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Mandó P, Rizzo M, de la Puente CP, et al. High Histologic Grade and High Ki-67 Expression Predict Phenotypic Alterations in Node Metastasis in Primary Breast Cancers. J Breast Cancer. 2017;20(2):170-175doi: 10.4048/jbc.2017.20.2.170.
Mandó, P., Rizzo, M., de la Puente, C. P., Maino, M., Ponce, C., Pombo, M. T., Amat, M., Costanzo, M. V., Nervo, A., Nadal, J., Fabiano, V., Loza, J., Loza, C. M., Colo, F., & Reinaldo, C. (2017). High Histologic Grade and High Ki-67 Expression Predict Phenotypic Alterations in Node Metastasis in Primary Breast Cancers. Journal of breast cancer, 20(2), 170-175. https://doi.org/10.4048/jbc.2017.20.2.170
Mandó, Pablo, et al. "High Histologic Grade and High Ki-67 Expression Predict Phenotypic Alterations in Node Metastasis in Primary Breast Cancers." Journal of breast cancer vol. 20,2 (2017): 170-175. doi: https://doi.org/10.4048/jbc.2017.20.2.170
Mandó P, Rizzo M, de la Puente CP, Maino M, Ponce C, Pombo MT, Amat M, Costanzo MV, Nervo A, Nadal J, Fabiano V, Loza J, Loza CM, Colo F, Reinaldo C. High Histologic Grade and High Ki-67 Expression Predict Phenotypic Alterations in Node Metastasis in Primary Breast Cancers. J Breast Cancer. 2017 Jun;20(2):170-175. doi: 10.4048/jbc.2017.20.2.170. Epub 2017 Jun 26. PMID: 28690653; PMCID: PMC5500400.
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J Breast Cancer. 2017 Jun;20(2):170-175. doi: 10.4048/jbc.2017.20.2.170. Epub 2017 Jun 26.

High Histologic Grade and High Ki-67 Expression Predict Phenotypic Alterations in Node Metastasis in Primary Breast Cancers.

Journal of breast cancer

Pablo Mandó, Manglio Rizzo, Constanza Perez de la Puente, Mercedes Maino, Carolina Ponce, Maria Teresa Pombo, Mora Amat, Maria Victoria Costanzo, Adrian Nervo, Jorge Nadal, Veronica Fabiano, Jose Loza, Carlos Martin Loza, Federico Colo, Chacon Reinaldo

Affiliations

  1. Department of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina.
  2. Department of Breast Surgery, Alexander Fleming Institute, Buenos Aires, Argentina.
  3. Department of Pathology, Alexander Fleming Institute, Buenos Aires, Argentina.

PMID: 28690653 PMCID: PMC5500400 DOI: 10.4048/jbc.2017.20.2.170

Abstract

PURPOSE: Several studies have shown that estrogen receptor (ER) and progesterone receptor (PR) expression and human epidermal growth factor receptor 2 (HER2) expression may vary during tumoral progression. We aimed to describe and compare ER, PR, and HER2 expressions in primary breast tumors and synchronic axillary nodal metastases, and evaluate phenotypic correlations between them.

METHODS: Patients were identified prospectively through surgical procedures between September 2013 and July 2016. The status of ER, PR, HER2, and Ki-67 were pathologically analyzed in breast cancers and axillary nodal metastases; these patients were classified based on the breast cancer phenotypes into five subgroups.

RESULTS: Synchronic axillary nodal metastases were observed in 127 patients. In breast cancers and nodal metastases, correlation analyses of ER, PR, and Ki-67 expression showed a statistical dependence and concordance between these samples was unambiguously demonstrated through Bland-Altman plots for each determination. Primary breast tumors were classified as follows: luminal A, 41.6%; luminal B, 40.0%; luminal B/HER2, 9.6%; HER2, 2.4%; triple negative, 6.4%. Alterations in phenotype were observed in 28% of patients. The most frequent phenotypic alteration was from luminal B to A (36.4%). Ten cases (30.3%) showed alterations with therapeutic implications; six gained HER2 overexpression, and four, hormonal receptor (HR) expression. A moderate strength of agreement (Cohen's κ coefficient, 0.59; 95% confidence interval, 0.48-0.71) was observed. In multivariate analyses, high histologic grade (odds ratio [OR], 2.79;

CONCLUSION: Strong correlations were observed in HR and Ki-67 expressions between primary breast tumors and axillary nodal metastases, and a moderate concordance was observed in their phenotypical characteristics. Nevertheless, alterations did exist, and one-third of these changes may have therapeutic implications. The nodal metastases of tumors with high grade and high Ki-67 expression may need to be analyzed, to obtain complete therapeutic information.

Keywords: Breast neoplasms; Ki-67 antigen; Lymphatic metastasis; Phenotype

Conflict of interest statement

CONFLICT OF INTEREST: The authors declare that they have no competing interests.

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