Different patterns of inflammation and prognosis in invasive carcinoma of the breast

Lee, A H S; Gillett, Cheryl; Ryder, Ken; Fentiman, Ian S.; Miles, David; Millis, Rosemary R.

doi:10.1111/j.1365-2559.2006.02410.x

Cited by 84 publications

(70 citation statements)

References 37 publications

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“…10,14 This is, at least in part, likely to be linked to histological grade as there is strong correlation between histological grade and intensity of inflammation 10 and 95% of tumours in the present series were grade 3. The separation of inflammation into two groups (absent and mild vs moderate and marked) was based on previous studies.…”

Section: Discussionmentioning

confidence: 83%

“…[11][12][13] Also, if the Ridolfi criteria are strictly applied then less than 1% of carcinomas are of this type. 14 In addition, medullary carcinomas also share histological and immunophenotypic features with tumours that arise in carriers of BRCA1 germ-line mutations, which have a poor prognosis. 15 This study aimed to test the hypotheses that medullary histological features are associated with each other and with a better prognosis in invasive basal-like carcinomas.…”

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confidence: 99%

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Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast

Marginean

Rakha

et al. 2010

Modern Pathology

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Medullary carcinomas have a better prognosis than other grade 3 mammary carcinomas, but they typically show basal-like biological features, which are associated with a poor prognosis. In this study we examined the associations and prognostic relevance of medullary histological features in a series of 165 invasive carcinomas with a basal-like phenotype: triple-negative (oestrogen receptor, progesterone receptor, HER2) and expressing at least one basal marker (CK5/6, CK14, CK17 or EGFR). The following histological features were associated with each other: prominent inflammation, anastomosing sheets, absence of fibrosis, absence of infiltrative margin and absence of gland formation. Prominent inflammation and anastomosing sheets in at least 30% of the tumour were associated with a better prognosis on univariate analysis. The combination of these two features (a simplified definition of medullary-like type) was present in 17% of tumours and was an independent prognostic factor on multivariate analysis. This simplified definition had good inter-observer reproducibility (j ¼ 0.61) and is worthy of more detailed assessment in an unselected group of mammary carcinomas. A fibrotic focus was present in 36% of carcinomas. Only 3% of tumours with a fibrotic focus had features of medullary-like carcinomas. Fibrotic focus of greater than 30% of the tumour was associated with a poor prognosis. This study emphasizes the heterogeneity of morphology and behaviour of triple-negative basal-like carcinomas.

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Section: Discussionmentioning

confidence: 83%

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confidence: 99%

Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast

Marginean

Rakha

et al. 2010

Modern Pathology

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“…Lymphocytic infiltrate is known to be associated with good prognosis (Lee et al, 2006), and a recent study by Kreike et al (2007) focused on triple-negative sporadic breast tumours revealed that 5-year metastasis-free survival in patients with a moderate or large amount of lymphocytic infiltrate in their tumours was 88%, which was higher than for those with minimal or no lymphocytic infiltrate. In our case it was not possible to determine whether the signature could predict patient outcome independently of infiltrate status, due to the almost perfect correlation between the presence of infiltrate and absence of angioinvasion, but the same results in an independent series support the biological significance of the immune response in the classification of ER-negative BRCA1 tumours.…”

Section: Signatures Associated With Brca1 Tumoursmentioning

confidence: 99%

Gene expression profiling integrated into network modelling reveals heterogeneity in the mechanisms of BRCA1 tumorigenesis

et al. 2009

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BACKGROUND: Gene expression profiling has distinguished sporadic breast tumour classes with genetic and clinical differences. Less is known about the molecular classification of familial breast tumours, which are generally considered to be less heterogeneous. Here, we describe molecular signatures that define BRCA1 subclasses depending on the expression of the gene encoding for oestrogen receptor, ESR1. METHODS: For this purpose, we have used the Oncochip v2, a cancer-related cDNA microarray to analyze 14 BRCA1-associated breast tumours. RESULTS: Signatures were found to be molecularly associated with different biological processes and transcriptional regulatory programs. The signature of ESR1-positive tumours was mainly linked to cell proliferation and regulated by ER, whereas the signature of ESR1-negative tumours was mainly linked to the immune response and possibly regulated by transcription factors of the REL/NFkB family. These signatures were then verified in an independent series of familial and sporadic breast tumours, which revealed a possible prognostic value for each subclass. Over-expression of immune response genes seems to be a common feature of ER-negative sporadic and familial breast cancer and may be associated with good prognosis. Interestingly, the ESR1-negative tumours were substratified into two groups presenting slight differences in the magnitude of the expression of immune response transcripts and REL/NFkB transcription factors, which could be dependent on the type of BRCA1 germline mutation. CONCLUSION: This study reveals the molecular complexity of BRCA1 breast tumours, which are found to display similarities to sporadic tumours, and suggests possible prognostic implications.

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“…The presence of inflammatory cells may represent an immune response to the tumour, but could also potentially exhibit pro-tumour effects including stimulation of tumour invasion or angiogenesis. Some studies have reported that a dense lymphohistiocytic infiltrate is associated with a favourable prognosis [3,4], however, other reports have shown an association between prominent inflammation and a poor patient outcome [5]. A detailed understanding of the functional peculiarities and phenotype of individual T lymphocyte subtypes may explain this paradox [6].…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the clinical significance of FOXP3+ infiltrating cells in human breast cancer

Mahmoud

Paish

Powe

et al. 2010

Breast Cancer Res Treat

159

115

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Different patterns of inflammation and prognosis in invasive carcinoma of the breast

Abstract: Moderate or marked diffuse inflammation in breast cancer is associated with a better prognosis, suggesting that the immune effects of the inflammation predominate over the protumour effects.

Cited by 84 publications

References 37 publications

Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast

Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast

Gene expression profiling integrated into network modelling reveals heterogeneity in the mechanisms of BRCA1 tumorigenesis

An evaluation of the clinical significance of FOXP3+ infiltrating cells in human breast cancer

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