Breast cancer in English and Japanese women: Prognostic significance of sinus histiocytosis and germinal center hyperplasia in axillary lymph nodes

Abstract

A prospective study of comparable Japanese and British breast cancer patients treated by radical mastectomy confirmed previously reported findings that sinus histiocytosis and germinal center hyperplasia are more frequently seen in axillary lymph nodes from Japanese than in those from British patients. In Japanese, but not British, cases of either of these two morphologic findings had favorable prognostic significance for recurrence. Sinus histiocytosis also had favorable prognostic significance in Japanese cases for five year survival. In a separate review of axillary nodes from Japanese autopsy cases sinus histiocytosis was absent, suggesting that this finding in Japanese breast cancer cases was related to presence of the disease.

Expression of c‐erbB2 and p53 protein is similar in breast cancer from British and Japanese women

“…Indeed, the only pathological difference that has been previously noted in these 2 groups of patients is in histological features of the axillary lymph nodes. The incidences of both sinus histiocytosis and germinal center activity were found to be significantly higher in Japanese than in British women (Friedell et al, 1991).…”

“…Recent follow-up data were only available for the Anglo patients. The results of other comparative studies of clinical, biochemical, histopathological features and prognosis carried out on these patients have been reported previously Friedell et al, 1991;Allen et al, 1991;Miura et al, 1991;Sato and Suchi, 1991;Moore et al, 1991). For the present study, patients with pure in situ carcinoma and minimally invasive carcinoma were excluded, as were cases where insufficient material remained in the tissue blocks for immunohistochemical evaluation of c-erbB2 and p53 proteins.…”

“…It was therefore considered of interest to evaluate these markers in breast carcinoma from Japanese women and compare the incidence of their expression with that seen in tumors from British women. The Breast Cancer Unit at Guy's Hospital has previously undertaken several studies of various aspects of mammary carcinoma in conjunction with Japanese collaborators, comparing well-documented series of patients with long follow-up from both countries (Friedell et al, 1983(Friedell et al, , 1991Chaudary et al, 1991;Allen et al, 1991).…”

Prognostic significance of microvessel density and other variables in Japanese and British patients with primary invasive breast cancer

“…Several investigators have found that Japanese patients with breast cancer have a better survival than American or British patients (Wynder et al, 1963;Morrison et al, 1976;Friedel et al, 1991). There are several limitations to these hospital-based studies.…”

“…Improved survival from this cancer in the UK may be due to increased social interest, advances in diagnosis according to the NHS Breast Screening Programme, and development of adjuvant endocrine therapy and chemotherapy (Beral et al, 1995;Kobayashi, 2004). There is also strong evidence to suggest a population-dependent variation in the biology of breast cancer, such as ER status, p53 gene mutation, HER-2/neu, S-phase fraction, lymphatic infiltration, sinus histiocytosis, and certain histological patterns (Sakamoto et al, 1981;Friedel et al, 1991;Elledge et al, 1994;Merchant et al, 1999). Differences in these biologic characteristics do not explain the relatively high survival rate of Japanese breast cancer patients.…”