Prognostic value of poorly differentiated clusters in invasive breast cancer

Abstract

BackgroundOur study aimed to assess the prognostic value of poorly differentiated clusters (PDCs) in invasive breast cancer.MethodsA total of 146 cases of operable invasive ductal carcinoma that was not otherwise specified (IDC-NOS), from 2002 to 2009, were pathologically reviewed. Cancer clusters with five or more cancer cells and lacking gland-like structures were counted from a field containing maximum clusters in H & E slides under a × 20 objective lens (0.950 mm2 field of vision).ResultsTumors with <5, 5 to 9, and ≥10 clusters were graded as G1, G2, and G3, respectively (n =41, 60, and 45 tumors, respectively). An interobserver test showed good reproducibility, with a Cohen’s kappa coefficient of 0.739. The PDC grade was significantly associated with N stage (P <0.001), lymphovascular invasion (P =0.007), tumor budding grade (P <0.001), relapse rate (P <0.001), and death rate (P <0.001). Survival analyses revealed that the PDC grade was a significant prognostic factor for disease-free survival (hazard ratio 3.811; P <0.001) and overall survival (hazard ratio 3.730; P =0.001), independent of T stage, N stage, or tumor budding grade.ConclusionsThe PDC grade is an independent prognostic factor of IDC-NOS. Considering the simplicity and availability of this method relative to conventional clinical pathology, PDCs may serve as a novel prognostic histological characteristic in IDC-NOS.

Her-2/neu overexpression in breast cancers in patients of West African extraction seen in Lagos state University Teaching hospital, Nigeria

“…Rasheed and colleagues found that poorly differentiated invasive ductal carcinoma have high Her-2/neu positivity [8]. Sun et al found that poorly differentiated clusters in invasive breast cancer is also associated with Her-2/neu overexpression [20]. This outcome cannot be effectively compared with our study in view of the fact that most of the tumours fall into grade II and III.…”

A novel 3D in vitro metastasis model elucidates differential invasive strategies during and after breaching basement membrane

“…While many models suggest metastasis begins with individual cells undergoing the epithelialmesenchymal transition (EMT) and leaving the boundaries of the primary tumor, analysis of tumor-stroma interfaces in clinical samples has revealed that it is the presence of invasive cell clusters [42], also termed tumor buds, that correlates with metastatic progression and poor prognosis in various solid tumor types [43][44][45][46][47]. This highlights the importance of understanding the cellular and molecular underpinnings of collective cancer cell invasion and the need for physiologically relevant in vitro models supporting this crucial mode of invasion.…”

Poorly differentiated clusters in colorectal cancer: a current review and implications for future practice

“…Three studies have evaluated the prognostic significance of PDC in other carcinoma types, including Crohn's disease-associated small bowel adenocarcinoma, [54][55][56] breast carcinoma and auditory canal carcinoma, with all finding high PDC grade to be significantly associated with adverse clinical outcomes. Interestingly, PDC grade in breast and auditory canal carcinomas was associated with strong interobserver agreement (kappa values 0.74 and 0.89, respectively), similar to that reported for CRC.…”