Pleomorphic lobular carcinoma of the breast with osteoclast-like giant cells: a case report and review of the literature

Peña-Jaimes, Lourdes; González-García, Irene; Reguero-Callejas, María Eugenia; Pinilla-Pagnon, Ignacio; Pérez-Míes, Belén; Albarrán-Artahona, Víctor; Martínez-Jáñez, Noelia; Rosa-Rosa, Juan Manuel; Palacios, José

doi:10.1186/s13000-018-0744-6

Cited by 13 publications

(13 citation statements)

References 19 publications

(35 reference statements)

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“…Regarding cytomorphology (see Figure 1), 7 cases (26%) showed histiocytoid differentiation and 3 cases (11%) apocrine differentiation. This series included an uncommon case rich in osteoclast-like cells [23]. According to classification criteria [17,18], 17 PLCs (~63%) were luminal A, 5 (~19%) PLCs were luminal B, 4 (~15%) PLCs were triple negative and 1 (~4%) PLC was HER2-enriched.…”

Section: Resultsmentioning

confidence: 99%

High Frequency of ERBB2 Activating Mutations in Invasive Lobular Breast Carcinoma with Pleomorphic Features

Rosa-Rosa

Caniego-Casas

Leskelä

et al. 2019

Cancers

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Background: Characterisation of molecular alterations of pleomorphic lobular carcinoma (PLC), an aggressive subtype of invasive lobular carcinoma (ILC), have not been yet completely accomplished. Methods: To investigate the molecular alterations of invasive lobular carcinoma with pleomorphic features, a total of 39 tumour samples (in situ and invasive lesions and lymph node metastases) from 27 patients with nuclear grade 3 invasive lobular carcinomas were subjected to morphological, immunohistochemical and massive parallel sequencing analyses. Results: Our observations indicated that invasive lobular carcinomas with pleomorphic features were morphologically and molecularly heterogeneous. All cases showed absence or aberrant expression of E-cadherin and abnormal expression of β-catenin and p120. CDH1 (89%), PIK3CA (33%) and ERRB2 (26%) were the most common mutated genes. ERBB2 mutations preferentially affected the tyrosine-kinase activity domain, being the most frequent the targetable mutation p.L755S (57%). We also observed higher frequency of mutations in ARID1B, KMT2C, MAP3K1, TP53 and ARID1A in PLC than previously reported in classic ILC. Alterations related to progression from in situ to invasive carcinoma and/or to lymph node metastases included TP53 mutation, amplification of PIK3CA and CCND1 and loss of ARID1A expression. Conclusions: The high frequency of ERBB2 mutations observed suggests that ERBB2 mutation testing should be considered in all invasive lobular carcinomas with nuclear grade 3.

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Section: Resultsmentioning

confidence: 99%

High Frequency of ERBB2 Activating Mutations in Invasive Lobular Breast Carcinoma with Pleomorphic Features

Rosa-Rosa

Caniego-Casas

Leskelä

et al. 2019

Cancers

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“…Immunohistochemical studies suggest that OGCs originate from mesenchymal cells, particularly macrophages, in response to cytokines produced by cancer cells [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given this discrepancy, the prognosis in these patients is much more likely associated with the BC histology than with the presence or absence of OGCs [ 26 , 28 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Invasive Ductal Breast Cancer with Osteoclast-Like Giant Cells: A Case Report Based on the Gene Expression Profile for Changes in Management

Irelli

Sirufo

Quaglione³

et al. 2021

JPM

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We report the case of a 49-year-old woman diagnosed with a rare histotype of early breast cancer (BC), invasive ductal carcinoma with osteoclast-like giant cells (OGCs), from the perspective of gene profile analysis tests. The patient underwent a quadrantectomy of the right breast with removal of 2 cm neoplastic nodule and three ipsilateral sentinel lymph nodes. The Oncotype Dx gave a recurrence score (RS) of 23, and taking into account the patient’s age, an RS of 23 corresponds to a chemotherapy benefit of 6.5%. After a multidisciplinary collegial discussion, and in consideration of the patient’s age, the absence of comorbidity, the premenopausal state, the rare histotype and the Oncotype Dx report, the patient was offered adjuvant chemotherapy treatment followed by hormone therapy. This case may be an example of the utility of integrating gene expression profiling tests into clinical practice in the adjuvant treatment decision of a rare histotype BC. The Oncotype Dx test required to supplement the histological examination made us opt for the proposal of a combined treatment of adjuvant chemotherapy followed by adjuvant hormone therapy. It demonstrates the importance of considering molecular tests and, in particular, the Oncotype Dx, in estimating the risk of disease recovery at 10 years in order to identify patients who benefit from hormone therapy alone versus those who benefit from the addition of chemotherapy, all with a view toward patient-centered oncology. Here, we discuss the possible validity and limitations of the Oncotype Dx in a rare luminal A-like histotype with high infiltrate of stromal/inflammatory cells.

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“…Interestingly, cases reported were aged 43 to 84 with a median age of 49 years old, suggesting that this type of lesion is not menopausal-status specific [ 166 ]. Since then, around 200 breast cancer cases with osteoclast-like giant cells in both in situ and infiltrating lesions were reported [ 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 ]. Breast osteoclast-like giant cells were positive for CD68 [ 171 , 172 , 175 , 177 ] and CD163 [ 174 ] staining confirming their monocytic lineage.…”

Section: Evidence Of the Presence Of Osteoblastic And Osteoclasticmentioning

confidence: 99%

Breast Cancer and Microcalcifications: An Osteoimmunological Disorder?

Clemenceau

Michou

Diorio

et al. 2020

IJMS

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The presence of microcalcifications in the breast microenvironment, combined with the growing evidences of the possible presence of osteoblast-like or osteoclast-like cells in the breast, suggest the existence of active processes of calcification in the breast tissue during a woman’s life. Furthermore, much evidence that osteoimmunological disorders, such as osteoarthritis, rheumatoid arthritis, or periodontitis influence the risk of developing breast cancer in women exists and vice versa. Antiresorptive drugs benefits on breast cancer incidence and progression have been reported in the past decades. More recently, biological agents targeting pro-inflammatory cytokines used against rheumatoid arthritis also demonstrated benefits against breast cancer cell lines proliferation, viability, and migratory abilities, both in vitro and in vivo in xenografted mice. Hence, it is tempting to hypothesize that breast carcinogenesis should be considered as a potential osteoimmunological disorder. In this review, we compare microenvironments and molecular characteristics in the most frequent osteoimmunological disorders with major events occurring in a woman’s breast during her lifetime. We also highlight what the use of bone anabolic drugs, antiresorptive, and biological agents targeting pro-inflammatory cytokines against breast cancer can teach us.

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Pleomorphic lobular carcinoma of the breast with osteoclast-like giant cells: a case report and review of the literature

Cited by 13 publications

References 19 publications

High Frequency of ERBB2 Activating Mutations in Invasive Lobular Breast Carcinoma with Pleomorphic Features

High Frequency of ERBB2 Activating Mutations in Invasive Lobular Breast Carcinoma with Pleomorphic Features

Invasive Ductal Breast Cancer with Osteoclast-Like Giant Cells: A Case Report Based on the Gene Expression Profile for Changes in Management

Breast Cancer and Microcalcifications: An Osteoimmunological Disorder?

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