Prognostic value of immunohistochemical stratification of invasive duct carcinoma of the breast

作     者：Asmaa Salama Habiba El-Fendy Sahar Talaat Badaweya Bayomi Amr Amin 

作者机构：Department of PathologyNational Cancer InstituteCairo University Department of PathologyFaculty of MedicineCairo University Department of Radiation Oncology & Nuclear MedicineNational Cancer InstituteCairo University 

出 版 物：《The Chinese-German Journal of Clinical Oncology》 (中德临床肿瘤学杂志（英文版）)

年 卷 期：2013年第12卷第6期

页      面：265-272页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：breast cancer (BC) subtype Ki-67 prognosis 

摘      要：Objective： Gene expression profiling of breast cancer has identified five molecularly distinct subtypes of breast cancer that have different biological behavior and clinical outcomes. These subtypes are termed luminal A, luminal B, luminal HER2, HER2-enriched and triple negative breast cancers （TNBC）. We aimed at identification of breast cancer subtypes among Egyptian population and their clinicopathologic features using ER, PR and HER2, KJ-67 and CK5/6. Methods： Tumors from 100 patients with invasive duct carcinoma were subtyped by immunohistochemistry using ER, PR, HER2, Ki-67 and CK5/6. The prognostic value of the immunohistochemical assignment for breast cancer disease-specific survival was inves- tigated by using Kaplan-Meier curves. Results： Immunohistochemical profiling classified 22 cases as luminal A, 33 cases as luminal B, 9 cases as luminal HER2, 26 cases as HER2-enriched and 10 cases as TNBC. Tumors that measured more than 3.5 cm, showed predominance of HER2-enriched subtype. HER2-enriched and luminal B subtypes dominated the node positive cases （35.4% and 33.8%; respectively）. Large tumor size （〉 3.5 cm）, hormone receptor negative state and HER2 positive state were associated with poor prognosis. Disease free survivals （DFSs） were significantly different （P 〈 0.0001） among different breast subtypes with worst 2-year DFS for HER2-enriched subtype （40.77%） followed by luminal A （63.56%）. DFS was almost similar in the remaining other subtypes, and luminal B, luminal HER2 and TNBC which were 86.85%, 87.5% and 88.89%; respectively. Conclusion： ER, PR, HER2 and Ki-67 constituted a strong surrogate for molecular breast cancer subtypes and can be easily applied. HER2-enriched subtype carries worse features being associated with large tumor size, nodal metastasis and is associated with poor outcome. Luminal A is a heterogeneous subtype with underlying several factors that can turn its prognosis adversely. TNBC subtype may behave unexpected in a favorable way.