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AbstractAbstract PDF
Background
Pure mucinous carcinoma (PMC) is a rare type of breast cancer, estimated to represent 2% of invasive breast cancer. PMC is typically positive for estrogen receptors (ER) and progesterone receptors (PR) and negative for human epidermal growth factor receptor 2 (HER2). The clinicopathologic characteristics of HER2-positive PMC have not been investigated.
Methods
Pathology archives were searched for PMC diagnosed from January 1999 to April 2018. Clinicopathologic data and microscopic findings were reviewed and compared between HER2-positive PMC and HER2-negative PMC. We also analyzed the differences in disease-free survival (DFS) and overall survival according to clinicopathologic parameters including HER2 status in overall PMC cases.
Results
There were 21 HER2-positive cases (4.8%) in 438 PMCs. The average tumor size of HER2-positive PMC was 32.21 mm (± 26.55). Lymph node metastasis was present in seven cases. Compared to HER2-negative PMC, HER2-positive PMC presented with a more advanced T category (p < .001), more frequent lymph node metastasis (p = .009), and a higher nuclear and histologic grade (p < .001). Microscopically, signet ring cells were frequently observed in HER2-positive PMC (p < .001), whereas a micropapillary pattern was more frequent in HER2-negative PMC (p = .012). HER2-positive PMC was more frequently negative for ER (33.3% vs. 1.2%) and PR (28.6% vs. 7.2%) than HER2-negative PMC and showed a high Ki-67 labeling index. During follow-up, distant metastasis and recurrence developed in three HER2-positive PMC patients. Multivariate analysis revealed that only HER2-positivity and lymph node status were significantly associated with DFS.
Conclusions
Our results suggest that HER2-positive PMC is a more aggressive subgroup of PMC. HER2 positivity should be considered for adequate management of PMC.

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Article image
Analysis of the molecular subtypes of preoperative core needle biopsy and surgical specimens in invasive breast cancer
Ye Sul Jeong, Jun Kang, Jieun Lee, Tae-Kyung Yoo, Sung Hun Kim, Ahwon Lee
J Pathol Transl Med. 2020;54(1):87-94.   Published online November 13, 2019
DOI: https://doi.org/10.4132/jptm.2019.10.14
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AbstractAbstract PDF
Background
Accurate molecular classification of breast core needle biopsy (CNB) tissue is important for determining neoadjuvant systemic therapies for invasive breast cancer. The researchers aimed to evaluate the concordance rate (CR) of molecular subtypes between CNBs and surgical specimens.
Methods
This study was conducted with invasive breast cancer patients who underwent surgery after CNB at Seoul St. Mary’s Hospital between December 2014 and December 2017. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 were analyzed using immunohistochemistry. ER and PR were evaluated by Allred score (0–8). HER2 was graded from 0 to +3, and all 2+ cases were reflex tested with silver in situ hybridization. The labeling index of Ki67 was counted by either manual scoring or digital image analysis. Molecular subtypes were classified using the above surrogate markers.
Results
In total, 629 patients were evaluated. The CRs of ER, PR, HER2, and Ki67 were 96.5% (kappa, 0.883; p<.001), 93.0% (kappa, 0.824; p<.001), 99.7% (kappa, 0.988; p<.001), and 78.7% (kappa, 0.577; p<.001), respectively. Digital image analysis of Ki67 in CNB showed better concordance with Ki67 in surgical specimens (CR, 82.3%; kappa, 0.639 for digital image analysis vs. CR, 76.2%; kappa, 0.534 for manual counting). The CRs of luminal A, luminal B, HER2, and triple negative types were 89.0%, 70.0%, 82.9%, and 77.2%, respectively.
Conclusions
CNB was reasonably accurate for determining ER, PR, HER2, Ki67, and molecular subtypes. Using digital image analysis for Ki67 in CNB produced more accurate molecular classifications.

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Association between p53 Expression and Amount of Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer
Miseon Lee, In Ah Park, Sun-Hee Heo, Young-Ae Kim, Gyungyub Gong, Hee Jin Lee
J Pathol Transl Med. 2019;53(3):180-187.   Published online March 11, 2019
DOI: https://doi.org/10.4132/jptm.2019.02.08
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AbstractAbstract PDF
Background
Most triple-negative breast cancers (TNBCs) have a high histologic grade, are associated with high endoplasmic stress, and possess a high frequency of TP53 mutations. TP53 missense mutations lead to the production of mutant p53 protein and usually show high levels of p53 protein expression. Tumor-infiltrating lymphocytes (TILs) accumulate as part of the anti-tumor immune response and have a strong prognostic and predictive significance in TNBC. We aimed to elucidate the association between p53 expression and the amount of TILs in TNBC.
Methods
In 678 TNBC patients, we evaluated TIL levels and expression of endoplasmic stress molecules. Immunohistochemical examination of p53 protein expression was categorized into three groups: no, low, and high expression.
Results
No, low, and high p53 expression was identified in 44.1% (n = 299), 20.1% (n = 136), and 35.8% (n = 243) of patients, respectively. Patients with high p53 expression showed high histologic grade (p < .001), high TIL levels (p = .009), and high expression of endoplasmic reticulum stress-associated molecules (p-eIF2a, p = .013; XBP1, p = .007), compared to patients with low p53 expression. There was no significant difference in disease-free (p = .406) or overall survival rates (p = .444) among the three p53 expression groups.
Conclusions
High p53 expression is associated with increased expression of endoplasmic reticulum stress molecules and TIL influx.

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Loss of Human Leukocyte Antigen Class I Expression Is Associated with Poor Prognosis in Patients with Advanced Breast Cancer
Hong Sik Park, Uiju Cho, So Young Im, Chang Young Yoo, Ji Han Jung, Young Jin Suh, Hyun Joo Choi
J Pathol Transl Med. 2019;53(2):75-85.   Published online November 14, 2018
DOI: https://doi.org/10.4132/jptm.2018.10.11
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AbstractAbstract PDF
Background
Human leukocyte antigen class I (HLA-I) molecules play important roles in regulating immune responses. Loss or reduction of HLA-I expression has been shown to be associated with prognosis in several cancers. Regulatory T-cells (Tregs) also play critical functions in immune response regulation. Evaluation of HLA-I expression status by the EMR8-5 antibody and its clinical impact in breast cancer have not been well studied, and its relationship with Tregs remains unclear.
Methods
We evaluated HLA-I expression and Treg infiltration by immunohistochemistry in 465 surgically resected breast cancer samples. We examined the correlation between HLA-I expression and Treg infiltration and clinicopathologic characteristics and survival analyses were performed.
Results
Total loss of HLA-I expression was found in 84 breast cancer samples (18.1%). Univariate survival analysis revealed that loss of HLA-I expression was significantly associated with worse disease-specific survival (DSS) (p = .029). HLA-I was not an independent prognostic factor in the entire patient group, but it was an adverse independent prognostic factor for DSS in patients with advanced disease (stage II–IV) (p = .031). Treg numbers were significantly higher in the intratumoral stroma of HLA-I–positive tumors than in HLA-I–negative tumors (median 6.3 cells/high power field vs 2.1 cells/high power field, p < .001). However, Tregs were not an independent prognostic factor in our cohort.
Conclusions
Our findings suggest that the loss of HLA-I expression is associated with poor prognosis in breast cancer patients, highlighting the role of HLA-I alterations in immune evasion mechanisms of breast cancer. HLA-I could be a promising marker that enables the application of more effective and precise immunotherapies for patients with advanced breast cancer.

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The Prognostic Impact of Synchronous Ipsilateral Multiple Breast Cancer: Survival Outcomes according to the Eighth American Joint Committee on Cancer Staging and Molecular Subtype
Jinah Chu, Hyunsik Bae, Youjeong Seo, Soo Youn Cho, Seok-Hyung Kim, Eun Yoon Cho
J Pathol Transl Med. 2018;52(6):396-403.   Published online October 23, 2018
DOI: https://doi.org/10.4132/jptm.2018.10.03
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AbstractAbstract PDF
Background
In the current American Joint Committee on Cancer staging system of breast cancer, only tumor size determines T-category regardless of whether the tumor is single or multiple. This study evaluated if tumor multiplicity has prognostic value and can be used to subclassify breast cancer.
Methods
We included 5,758 patients with invasive breast cancer who underwent surgery at Samsung Medical Center, Seoul, Korea, from 1995 to 2012.
Results
Patients were divided into two groups according to multiplicity (single, n = 4,744; multiple, n = 1,014). Statistically significant differences in lymph node involvement and lymphatic invasion were found between the two groups (p < .001). Patients with multiple masses tended to have luminal A molecular subtype (p < .001). On Kaplan-Meier survival analysis, patients with multiple masses had significantly poorer disease-free survival (DFS) (p = .016). The prognostic significance of multiplicity was seen in patients with anatomic staging group I and prognostic staging group IA (p = .019 and p = .032, respectively). When targeting patients with T1-2 N0 M0, hormone receptor–positive, and human epidermal growth factor receptor 2 (HER2)–negative cancer, Kaplan-Meier survival analysis also revealed significantly reduced DFS with multiple cancer (p = .031). The multivariate analysis indicated that multiplicity was independently correlated with worse DFS (hazard ratio, 1.23; 95% confidence interval, 1.03 to 1.47; p = .025). The results of this study indicate that tumor multiplicity is frequently found in luminal A subtype, is associated with frequent lymph node metastasis, and is correlated with worse DFS.
Conclusions
Tumor multiplicity has prognostic value and could be used to subclassify invasive breast cancer at early stages. Adjuvant chemotherapy would be necessary for multiple masses of T1–2 N0 M0, hormone-receptor-positive, and HER2-negative cancer.

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High Cytoplasmic CXCR4 Expression Predicts Prolonged Survival in Triple-Negative Breast Cancer Patients Treated with Adjuvant Chemotherapy
Bobae Shim, Min‐Sun Jin, Ji Hye Moon, In Ae Park, Han Suk Ryu
J Pathol Transl Med. 2018;52(6):369-377.   Published online October 1, 2018
DOI: https://doi.org/10.4132/jptm.2018.09.19
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AbstractAbstract PDF
Background
Chemokine receptor CXC chemokine receptor type 4 (CXCR4) and its ligand CXC motif chemokine 12 (CXCL12; stromal cell-derived factor-1) are implicated in tumor growth, metastasis, and tumor cell-microenvironment interaction. A number of studies have reported that increased CXCR4 expression is associated with worse prognosis in triple-negative breast cancer (TNBC), but its prognostic significance has not been studied in TNBC patients treated with adjuvant chemotherapy.
Methods
Two hundred eighty-three TNBC patients who received adjuvant chemotherapy were retrospectively analyzed. Tissue microarray was constructed from formalinfixed, paraffin-embedded tumor tissue and immunohistochemistry for CXCR4 and CXCL12 was performed. Expression of each marker was compared with clinicopathologic characteristics and outcome.
Results
High cytoplasmic CXCR4 expression was associated with younger age (p = .008), higher histologic grade (p = .007) and lower pathologic stage (p = .045), while high CXCL12 expression was related to larger tumor size (p = .045), positive lymph node metastasis (p = .005), and higher pathologic stage (p = .017). The patients with high cytoplasmic CXCR4 experienced lower distant recurrence (p = .006) and better recurrence-free survival (RFS) (log-rank p = .020) after adjuvant chemotherapy. Cytoplasmic CXCR4 expression remained an independent factor of distant recurrence (p = .019) and RFS (p = .038) after multivariate analysis.
Conclusions
High cytoplasmic CXCR4 expression was associated with lower distant recurrence and better RFS in TNBC patients treated with adjuvant chemotherapy. This is the first study to correlate high CXCR4 expression to better TNBC prognosis, and the underlying mechanism needs to be elucidated in further studies.

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Detection of Human Papillomavirus in Korean Breast Cancer Patients by Real-Time Polymerase Chain Reaction and Meta-Analysis of Human Papillomavirus and Breast Cancer
Jinhyuk Choi, Chungyeul Kim, Hye Seung Lee, Yoo Jin Choi, Ha Yeon Kim, Jinhwan Lee, Hyeyoon Chang, Aeree Kim
J Pathol Transl Med. 2016;50(6):442-450.   Published online October 10, 2016
DOI: https://doi.org/10.4132/jptm.2016.07.08
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AbstractAbstract PDF
Background
Human papillomavirus (HPV) is a well-established oncogenic virus of cervical, anogenital, and oropharyngeal cancer. Various subtypes of HPV have been detected in 0% to 60% of breast cancers. The roles of HPV in the carcinogenesis of breast cancer remain controversial. This study was performed to determine the prevalence of HPV-positive breast cancer in Korean patients and to evaluate the possibility of carcinogenic effect of HPV on breast.
Methods
Meta-analysis was performed in 22 case-control studies for HPV infection in breast cancer. A total of 123 breast cancers, nine intraductal papillomas and 13 nipple tissues of patients with proven cervical HPV infection were tested by real-time polymerase chain reaction to detect 28 subtypes of HPV. Breast cancers were composed of 106 formalin-fixed and paraffin embedded (FFPE) breast cancer samples and 17 touch imprint cytology samples of breast cancers.
Results
The overall odds ratio between breast cancer and HPV infection was 5.43 (95% confidence interval, 3.24 to 9.12) with I2 = 34.5% in meta-analysis of published studies with case-control setting and it was statistically significant. HPV was detected in 22 cases of breast cancers (17.9%) and two cases of intaductal papillomas (22.2%). However, these cases had weak positivity.
Conclusions
These results failed to serve as significant evidence to support the relationship between HPV and breast cancer. Further study with larger epidemiologic population is merited to determine the relationship between HPV and breast cancer.

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Review
Pathologic Evaluation of Breast Cancer after Neoadjuvant Therapy
Cheol Keun Park, Woo-Hee Jung, Ja Seung Koo
J Pathol Transl Med. 2016;50(3):173-180.   Published online April 11, 2016
DOI: https://doi.org/10.4132/jptm.2016.02.02
  • 17,638 View
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  • 33 Web of Science
  • 34 Crossref
AbstractAbstract PDF
Breast cancer, one of the most common cancers in women, has various treatment modalities. Neoadjuvant therapy (NAT) has been used in many clinical trials because it is easy to evaluate the treatment response to therapeutic agents in a short time period; consequently, NAT is currently a standard treatment modality for large-sized and locally advanced breast cancers, and its use in early-stage breast cancer is becoming more common. Thus, chances to encounter breast tissue from patients treated with NAT is increasing. However, systems for handling and evaluating such specimens have not been established. Several evaluation systems emphasize a multidisciplinary approach to increase the accuracy of breast cancer assessment. Thus, detailed and systematic evaluation of clinical, radiologic, and pathologic findings is important. In this review, we compare the major problems of each evaluation system and discuss important points for handling and evaluating NAT-treated breast specimens.

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Original Article
Interobserver Variability of Ki-67 Measurement in Breast Cancer
Yul Ri Chung, Min Hye Jang, So Yeon Park, Gyungyub Gong, Woo-Hee Jung, The Korean Breast Pathology Ki- Study Group
J Pathol Transl Med. 2016;50(2):129-137.   Published online February 15, 2016
DOI: https://doi.org/10.4132/jptm.2015.12.24
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AbstractAbstract PDF
Background
As measurement of Ki-67 proliferation index is an important part of breast cancer diagnostics, we conducted a multicenter study to examine the degree of concordance in Ki-67 counting and to find factors that lead to its variability. Methods: Thirty observers from thirty different institutions reviewed Ki-67–stained slides of 20 different breast cancers on whole sections and tissue microarray (TMA) by online system. Ten of the 20 breast cancers had hot spots of Ki-67 expression. Each observer scored Ki-67 in two different ways: direct counting (average vs. hot spot method) and categorical estimation. Intraclass correlation coefficient (ICC) of Ki-67 index was calculated for comparative analysis. Results: For direct counting, ICC of TMA was slightly higher than that of whole sections using average method (0.895 vs 0.858). The ICC of tumors with hot spots was lower than that of tumors without (0.736 vs 0.874). In tumors with hot spots, observers took an additional counting from the hot spot; the ICC of whole sections using hot spot method was still lower than that of TMA (0.737 vs 0.895). In categorical estimation, Ki-67 index showed a wide distribution in some cases. Nevertheless, in tumors with hot spots, the range of distribution in Ki-67 categories was decreased with hot spot method and in TMA platform. Conclusions: Interobserver variability of Ki-67 index for direct counting and categorical estimation was relatively high. Tumors with hot spots showed greater interobserver variability as opposed to those without, and restricting the measurement area yielded lower interobserver variability.

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Review
Current Issues and Clinical Evidence in Tumor-Infiltrating Lymphocytes in Breast Cancer
Sung Gwe Ahn, Joon Jeong, SoonWon Hong, Woo Hee Jung
J Pathol Transl Med. 2015;49(5):355-363.   Published online August 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.07.29
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AbstractAbstract PDF
With the advance in personalized therapeutic strategies in patients with breast cancer, there is an increasing need for biomarker-guided therapy. Although the immunogenicity of breast cancer has not been strongly considered in research or practice, tumor-infiltrating lymphocytes (TILs) are emerging as biomarkers mediating tumor response to treatments. Earlier studies have provided evidence that the level of TILs has prognostic value and the potential for predictive value, particularly in triple-negative and human epidermal growth factor receptor 2–positive breast cancer. Moreover, the level of TILs has been associated with treatment outcome in patients undergoing neoadjuvant chemotherapy. To date, no standardized methodology for measuring TILs has been established. In this article, we review current issues and clinical evidence for the use of TILs in breast cancer.

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Original Articles
Microtubule-Associated Protein Tau, α-Tubulin and βIII-Tubulin Expression in Breast Cancer
Soyoung Im, Changyoung Yoo, Ji-Han Jung, Ye-Won Jeon, Young Jin Suh, Youn Soo Lee, Hyun Joo Choi
Korean J Pathol. 2013;47(6):534-540.   Published online December 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.534
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AbstractAbstract PDF
Background

The microtubule-associated protein Tau binds to both inner and outer surfaces of microtubules, leading to tubulin assembly and microtubule stabilization. The aim of this study was to evaluate the significance of Tau, α-tubulin, and βIII-tubulin expression in breast carcinoma and to assess their relationships with disease progression in the context of taxane treatment.

Methods

Immunohistochemical expressions of Tau, α-tubulin, and βIII-tubulin were assessed in 183 breast cancer cases. Expression was correlated with clinicopathologic parameters, disease progression and overall survival.

Results

Tau expression was correlated with lymph node metastasis and estrogen receptor (ER) positivity (p=.003 and p<.001, respectively). Loss of α-tubulin was significantly correlated with distant metastasis (p=.034). Loss of βIII-tubulin was correlated with lymph node metastasis and ER positivity (p=.004 and p<.001, respectively). In taxane-treated cases, Tau expression and loss of α-tubulin and βIII-tubulin expression were related to disease progression (p=.001, p=.028, and p=.030, respectively). Tau expression was associated with a worse survival rate in taxane-treated patients (p=.049).

Conclusions

Tau expression and loss of α-tubulin and βIII-tubulin expression were correlated with aggressive behavior in taxane-treated breast cancer. Further evaluation of Tau, α-tubulin and βIII-tubulin may be useful in predicting clinical behavior and seeking therapeutic measures in taxane-based chemotherapy for breast cancer.

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Hedgehog Related Protein Expression in Breast Cancer: Gli-2 Is Associated with Poor Overall Survival
Soyoung Im, Hyun Joo Choi, Changyoung Yoo, Ji-Han Jung, Ye-Won Jeon, Young Jin Suh, Chang Suk Kang
Korean J Pathol. 2013;47(2):116-123.   Published online April 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.116
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AbstractAbstract PDF
Background

The hedgehog (Hh) signaling pathway is known to play a critical role in various malignancies, but its clinicopathologic role in breast cancer is yet to be established.

Methods

Tissue microarray blocks from 334 cases of breast cancer were prepared. The expression of six Hh signaling proteins including sonic hedgehog (Shh), patched (Ptch), smoothened (Smo), and the glioma-associated oncogene (Gli)-1, Gli-2, and Gli-3 were analyzed immunohistochemically.

Results

The expression of Hh signaling proteins was significantly correlated with some prognostic factors including the correlation of lymph node metastasis with the expression of Shh (p=0.001) and Ptch (p=0.064), the correlation of the stages with Shh and Gli-3 expression (p=0.007 and p=0.024, respectively), the correlation of the nuclear grade with the Smo (p=0.004) and Gli-3 (p=0.000), and the correlation of the histologic grade with the Ptch (p=0.016), Smo (p=0.007), and Gli-3 (p=0.000). The Shh, Ptch, Smo, Gli-1, and Gli-2 expression was significantly different between the phenotypes (p=0.000, p=0.001, p=0.004, p=0.039, and p=0.031, respectively). Gli-2 expression was correlated with a worse overall survival outcome (p=0.012).

Conclusions

Hh pathway activation is correlated with a more aggressive clinical behavior in breast carcinomas. The comparison of phenotypes suggested that the Hh pathway may be a useful therapeutic target for breast carcinoma. Patients with Gli-2 expression had a significantly lower overall survival rate and, therefore, it showed promise as a prognostic marker.

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EGFR Gene Amplification and Protein Expression in Invasive Ductal Carcinoma of the Breast
Won Hwangbo, Jeong Hyeon Lee, Sangjeong Ahn, Seojin Kim, Kyong Hwa Park, Chul Hwan Kim, Insun Kim
Korean J Pathol. 2013;47(2):107-115.   Published online April 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.107
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AbstractAbstract PDF
Background

The epidermal growth factor receptor (EGFR) is a surrogate marker for basal-like breast cancer. A recent study suggested that EGFR may be used as a target for breast cancer treatment.

Methods

A total of 706 invasive ductal carcinomas (IDC) of the breast were immunophenotyped, and 82 cases with EGFR protein expression were studied for EGFR gene amplification.

Results

EGFR protein was expressed in 121 of 706 IDCs (17.1%); 5.9% were of luminal type, 25.3% of epidermal growth factor receptor 2 (HER-2) type, and 79.3% of basal-like tumors. EGFR gene amplification and high polysomy (fluorescent in situ hybridization [FISH]-positive) were found in 18 of 82 cases (22.0%); 41.2% of the HER-2+, EGFR+, cytokeratin 5/6- (CK5/6-) group, 11.2% of the HER-2-, EGFR+, CK5/6- group, and 19.1% of the HER-2-, EGFR+, CK5/6+ group. FISH-positive cases were detected in 8.3% of the EGFR protein 1+ expression cases, 15.9% of 2+ expression cases, and 38.5% of 3+ expression cases. In group 2, the tumors had a high Ki-67 labeling (>60%), but the patients showed better disease-free survival than those with tumors that co-expressed HER-2 or CK5/6.

Conclusions

EGFR-directed therapy can be considered in breast cancer patients with EGFR protein overexpression and gene amplification, and its therapeutic implication should be determined in HER-2 type breast cancer patients.

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    GANG LIN, XIAO-JIANG SUN, QIAN-BO HAN, ZHUN WANG, YA-PING XU, JIA-LEI GU, WEI WU, GU ZHANG, JIN-LIN HU, WEN-YONG SUN, WEI-MIN MAO
    Oncology Letters.2015; 10(2): 901.     CrossRef
  • Immunohistochemical Classification of Primary and Secondary Glioblastomas
    Kyu Sang Lee, Gheeyoung Choe, Kyung Han Nam, An Na Seo, Sumi Yun, Kyung Ju Kim, Hwa Jin Cho, Sung Hye Park
    Korean Journal of Pathology.2013; 47(6): 541.     CrossRef
  • A Comparison of Tumor Biology in Primary Ductal CarcinomaIn SituRecurring as Invasive Carcinoma versus a NewIn Situ
    Wenjing Zhou, Christine Johansson, Karin Jirström, Anita Ringberg, Carl Blomqvist, Rose-Marie Amini, Marie-Louise Fjallskog, Fredrik Wärnberg
    International Journal of Breast Cancer.2013; 2013: 1.     CrossRef
Expressional Difference of RHEB, HDAC1, and WEE1 Proteins in the Stromal Tumors of the Breast and Their Significance in Tumorigenesis
Minseob Eom, Airi Han, Mi Jeong Lee, Kwang Hwa Park
Korean J Pathol. 2012;46(4):324-330.   Published online August 23, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.324
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AbstractAbstract PDF
Background

Fibroadenoma (FA) and phyllodes tumor (PT) are stromal tumors of breast and are histologically similar. There are no established differences in tumorigenesis and oncogene expression among them. Ras homolog enriched in brain (RHEB) plays an important role in cell growth and cell-cycle control, histone deacetylase 1 (HDAC1) is an important factor in breast tumor progression and prognosis, and WEE1 homolog (WEE1) functions as a tumor suppressor. No studies on the expressional differences of these proteins in FA and PT have been reported to date.

Methods

The expression of these proteins in FA, PT, and normal breast was compared. We used 102 cases of FA and 25 cases of benign PT.

Results

In epithelial cells, the expression of RHEB, HDAC1, and WEE1 was lowest in PT, higher in FA, and most enhanced in normal breast. In addition, the expression of RHEB and HDAC1 was higher in the stromal cells of PT than in FA and normal breast.

Conclusions

Both epithelial and stromal cells of FA and PT express these proteins, which indicates that epithelial cells play an important role in the development of stromal tumors. In addition, the expressional differences of these proteins may be associated with the tumorigenesis of breast stromal tumors.

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    Jun Hu, Jianwei Chen, Xiaojian Xu, Qiliang Hou, Jing Ren, Xianghua Yan
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    Reem Altaf, Humaira Nadeem, Mustafeez Mujtaba Babar, Umair Ilyas, Syed Aun Muhammad
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  • Wee1 Kinase: A Potential Target to Overcome Tumor Resistance to Therapy
    Francesca Esposito, Raffaella Giuffrida, Gabriele Raciti, Caterina Puglisi, Stefano Forte
    International Journal of Molecular Sciences.2021; 22(19): 10689.     CrossRef
  • MiR-503 enhances the radiosensitivity of laryngeal carcinoma cells via the inhibition of WEE1
    Huimin Ma, Rong Lian, Zhiyan Wu, Xiao Li, Wenfa Yu, Yun Shang, Xixia Guo
    Tumor Biology.2017; 39(10): 101042831770622.     CrossRef
  • Rheb phosphorylation is involved in p38-regulated/activated protein kinase-mediated tumor suppression in liver cancer
    MIN ZHENG, SHENGBING ZANG, LINNA XIE, XUETING FANG, YU ZHANG, XIAOJIE MA, JINGFENG LIU, DEXIN LIN, AIMIN HUANG
    Oncology Letters.2015; 10(3): 1655.     CrossRef
  • Expression of CDK1Tyr15, pCDK1Thr161, Cyclin B1 (Total) and pCyclin B1Ser126 in Vulvar Squamous Cell Carcinoma and Their Relations with Clinicopatological Features and Prognosis
    Zhihui Wang, Ana Slipicevic, Mette Førsund, Claes G. Trope, Jahn M. Nesland, Ruth Holm, Xin-Yuan Guan
    PLOS ONE.2015; 10(4): e0121398.     CrossRef
  • High expression of wee1 is associated with malignancy in vulvar squamous cell carcinoma patients
    Gry Irene Magnussen, Ellen Hellesylt, Jahn M Nesland, Claes G Trope, Vivi Ann Flørenes, Ruth Holm
    BMC Cancer.2013;[Epub]     CrossRef
The Clinicopathologic Features of Molecular Apocrine Breast Cancer
Yoon Jin Cha, Woo-Hee Jung, Ja Seung Koo
Korean J Pathol. 2012;46(2):169-176.   Published online April 25, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.169
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AbstractAbstract PDF
Background

To elucidate the clinicopathologic features and their implications on the immunohistochemistry in cases of molecular apocrine breast cancer (MABC).

Methods

Immunohistochemical (IHC) staining for estrogen receptor (ER), human epidermal growth factor receptor 2 (HER-2), cytokeratin (CK) 5/6, epidermal growth factor receptor (EGFR), androgen receptor (AR), gamma-glutamyltrasferase 1 (GGT1) and Ki-67 was performed on tissue microarray breast cancer samples from 204 patients. Phenotypes of breast cancer were divided based on the IHC status of ER, AR and GGT1 into the following: luminal type, ER positive and AR and/or GGT1 positive; basal type, ER, AR, and GGT1 negative; non-basal type, ER positive and AR and GGT1 negative; and MABC type, ER negative and AR and/or GGT1 positive.

Results

In our series of patients (n=204), there were 26 cases of MABC. Besides, there were 18, 60, and 100 cases of luminal type, basal type and non-basal type, respectively. The MABC demonstrated apocrine histology and a higher prevalence of HER-2 positivity than other phenotypes. With the basal type, the MABC manifested a more frequent expression of CK5/6 and EGFR and a higher Ki-67 index than other phenotypes (p<0.001). There were no significant differences in patient prognosis between the phenotypes of breast cancer.

Conclusions

MABC are distinguishable from other phenotypes based on the apocrine histology and a higher expression rate of HER-2.

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    Burak Ilhan, Selman Emiroğlu, Rustu Türkay, Rıdvan Ilhan
    Current Problems in Cancer.2020; 44(2): 100501.     CrossRef
  • Cancer du sein triple négatif exprimant le récepteur aux androgènes : de la biologie à la thérapeutique
    Thomas Grellety
    Bulletin du Cancer.2020; 107(4): 506.     CrossRef
  • Triple‐negative apocrine carcinoma: A rare pathologic subtype with a better prognosis than other triple‐negative breast cancers
    Cletus A. Arciero, Albert H. Diehl, Yuan Liu, Qin Sun, Theresa Gillespie, Xiaoxian Li, Preeti Subhedar
    Journal of Surgical Oncology.2020; 122(6): 1232.     CrossRef
  • Apocrine lesions of the breast: part 2 of a two-part review. Invasive apocrine carcinoma, the molecular apocrine signature and utility of immunohistochemistry in the diagnosis of apocrine lesions of the breast
    Clare D'Arcy, Cecily M Quinn
    Journal of Clinical Pathology.2019; 72(1): 7.     CrossRef
  • Enhancing Abiraterone Acetate Efficacy in Androgen Receptor–positive Triple-negative Breast Cancer: Chk1 as a Potential Target
    Thomas Grellety, Celine Callens, Elodie Richard, Adrien Briaux, Valérie Vélasco, Marina Pulido, Anthony Gonçalves, Pierre Gestraud, Gaetan MacGrogan, Hervé Bonnefoi, Bruno Cardinaud
    Clinical Cancer Research.2019; 25(2): 856.     CrossRef
  • A clinicopathologic study of invasive apocrine carcinoma of the breast: A single-center experience
    Denira Imamovic, Nurija Bilalovic, Faruk Skenderi, Vanesa Beslagic, Timur Ceric, Berisa Hasanbegovic, Semir Beslija, Semir Vranic
    The Breast Journal.2018; 24(6): 1105.     CrossRef
  • Dose invasive apocrine adenocarcinoma has worse prognosis than invasive ductal carcinoma of breast: evidence from SEER database
    Ning Zhang, Hanwen Zhang, Tong Chen, Qifeng Yang
    Oncotarget.2017; 8(15): 24579.     CrossRef
  • Pure Apocrine Carcinomas Represent a Clinicopathologically Distinct Androgen Receptor–Positive Subset of Triple-Negative Breast Cancers
    Anne M. Mills, Chelsea E. Gottlieb, Scott M. Wendroth, Christiana M. Brenin, Kristen A. Atkins
    American Journal of Surgical Pathology.2016; 40(8): 1109.     CrossRef
  • Androgen Receptor: A Complex Therapeutic Target for Breast Cancer
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  • Early versus late distant metastasis and adjuvant chemotherapy alone versus both radiotherapy and chemotherapy in molecular apocrine breast cancer
    Xiaozhen Liu, Yang Yang, Xiaolong Feng, Honghong Shen, Jian Liu, Xia Liu, Yun Niu
    Oncotarget.2016; 7(31): 48905.     CrossRef
  • Molecular and diagnostic features of apocrine breast lesions
    Pavel Gromov, Jaime A Espinoza, Irina Gromova
    Expert Review of Molecular Diagnostics.2015; 15(8): 1011.     CrossRef
  • Prevalencia de receptores androgénicos en el cáncer de mama
    Claudia Janeth Rodríguez-Silva, José Luis González-Vela, Ascary Alcides Velázquez-Pacheco
    Gaceta Mexicana de Oncología.2015; 14(3): 135.     CrossRef
Case Reports
Mimicry of Minute Pulmonary Meningothelial-like Nodules to Metastatic Deposits in a Patient with Infiltrating Lobular Carcinoma: A Case Report and Review of the Literature
Hala Kfoury, Maria A. Arafah, Maha M. Arafah, Sami Alnassar, Waseem Hajjar
Korean J Pathol. 2012;46(1):87-91.   Published online February 23, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.87
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AbstractAbstract PDF

Minute pulmonary meningothelial-like nodules (MPMNs) are incidentally found lesions in lung resection specimens and autopsies. MPMNs have been associated with neoplastic and non-neoplastic pulmonary conditions and occasionally with extrapulmonary diseases. We report a case of a female patient presenting with invasive lobular carcinoma of the breast and MPMNs, masquerading as metastatic deposits. We describe the morphological, immunohistochemical and ultrastructural features of MPMNs and emphasize the importance of their recognition for proper staging and treatment of patients. To our knowledge, this is the first case in the English literature describing this coexistence.

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  • Diffuse pulmonary meningotheliomatosis with pan-TRK expression by immunohistochemistry: a novel finding and potential pitfall
    Cansu Karakas, Michael A. Nead, Moises J. Velez
    Diagnostic Pathology.2023;[Epub]     CrossRef
  • Diffuse Pulmonary Meningotheliomatosis: Clinic-Pathologic Entity or Indolent Metastasis from Meningioma (or Both)?
    Laura Melocchi, Giulio Rossi, Mirca Valli, Maria Cecilia Mengoli, Michele Mondoni, Luigi Lazzari-Agli, Giacomo Santandrea, Fabio Davoli, Chiara Baldovini, Alberto Cavazza, Thomas V. Colby
    Diagnostics.2023; 13(4): 802.     CrossRef
  • Pathological diagnosis and immunohistochemical analysis of minute pulmonary meningothelial-like nodules: A case report
    Xin Ruan, Liu-Sheng Wu, Zheng-Yang Fan, Qi Liu, Jun Yan, Xiao-Qiang Li
    World Journal of Clinical Cases.2023; 11(33): 8022.     CrossRef
  • Benign disease prone to be misdiagnosed as malignant pulmonary nodules: Minute meningothelioid nodules
    Xiao‐Xiao Peng, Li‐Xu Yan, Chao Liu, Si‐Yun Wang, Wen‐Feng Li, Xing Gao, Xue‐Wu Wei, Qing Zhou
    Thoracic Cancer.2019; 10(5): 1182.     CrossRef
  • Atypical finding of meningothelial-like inclusions in cervical lymph nodes
    Rebecca Donkin, Andrew Dettrick, Penelope Wyche, Sarah Grigg
    Pathology.2018; 50(7): 785.     CrossRef
  • Minute Pulmonary Meningothelial-Like Nodules Simulating Hematogenous Lung Metastasis: A Case Report
    Sang Kook Lee, Gi Jeong Kim, Young Jae Kim, Ah Young Leem, Eu Dong Hwang, Se Kyu Kim, Joon Chang, Young Ae Kang, Song Yee Kim
    Tuberculosis and Respiratory Diseases.2013; 75(2): 67.     CrossRef
  • Diffuse Pulmonary Meningotheliomatosis Diagnosed by Transbronchial Lung Biopsy
    Roberto Bernabeu Mora, Juan Miguel Sánchez Nieto, Chunshao Hu, Eduardo Alcaraz Mateos, Alberto Giménez Bascuñana, Manuel Rodríguez Rodríguez
    Respiration.2013; 86(2): 145.     CrossRef
HER2-Positive Breast Carcinomas with Co-amplification or Gain of Chromosome 17 Centromere Locus: Report of Three Cases and an Impact on HER2 Testing.
Hyeong Chan Shin, Young Kyung Bae, Aeri Kim, Seok Ju Park
Korean J Pathol. 2011;45(6):665-669.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.665
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AbstractAbstract PDF
Recently we experienced three cases of human epidermal growth factor receptor 2 (HER2)-amplified invasive breast carcinomas associated with co-amplification or gain of chromosome 17 centromere (CEP17) in silver-enhanced in situ hybridization (SISH) analysis. These cases revealed 2+ or 3+ staining for HER2 immunohistochemistry and >6 HER2 copies per cell on SISH analyses. However, the calculated HER2/CEP17 ratios were low (<2.2) and did not fit within the HER2-positive category. We interpreted those cases as HER2-positive tumors based on the number of HER2 copies per cell. There is a potential for misinterpretation of SISH analysis in cases showing increased CEP17 copy number, based on the criterion used for HER2 positivity (HER2 copies >6 per cell vs HER2/CEP17 ratio>2.2). We recommend reporting raw SISH or fluorescence in situ hybridization data, including number of cells counted, average numbers of HER2 and CEP17 signals, and the calculated HER2/CEP17 ratio to prevent underreporting of HER2 amplification.
Original Articles
The Significance of MicroRNA Let-7b, miR-30c, and miR-200c Expression in Breast Cancers.
Sung Min Chun, Hee Jung Park, Chul Hwan Kim, Insun Kim
Korean J Pathol. 2011;45(4):354-360.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.354
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AbstractAbstract PDF
BACKGROUND
MicroRNA (miRNA) is a class of noncoding protein RNA as a promising biomarker for various diseases. In this study, the expression of let-7b, miR-30c, and miR-200c was studied in breast cancer tissues to evaluate the potential relationship with known clinicopathological parameters.
METHODS
Quantitative real-time polymerase chain reaction was performed to determine the expression level of three miRNAs in 37 pairs of noncancerous normal and cancer tissues and an additional 38 cancer tissues from patients with invasive ductal carcinoma.
RESULTS
miR-200c expression was higher in cancer tissues compared to noncancerous normal tissues, and its ratio was correlated with patient age at surgery, type of surgery, and Ki-67 expression. The expression level of let-7b in cancer tissues was inversely correlated with lymph node metastasis, histological grade, and Ki-67 expression but positively correlated with estrogen and progesterone receptor expression. miR-200c expression level was positively correlated with Her-2 expression. The miR-30c expression level in breast cancer was not correlated with any parameters.
CONCLUSIONS
miR-200c and let-7b could be used as biomarkers in patients with breast cancer, but its pathological mechanism should be determined.

Citations

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  • Evaluating MicroRNAs as diagnostic tools for lymph node metastasis in breast cancer: Findings from a systematic review and meta-analysis
    Coral González Martínez, Stavros Therapontos, Jose A. Lorente, Miriam Alcaide Lucena, F.Gabriel Ortega, M.Jose Serrano
    Critical Reviews in Oncology/Hematology.2025; 207: 104598.     CrossRef
  • High DRC Levels Are Associated with Let-7b Overexpression in Women with Breast Cancer
    Jarline Encarnación, Carmen Ortiz, Ralphdy Vergne, Wanda Vargas, Domenico Coppola, Jaime Matta
    International Journal of Molecular Sciences.2016; 17(6): 865.     CrossRef
Prognostic Implications of the Expression of CXCL16 in Breast Carcinoma.
Dong Youl Choi, Ran Hong, Sung Churl Lim, Keun Hong Kee, Chae Hong Suh, Mija Lee
Korean J Pathol. 2011;45(1):15-20.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.15
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AbstractAbstract PDF
BACKGROUND
Of the many prognostic factors for breast cancer, the relationship between an infiltration of inflammatory cells and the prognosis is debatable. Of the chemokines affecting cancer's inflammatory reactions, chemokine (C-X-C motif) ligand 16 (CXCL16) has attracted attention for its prognostic value in many cancers, including colorectal cancer and renal cell carcinoma. But the situation for breast carcinoma is unknown. The aim of this study was to examine the relationship between the prognostic factors and the CXCL16 expression in patients with breast carcinoma.
METHODS
The patients (n=106) diagnosed with invasive ductal cancer of the breast were enrolled. We reviewed the clinicopathological factors of these patients, hematoxylin and eosin stains were prepared and estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2/neu) and CXCL16 immunostaining was performed.
RESULTS
The ER expression was significantly correlated with age and inflammation. A CXCL16 expression was noted in 81.1% of the cases. No association was evident between a CXCL16 expression and any other parameter, including the survival rate. Multivariate analysis did not implicate ER, HER2/neu or CXCL16 as an independent prognostic factor, but the tumor size was independent predictive factor for the patient outcome.
CONCLUSIONS
An inflammatory reaction mediated by CXCL16 is not associated with the prognosis of breast cancer or any clinicopathological factors.

Citations

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  • The Emerging Role of CXC Chemokines And Their Receptors in Cancer
    Victoria Vinader, Kamyar Afarinkia
    Future Medicinal Chemistry.2012; 4(7): 853.     CrossRef
Automated Silver-enhanced In Situ Hybridization for Evaluation of HER2 Gene Status in Breast Carcinoma: Comparison with Fluorescence In Situ Hybridization and Immunohistochemistry.
Woo Jung Sung, Seok Ju Park, Mi Jin Gu, Young Kyung Bae
Korean J Pathol. 2010;44(1):28-34.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.28
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AbstractAbstract PDF
BACKGROUND
The human epidermal growth factor receptor 2 (HER2) is amplified in 20-25% of breast cancers. HER2 overexpression or amplification is associated with a worse clinical outcome and it can predict the benefit from anthracycline and anti-HER2 therapies. The HER2 status has usually been assessed by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) in clinical samples. A new silver-enhanced in situ hybridization (SISH) technique was recently introduced. Therefore we evaluated the usefulness of SISH for detecting HER2 amplification.
METHODS
Tissue microarrays (TMAs) were constructed with 144 invasive breast cancer tissue samples. We performed IHC, FISH and SISH for HER2 on the tissue sections from the TMAs and we interpreted the results according to the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines. The concordant rates between the two different tests were calculated.
RESULTS
HER2 was overexpressed and amplified in 16.9%, 16.9%, and 18% of the cases by IHC, FISH and SISH, respectively. The concordant rates between IHC and FISH, IHC and SISH, and FISH and SISH were 95.1%, 95.7%, and 97.8%, respectively.
CONCLUSIONS
SISH can be an alternative test for evaluating HER2 amplification because the 97.8% concordance with FISH satisfies the ASCO/CAP requirement of > 95% concordance with an alternative validated method.

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  • HER2 assessment by silverin situhybridization: where are we now?
    Francesca Sanguedolce, Pantaleo Bufo
    Expert Review of Molecular Diagnostics.2015; 15(3): 385.     CrossRef
  • Diagnostic Effectiveness of PCR-based Tests DetectingBRAFMutation for Treating Malignant Melanoma: A Systematic Review
    Hae-Won Shin, Ryeo-Jin Ko, Min Lee, Hee-Young Bang, Kye-Chul Kwon, Jong-Woo Park, Sun-Hoe Koo
    Laboratory Medicine Online.2014; 4(4): 203.     CrossRef
  • Effectiveness of Silver-enhanced In Situ Hybridization for Evaluating HER2 Gene Status in Invasive Breast Carcinoma: A Comparative Study
    Youngseok Lee, Youngjoon Ryu, Hoiseon Jeong, Hyeyoon Chang, Younghye Kim, Aeree Kim
    Archives of Medical Research.2012; 43(2): 139.     CrossRef
  • HER2 Status by Standardized Immunohistochemistry and Silver-EnhancedIn SituHybridization in Korean Breast Cancer
    Young Kyung Bae, Gyungyub Gong, Jun Kang, Ahwon Lee, Eun Yoon Cho, Ji Shin Lee, Kwang-Sun Suh, Dong Wha Lee, Woo Hee Jung
    Journal of Breast Cancer.2012; 15(4): 381.     CrossRef
  • Multiplication of Chromosome 17 Centromere Is Associated with Prognosis in Patients with Invasive Breast Cancers Exhibiting NormalHER2andTOP2AStatus
    Aeri Kim, Hyung Chan Shin, Young Kyung Bae, Min Kyoung Kim, Su Hwan Kang, Soo Jung Lee, Eun Hee Lee
    Journal of Breast Cancer.2012; 15(1): 24.     CrossRef
  • HER2-Positive Breast Carcinomas with Co-amplification or Gain of Chromosome 17 Centromere Locus: Report of Three Cases and an Impact on HER2 Testing
    Hyeong Chan Shin, Young Kyung Bae, Aeri Kim, Seok Ju Park
    The Korean Journal of Pathology.2011; 45(6): 665.     CrossRef
  • The Effectiveness of SilverIn SituHybridization in Patients with Breast Cancer: A Systematic Review
    Sunyoung Jang, Seon-Heui Lee, Soojin Kim, You-Kyoung Lee, Young-Hyuck Im, Wonshik Han, Hee-Sook Park
    Journal of Breast Cancer.2011; 14(Suppl 1): S1.     CrossRef
  • Clinical and health economic outcomes of alternative HER2 test strategies for guiding adjuvant trastuzumab therapy
    James A Lee, Megan Shaheen, Thomas Walke, Matt Daly
    Expert Review of Pharmacoeconomics & Outcomes Research.2011; 11(3): 325.     CrossRef
  • HER2 expression in breast cancer: Comparisons of fluorescence in situ hybridization and silver in situ hybridization, and immunohistochemical staining using monoclonal antibody and polyclonal antibody
    Jung Sik Jang, Eun Jeong Jang, Ji‐Young Park
    Basic and Applied Pathology.2010; 3(4): 115.     CrossRef
  • HER2Status in Gastric Adenocarcinomas Assessed by Immunohistochemistry, Automated Silver-EnhancedIn SituHybridization and FluorescenceIn SituHybridization
    Aeri Kim, Jung Min Bae, Se Won Kim, Mi Jin Gu, Young Kyung Bae
    The Korean Journal of Pathology.2010; 44(5): 493.     CrossRef
The Loss of E-cadherin is Associated with the Epigenetic Alteration of CDH1 in Breast Cancer and it is also Associated with an Abnormal beta-catenin Expression in Lobular Carcinoma.
Gwangil Kim, Ji Young Kim, Hee Jung An, Haeyoun Kang, Tae Heon Kim, Jung Yon Shim, Jin Hyung Heo, Hai Lin Park, Young Kil Choi
Korean J Pathol. 2009;43(5):400-407.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.400
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AbstractAbstract PDF
BACKGROUND
APC and E-cadherin are the key molecules in the Wnt/beta-catenin pathway. We attempted to define the epigenetic alteration of APC and CDH1 (the E-cadherin gene) and the expression of Wnt-related molecules in human mammary carcinomas.
METHODS
Sixty-four mammary carcinomas, including 52 invasive ductal carcinomas (IDCs) and 12 invasive lobular carcinomas (ILCs), were evaluated using methylation-specific PCR and immunohistochemistry. We performed immunohistochemistry for E-cadherin, beta-catenin, APC, Wnt1, cyclin D1, ER, PR and C-erb B2.
RESULTS
Hypermethylation of APC and CDH1 was observed in 38 (59%) and 28 (44%) cases, respectively. CDH1 hypermethylation in ILCs was increased compared to that in IDCs (p=0.002) and it was associated with the loss of E-cadherin (p=0.02) and beta-catenin (p=0.042). APC methylation was positively correlated with the ER expression (p=0.021). Abnormal cytoplasmic localization of beta-catenin was found in 10 cases and any expression was not detected in six cases. In ILCs, the E-cadherin or beta-catenin expression was markedly decreased compared to that in IDCs (p<0.001 in both).
CONCLUSIONS
Methylation of APC or CDH1 was relatively frequent in mammary carcinomas. The loss of E-cadherin in mammary carcinoma was associated with CDH1 methylation, and abnormal beta-catenin expression was related to the loss of E-cadherin in ILC.

Citations

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  • Wnt/β-catenin signaling pathway activation reverses gemcitabine resistance by attenuating Beclin1-mediated autophagy in the MG63 human osteosarcoma cell line
    Hao Tao, Feng Chen, Haifei Liu, Yanling Hu, Yingzhen Wang, Haiyan Li
    Molecular Medicine Reports.2017; 16(2): 1701.     CrossRef
Case Report
Intraductal Cystic Hypersecretory Carcinoma of the Breast: A case report.
Jin Haeng Chung, Seung Sook Lee, Jae Soo Koh, Kyung Ja Cho, Jong Inn Lee
Korean J Pathol. 1999;33(2):137-140.
  • 2,066 View
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AbstractAbstract
The cystic hypersecretory duct carcinoma of the breast was first described in 1984 by Rosen and Scott and warrants separate discussion because of its unusual pathological features. It is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma or mucocele-like tumor. We present a case report of intraductal cystic hypersecretory carcinoma of the breast with hormone receptor and oncogene study. The histologic differential diagnosis, with an emphasis on benign lesions that may have a predominant cystic component, is also discussed.
Original Articles
E-cadherin Expression in Distinguishing Ductal and Lobular Carcinomas of the Breast.
Eun Deok Chang, An Hi Lee, Eun Jung Lee, Seok Jin Kang, Chang Suk Kang
Korean J Pathol. 2002;36(5):323-327.
  • 2,465 View
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AbstractAbstract PDF
BACKGROUND
Most breast carcinomas are easily categorized as ductal or lobular. However, in some cases the distinction can be difficult since some tumors may have intermediate features of these two. Prior studies suggest that E-cadherin is useful to classify tumors as ductal or lobular, as it is lost in lobular but not in ductal carcinomas.
METHODS
We studied the histologic features and E-cadherin expression by immunohistochemistry in 57 cases of breast carcinomas, which were divided into three groups based on histology. Group 1 included 4 cases of infiltrating lobular carcinoma (IFL) and 1 case of lobular carcinoma in situ (LCIS) (n=5). Group 2 included infiltrating ductal carcinoma (IFD) with some features of IFL (n=48). Group 3 included a solid type of intraductal carcinoma (DCIS) (n=4). E-cadherin staining was scored as negative or positive.
RESULTS
All 5 cases from group 1 were E-cadherin negative, and all 4 DCIS cases were positive. Only 2 (0.04%) of the 48 cases from group 2 were E-cadherin negative.
CONCLUSIONS
Our findings suggest that the majority of cases with morphologically IFD with some IFL features are ductal. E-cadherin immunostaining is of value in helping to characterize breast carcinomas with indeterminate morphologic features.
Expression of p21, p53 and bcl-2 Proteins in Invasive Ductal Carcinoma of the Breast.
Hyang Jeong Jo, Ki Jung Yun, Hyung Bae Moon
Korean J Pathol. 2003;37(6):393-399.
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AbstractAbstract PDF
BACKGROUND
This study was designed to investigate the prognostic significance of p21, p53, and bcl-2 proteins in invasive ductal carcinoma of the breast.
METHODS
Seventy-two cases of invasive ductal carcinoma were examined by immunohistochemical staining for p21, p53 and bcl-2 proteins. The results were correlated with clinicopathological variables, including age, tumor size, histologic grade, nuclear grade, lymph node status, estrogen receptor (ER) and progesterone receptor (PR) expression.
RESULTS
Of 72 cases, p21, p53 and bcl-2 proteins were positive in 25 (34.8%), 35 (50.0%) and 27 (37.5%), respectively. There were no statistically significant correlations between the p21 protein expression and the other clinicopathological variables. The expression of p53 protein, however, showed a significant relation to ER expression, and that of bcl-2 was positively correlated with tumor size. In survival analysis, p21, p53, and bcl-2 proteins, nuclear grade and lymph node status were associated with survival rate.
CONCLUSIONS
These results indicate that p21, p53, and bcl-2 proteins might play a role in tumorigenesis of breast carcinoma. In addition, the increased expression of p21, p53, and bcl-2 proteins could be used as factors suggesting poor prognosis in breast carcinomas.
Expression of MMP-2, MT1-MMP, and TIMP-2 mRNA in Breast Carcinomas.
Dong Won Kim, So Young Jin, Dong Wha Lee
Korean J Pathol. 2003;37(6):400-406.
  • 2,145 View
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AbstractAbstract PDF
BACKGROUND
The activation of proMMP-2 is induced by membrane type 1-matrix metalloproteinase (MT1-MMP), but inhibited by tissue inhibitors of matrix metalloproteinase type 2 (TIMP-2). This study was carried out to establish the pattern of mRNA expression of MMP-2, MT1-MMP, and TIMP-2 in breast carcinomas.
METHODS
Seventy-nine cases of invasive ductal carcinoma, 10 of ductal carcinoma in situ, and 10 of fibrocystic disease as a control were analysed for the expression of MMP-2, MT1-MMP, and TIMP-2 mRNA, using in situ hybridization. Correlations of the results with the clinical stage, tumor size, nodal status, and nuclear grade were analysed.
RESULTS
The expression rates of MMP-2, MT1-MMP, and TIMP-2 mRNA in invasive ductal carcinoma were 68%, 73%, and 56%, respectively. They were localized to both stromal and tumor cells, but mainly in the latter. The MMP-2 mRNA expression was significantly correlated with the clinical stage (p < 0.05), while the expression of TIMP-2 mRNA was inversely correlated with clinical stage and tumor size(p < 0.05). Significant positive correlations between MMP-2 and MT1-MMP expressions, along with inverse relationships between MMP-2 and TIMP-2, and between TIMP-2 and MT1-MMP, were also found. CONCLUSIONS: MMP-2 and TIMP-2 mRNA expressions might be useful as one of a range of prognostic parameters in breast carcinoma patients.

J Pathol Transl Med : Journal of Pathology and Translational Medicine
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