Breast Cancer Molecular Subtypes Among Moroccan Women
Introduction: Breast cancer remains despite the therapeutic progress, the leading cause of death by cancer among women. It represents a group of very heterogeneous clinical, histopathological and molecular diseases. Molecular heterogeneity has been demonstrated by genomic analysis, even for similar histology cancers. Four subgroups of breast carcinomas are distinguished: Luminal A, Luminal B, HER2 over expression and Basal - like. The Immuno-histo-chemical analysis useip (estrogen receptors) RE, the PR (progesterone receptors), the ((Human Epidermal Growth Factor Receptor-2), the Ki67 (proliferation marker) HER2, CK5/6) has shown a subdivision into subgroups similar to those found by genomic analysis. These subgroups are different from the point of view of clinical course and response to adjuvant treatment.
Objectives: The aim of this work is to study the molecular profile of the breast cancers by immunostaining on Moroccan series to a classification with a prognostic value allowing a treatment tailored to each group of patients. Furthermore, the molecular subgroups were correlated to other clinical and histological factors.
Material and methods: It is a prospective study of the laboratory of Anatomy and Pathologic cytology of the children's Hospital, the service I of the maternity hospital in Rabat and in cooperation with the United Nations Centre of pathological anatomy. To do this, 88 cases of breast cancer together were diagnosed between January 1, 2010 and December 31, 2014, taking a period of five years. All tissue samples made subject study of Immuno-histo-chemistry with the following markers: RE, PR, HER2 and Ki67. Only negative triple cases (HR and HER2 negative) benefited from an additional marking with CK5/6 and EGFR to set the basal profile.
Results: Series of 88 cases of mammary carcinomas observed on operating parts, ranged in age between 28 and 84 years old, with an average of 51 ± 12, 8. Carcinoma infiltrating non-specific (DOCTORS) was the most frequent (87.5%). Ranks histo-prognostic Scarff Bloom and Richardson (SBR) 2 and 3 respectively accounted for 45.5 and 51.1% of cases and only 2, 3% of the DOCTORS were grade 1. The Luminal B (53.4%) was under the most common molecular group, followed by Luminal A (23.9%), HER2 + (15.9%) and triple negative (6.8%). The correlation of molecular type of tumors with different prognostic factors showed only one significant connection with the SBR grade.
Frédérique Penault-Llorca, Marie-Hélène Dauplat. Les signatures moléculaires des cancers du sein : le point de vue du pathologiste, Revue Francophonedes Laboratoires. Janvier 2011, N°428, pp 43-47
M.C. Mathieu. Les sous-types moléculaires des cancers du sein. La Lettre du Sénologue - n ° 38 - octobre-novembre-décembre 2007. Pp 33-34
Perou CM, Sorlie T, Eisen MB et al. Molecular portraits of human breast tumours. Nature 2000;406:747-52.f.
Cheang MC, Chia SK, Voduc D, Gao D, Leung S, Snider J, et al. Ki-67 Index, Her2 status, and prognosis of patients with luminal B breast cancer. J Nat Cancer Inst. 2009;101:736–750.
Viani GA, Afonso SL, Stefano EJ, et al.: Adjuvant trastuzumab in the treatment of her‐
‐positive early breast cancer: A meta‐analysis of published randomized trials. BMC Cancer 7:153, 2007.
Soerjomataram I, Louwman MW, Ribot JG, Roukema JA, Coebergh JW. An overview of prognostic factors for long-term survivors of breast cancer. Breast Cancer Res Treat 2008;107:309—30.
Hu Z, Fan C, Oh DS, Marron JS, He X, Qaqish BF, et al. The molecular portraits of breast tumors are conserved across microarray platforms. BMC Genom 2006;7:96.
Abbass Fouad, Akasbi Yousra, Znati Kaoutar, El Mesbahi Omar, Amarti Afaf, et Bennis Sanae ; Classification moléculaire du cancer du sein au Maroc. Pan Afr Med J. 2012; 13: 91.
Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. Jama. 2006;295:2492–2502.
Hugh J, Hanson J, Cheang MC, Nielsen TO, Perou CM, et al. Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 Trial. J Clin Oncol. 2009 Mar 10;27(8):1168–76.
Nielsen TO, Hsu FD, Jensen K, Cheang M, Karaca G, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res. 2004 Aug 15;10(16):5367–74.
Weigelt B, Geyer FC, Natrajan R, Lopez-Garcia MA, Ahmad AS, Savage K, et al. The molecular underpinning of lobular histological growth pattern: a genome-wide transcriptomic analysis of invasive ductal carcinomas of no special type. J Pathol 2010;220:45-57
Van’t Veer LJ, Dal H, van de Vijver MJ et al. Gene expression profling predicts clinical outcome of breast cancer. Nature 2002;415:530-6.
de Vijver MJ, He Y, Van’t Veer LJ et al. A gene-expression signature as a predictor of survival in breast cancer. N Engl J Med 2002;347:1999-2009.
Bechr Hamrita, Hela Ben Nasr, Philippe Hammann, Lauriane Kuhn, Amel Ben Anes, Saloua Dimassi, Anouar Chaieb, Hedi Khairi, Karim Chahed. Pour une meilleure compréhension de la physiopathologie des cancers mammaires : l’approche protéomique. Annales de Biologie Clinique. 2012;70(5):553-565. doi:10.1684/abc.2012.0741
Ashraf Khan, Ian O. Ellis Andrew, M. Hanby, Ediz F. Cosar, Emad A. Rakha, Dina Kandil. Precision Molecular Pathology of Breast Cancer. Series Editor: Philip T. Cagle. Springer Science+Business Media New York 2015 LIVRE ??
Chuthapisith S, Permsapaya W, Warnnissorn M, et al (2012). Breast cancer subtypes identified by the ER, PR and Her-2 status in Thai women. Asian Pac J Cancer Prev, 13, 459-62.
var M, Mafi N, Joulaee A, et al (2012). Breast cancer molecular subtypes and association with clinicopathological characteristics in Iranian women, 2002-2011. Asian Pac J Cancer Prev, 13, 1881-6.
Abalkail AA, Zahawi HM, Almasri NM, Hameed OK. The role of young population structure in determining age distribution of breast cancer in Jordan. J Bahrain Med Society. 2003; 15: 28-33.
Ontilo AA, Enget JM, Greenlee RT, Mukesh BN. (2008). Breast cancer subtypes based on ER/PR and HER-2/neu expression: Comparison of clinicopathologic features and survival. Clinical Medicine & Research, 7, 4-13.
Camille Franchet, Raphaëlle Duprez-Paumier, Magali Lacroix-Trik. Cancer du sein luminal et apport des classifications intrinsèques moléculaires : comment identifier les tumeurs luminales A et B en 2015?. Bull Cancer 2015; 102: S34–S46
Najafi B, Anvari S, Roshan ZA. (2013). Disease free survival among molecular subtypes of early stage breast cancer between 2001 and 2002 in Iran. Asian Pac J Cancer Prev, 14, 5811-16.
Sorlie T, Tibshirani R, Parker J et al. Repeated observation of breast tumor subtypes in independant gene expression data sets. Proc Natl Acad Sci 2003;100:8418-23.
Milikan RC, Newman B, Tse CK, et al (2008). Epidemiology of basal-like breast cancer. Breast Cancer Res Treat, 109, 123-39.
Jia WJ, Jia HX, Feng HY, et al (2014). Her-2 enriched tumors have the highest risk of local recurrence in Chinese patients treated with breast conservation therapy. Asian Pac J Cancer Prev, 15, 315-20.
Su Y, Zheng Y, Zheng W, et al (2011). Distinct distribution and prognostic significance of molecular subtypes of breast cancer in Chinese women: a population-based cohort study. BMC Cancer, 11, 292.
El-Hawary AK, Abbas AS, Elsyayed AA, Zalata KR (2012). Molecular subtypes of breast carcinoma in Egyptian women: Clinicopathological features. Pathology-Research and Practice, 208, 382-6.
Brig Nikhilesh Kumar, Lt Col Preeti Patni, Lt Col A. Agarwal, Col M.A. Khan, Nidhi Parashar, Prevalence of molecular subtypes of invasive breast cancer: A retrospective study, medical journal armed forces india 71 (2015) 254-258).
Junichi K, Takoya M, Takanori I, Hisahi H, Masafumi K, Futoshi A, et al. the prevalence of intrinsic subtypes and prognosis in breast cancer patients of different races. The Breast. 2007; 16: S72-S77
Fernandes RC, Bevilacqua JL, Soares IC, et al. Coordinated expression of ER, PR and HER-2 define different prognostic subtypes among poorly differentiated breast carcinomas. Histopathology. 2009;55:346-352
Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thurlimann B, et al. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol (official journal of the European Society for Medical Oncology/ESMO). 2013;24(9):2206–23. PubMed PMID: 23917950. Pubmed Central PMCID: PMC3755334.
Ward S, Pilgrim H, Hind D. Trastuzumab for the treatment of primary breast cancer in HER2-positive women: a single technology appraisal. Health Technol Assess. 2009;13(Suppl 1):1–6.
Cheang MC, Voduc D, Bajdik C, Leung S, McKinney S, Chia SK, et al. Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Clin Cancer Res. 2008;14(5):1368–76.
Livasy CA, Karaca G, Nanda R, Tretiakova MS, Olopade OI, Moore DT, et al. Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma. Mod Pathol. 2006;19(2):264–71.
Hamrita B, Ben Nasr H, Hammann P, Kuhn L, Ben Anes A, Dimassi S, Chaieb A, Khairi H, Chahed K. Pour une meilleure compréhension de la physiopathologie des cancers mammaires : l’approche protéomique. Ann Biol Clin 2012 ; 70(5) : 553-65 doi:10.1684/abc.2012.0741
Calza S, Hall P, Auer G, et al. Intrinsic molecular signature of breast cancer in a population-based cohort of 412 patients. Breast Cancer Res. 2006;8:R34.
Jumppanen M, Gruvberger-Saal S, Kauraniemi P, et al. Basal-like phenotype is not associated with patient survival in estrogen-receptor-negative breast cancers. Breast Cancer Res. 2007;9:R16.
Fulford LG, Reis-Filho JS, Ryder K, et al. Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival. Breast Cancer Res. 2007;9:R4 ,
Siziopikou KP, Cobleigh M. The basal subtype of breast carcinomas may represent the group of breast tumors that could benefit from EGFR-targeted therapies. Breast. 2007;16:104 - 107.
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 3.0 License.