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Difference between revisions of "Invasive breast cancer"
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→Molecular classification of invasive carcinoma
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The above is not applied clinically. A panel of [[immunostains]] (ER, PR, HER2, EGFR, CK5/6) can reproduce the molecular groupings; however, these groupings originate from gene expression profiling studies<ref name=pmid19704256>{{Cite journal | last1 = Tang | first1 = P. | last2 = Skinner | first2 = KA. | last3 = Hicks | first3 = DG. | title = Molecular classification of breast carcinomas by immunohistochemical analysis: are we ready? | journal = Diagn Mol Pathol | volume = 18 | issue = 3 | pages = 125-32 | month = Sep | year = 2009 | doi = 10.1097/PDM.0b013e31818d107b | PMID = 19704256 }}</ref> | The above is not applied clinically. A panel of [[immunostains]] (ER, PR, HER2, EGFR, CK5/6) can reproduce the molecular groupings; however, these groupings originate from gene expression profiling studies<ref name=pmid19704256>{{Cite journal | last1 = Tang | first1 = P. | last2 = Skinner | first2 = KA. | last3 = Hicks | first3 = DG. | title = Molecular classification of breast carcinomas by immunohistochemical analysis: are we ready? | journal = Diagn Mol Pathol | volume = 18 | issue = 3 | pages = 125-32 | month = Sep | year = 2009 | doi = 10.1097/PDM.0b013e31818d107b | PMID = 19704256 }}</ref> | ||
Basal-like breast cancer | A newer classification outlines 10 subtypes based on molecular drivers identified by analysis of genomic and transcriptomic data from 2,000 breast tumors.<ref>{{Cite journal | last1 = Curtis | first1 = C. | last2 = Shah | first2 = SP. | last3 = Chin | first3 = SF. | last4 = Turashvili | first4 = G. | last5 = Rueda | first5 = OM. | last6 = Dunning | first6 = MJ. | last7 = Speed | first7 = D. | last8 = Lynch | first8 = AG. | last9 = Samarajiwa | first9 = S. | title = The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. | journal = Nature | volume = 486 | issue = 7403 | pages = 346-52 | month = Jun | year = 2012 | doi = 10.1038/nature10983 | PMID = 22522925 }}</ref> | ||
== Basal-like breast cancer ==<ref>{{Cite journal | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }} | |||
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*Overview | *Overview | ||
**A type of breast cancer defined by gene expression profiling | **A type of breast cancer defined by gene expression profiling | ||
**Can be identified by | **Can be identified by immunohistochemistry - basal markers (CK14, p63, calponin, SMA) | ||
**Not derived from myoepithelial cells, merely express a phenotype more in keeping with basal cells than ductal cells | **Not derived from myoepithelial cells, merely express a phenotype more in keeping with basal cells than ductal cells | ||
**Most triple negative (ER, PgR, Her-2); therefore cannot be treated with the usual therapeutic agents | **Most triple negative (ER, PgR, Her-2); therefore cannot be treated with the usual therapeutic agents | ||
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****Hematogenous spread -greater tendency to metastasise to visceral sites associated with poorer prognosis (such as lung and brain) instead of to nodes and bone | ****Hematogenous spread -greater tendency to metastasise to visceral sites associated with poorer prognosis (such as lung and brain) instead of to nodes and bone | ||
Triple Negative Breast Carcinomas | |||
== Triple Negative Breast Carcinomas ==<ref>{{Cite journal | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }}</ref> | |||
**About 15% of breast carcinomas. | **About 15% of breast carcinomas. | ||
**Important group due to a lack of tailored therapies for this group | **Important group due to a lack of tailored therapies for this group | ||
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***About 70% of triple-negative tumours are basal-like. | ***About 70% of triple-negative tumours are basal-like. | ||
***About 70% of basal-like tumors are triple-negative tumours are. | ***About 70% of basal-like tumors are triple-negative tumours are. | ||
**Classic morphological clues | **Classic 'morphological clues' to a triple negative cancer usually refer to medullary carcinoma features. | ||
**BCL11A overexpression recently identified as an oncogenic driver in this group <ref>{{Cite journal | last1 = Khaled | first1 = WT. | last2 = Choon Lee | first2 = S. | last3 = Stingl | first3 = J. | last4 = Chen | first4 = X. | last5 = Raza Ali | first5 = H. | last6 = Rueda | first6 = OM. | last7 = Hadi | first7 = F. | last8 = Wang | first8 = J. | last9 = Yu | first9 = Y. | title = BCL11A is a triple-negative breast cancer gene with critical functions in stem and progenitor cells. | journal = Nat Commun | volume = 6 | issue = | pages = 5987 | month = | year = 2015 | doi = 10.1038/ncomms6987 | PMID = 25574598 }}</ref> | |||
==Immunostains for typing and diagnosis== | ==Immunostains for typing and diagnosis== | ||