Background: We aimed to demonstrate that in breast carcinomas the tumor profile is not stable during the metastatic process, with impact on therapeutic decisions. Materials and Methods: We analyzed the estrogen receptor (ER), progesterone receptor (PR), and HER2 status and Ki67 index in 41 primary unifocal (PU) and 37 primary multiple (PM) breast carcinomas with identical immunohistochemical profiles among multiple tumor foci and the matched axillary lymph node metastases. We defined as concordant cases in which the primary tumor (PU or PM) and lymph node metastases displayed identical positivity or negativity for ER, PR, HER2, Ki67 and as discordant cases in which there was a mismatch in at least 1 biological parameter among PU and PM tumor and lymph node metastases. Moreover, we defined as concordant cases in which the molecular profile (based on the immunohistochemical evaluation of ER, PR, HER2, and Ki67) was concordant among PU and PM tumors and lymph node metastases and mismatch cases as those in which the molecular profile of the primary tumor differs from one of the lymph node metastases in at least 1 lymph node. Results: The positivity for the biological markers is not stable during the metastatic process. In this study the total rate of discordant cases was 92.7% in PU tumors and 75.7% in PM homogenous tumors (P=0.058, odds ratio=0.245, 95% confidence interval, 0.06-0.991). The total rate of shifted cases was 64.9% in PM tumors and 82.9% in PU tumors. The highest rate of shifting was encountered from Luminal B-like to Luminal A-like. In 11 out of 37 (29.7%) PM and in 17 out of 41 (41.5%) PU cases the subtype shifted to a poorer one with respect to prognosis. Conclusions: The patients in whom the primary tumor is hormone receptor and/or HER2 negative but is positive for these markers in the axillary lymph nodes could become eligible for hormonal treatment and/or trastuzumab treatment, which may significantly improve the patient's outcome. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://ift.tt/1hexVwJ Copyright 2017 Wolters Kluwer Health, Inc. All rights reserved.
from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2iMh760
via IFTTT
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Abstract BACE1 is an indispensable enzyme for generating β-amyloid peptides, which are excessively accumulated in brains of Alzheimer'...
-
Rhinoplasty is perhaps the most challenging and elegant procedure within all of plastic surgery. In this issue of JAMA Facial Plastic Surger...
-
Publication date: October 2017 Source: International Journal of Biological Macromolecules, Volume 103 Author(s): Sapna, Bijender Singh A...
-
This Viewpoint discusses variances in cardiovascular prevention guidelines from the United States, Europe, and Canada and the debate surroun...
-
Publication date: Available online 3 May 2017 Source: Journal of Dairy Science Author(s): W.A. Knauer, S.M. Godden, A. Dietrich, R.E. Jam...
-
The retina is a specialized sensory organ, which is essential for light detection and visual formation in the human eye. Inherited retinal d...
-
Symptom Presentation and Prescription of Sleep Medications for Veterans With Posttraumatic Stress Disorder. J Nerv Ment Dis. 2017 Jan ...
-
Objectives Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliabl...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου