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Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer

Metaplastic breast carcinoma (MBC) comprises a heterogeneous group of tumors with difficult to predict biological behavior. A subset of MBC, characterized by spindle-shaped tumor cells with a myoepithelial-like immunophenotype, was entered into a retrospective study (n = 42, median follow-up time 43...

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Autores principales: Leo, Fabian, Bartels, Stephan, Mägel, Lavinia, Framke, Theodor, Büsche, Guntram, Jonigk, Danny, Christgen, Matthias, Lehmann, Ulrich, Kreipe, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978764/
https://www.ncbi.nlm.nih.gov/pubmed/27220763
http://dx.doi.org/10.1007/s00428-016-1950-9
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author Leo, Fabian
Bartels, Stephan
Mägel, Lavinia
Framke, Theodor
Büsche, Guntram
Jonigk, Danny
Christgen, Matthias
Lehmann, Ulrich
Kreipe, Hans
author_facet Leo, Fabian
Bartels, Stephan
Mägel, Lavinia
Framke, Theodor
Büsche, Guntram
Jonigk, Danny
Christgen, Matthias
Lehmann, Ulrich
Kreipe, Hans
author_sort Leo, Fabian
collection PubMed
description Metaplastic breast carcinoma (MBC) comprises a heterogeneous group of tumors with difficult to predict biological behavior. A subset of MBC, characterized by spindle-shaped tumor cells with a myoepithelial-like immunophenotype, was entered into a retrospective study (n = 42, median follow-up time 43 months). Molecular parameters (DNA sequences of mutation hot spots in AKT1, ALK, APC, BRAF, CDH1, CTNNB1, EGFR, ERBB2, FBXW7, FGFR2, FOXL2, GNAQ, GNAS, KIT, KRAS, MAP2K1, MET, MSH6, NRAS, PDGFRA, PIK3CA, PTEN, SF3B1, SMAD4, SRC, SRSF2, STK11, TP53, and U2AF1; copy numbers for EGFR, c-myc, FGFR, PLAG, c-met) were assessed. None of the patients had axillary lymph node involvement. In 13 cases, local recurrence developed after surgery (30.9 %). Distant metastasis occurred in seven patients (17 %; four after local recurrence). The most frequent genetic alteration was PIK3CA mutation (50 % of cases). None of the pathological parameters (size, grade, stage, Ki-67 labeling index) was significantly associated with disease-free survival (DFS) or overall survival (OS). PIK3CA mutation, especially the H1047R type, tended to adversely affect OS. Type of resection (mastectomy vs. breast-conserving therapy, width of margins) or adjuvant radiotherapy had no influence on DFS or OS, whereas in the group treated with radio-/chemotherapy, no local recurrence or metastasis and no death occurred. We conclude that the spindle cell type of MBC with myoepithelial features exhibits a higher frequency of PIK3CA mutation than other types of metaplastic or basal-like breast cancer and may benefit from combined radio-/chemotherapy. Classical pathological parameters are not helpful in identifying the high-risk tumors among this subgroup of MBC.
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spelling pubmed-49787642016-08-18 Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer Leo, Fabian Bartels, Stephan Mägel, Lavinia Framke, Theodor Büsche, Guntram Jonigk, Danny Christgen, Matthias Lehmann, Ulrich Kreipe, Hans Virchows Arch Original Article Metaplastic breast carcinoma (MBC) comprises a heterogeneous group of tumors with difficult to predict biological behavior. A subset of MBC, characterized by spindle-shaped tumor cells with a myoepithelial-like immunophenotype, was entered into a retrospective study (n = 42, median follow-up time 43 months). Molecular parameters (DNA sequences of mutation hot spots in AKT1, ALK, APC, BRAF, CDH1, CTNNB1, EGFR, ERBB2, FBXW7, FGFR2, FOXL2, GNAQ, GNAS, KIT, KRAS, MAP2K1, MET, MSH6, NRAS, PDGFRA, PIK3CA, PTEN, SF3B1, SMAD4, SRC, SRSF2, STK11, TP53, and U2AF1; copy numbers for EGFR, c-myc, FGFR, PLAG, c-met) were assessed. None of the patients had axillary lymph node involvement. In 13 cases, local recurrence developed after surgery (30.9 %). Distant metastasis occurred in seven patients (17 %; four after local recurrence). The most frequent genetic alteration was PIK3CA mutation (50 % of cases). None of the pathological parameters (size, grade, stage, Ki-67 labeling index) was significantly associated with disease-free survival (DFS) or overall survival (OS). PIK3CA mutation, especially the H1047R type, tended to adversely affect OS. Type of resection (mastectomy vs. breast-conserving therapy, width of margins) or adjuvant radiotherapy had no influence on DFS or OS, whereas in the group treated with radio-/chemotherapy, no local recurrence or metastasis and no death occurred. We conclude that the spindle cell type of MBC with myoepithelial features exhibits a higher frequency of PIK3CA mutation than other types of metaplastic or basal-like breast cancer and may benefit from combined radio-/chemotherapy. Classical pathological parameters are not helpful in identifying the high-risk tumors among this subgroup of MBC. Springer Berlin Heidelberg 2016-05-25 2016 /pmc/articles/PMC4978764/ /pubmed/27220763 http://dx.doi.org/10.1007/s00428-016-1950-9 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Leo, Fabian
Bartels, Stephan
Mägel, Lavinia
Framke, Theodor
Büsche, Guntram
Jonigk, Danny
Christgen, Matthias
Lehmann, Ulrich
Kreipe, Hans
Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
title Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
title_full Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
title_fullStr Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
title_full_unstemmed Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
title_short Prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
title_sort prognostic factors in the myoepithelial-like spindle cell type of metaplastic breast cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978764/
https://www.ncbi.nlm.nih.gov/pubmed/27220763
http://dx.doi.org/10.1007/s00428-016-1950-9
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