Race, Breast Cancer Subtypes, and Survival in the Carolina Breast Cancer Study

Carey, Lisa A.; Perou, Charles M.; Livasy, Chad; Dressler, Lynn G.; Cowan, David P.; Conway, Kathleen; Karaca, Gamze; Troester, Melissa A.; Tse, Chiu Kit; Edmiston, Sharon N.; Deming, Sandra L.; Geradts, Joseph; Cheang, Maggie C.U.; Nielsen, Torsten O.; Moorman, Patricia G.; Earp, H. Shelton; Millikan, Robert C.

doi:10.1001/jama.295.21.2492

Cited by 3,343 publications

(3,529 citation statements)

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“…These findings support the existence of distinct genetic pathways of tumor evolution, common to sporadic and FBC, which underlie the pathogenesis of the different breast tumor subtypes and may explain their distinct biological behavior. Furthermore, we would postulate that gene-expression profiling, clinical presentation and response to therapy also differ in the five FBC IHC subtypes, as already reported in SBC subtypes (Perou et al, 2000;Sorlie et al, 2001Sorlie et al, , 2003Carey et al, 2006;Hu et al, 2006). Taking into account these differences, the BC subtypes should be studied as distinct entities to better describe their features, as has been done for basal-like tumors Yehiely et al, 2006;VincentSalomon et al, 2007).…”

Section: Resultsmentioning

confidence: 54%

Distinct genomic aberration patterns are found in familial breast cancer associated with different immunohistochemical subtypes

et al. 2007

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Five breast cancer subtypes have been described in sporadic breast cancer (SBC) using expression arrays: basal-like, ERBB2, normal breast-like, luminal A and B. These molecular subtypes show different genomic aberration patterns (GAPs). Recently, our group described these breast cancer subtypes in 50 non-BRCA1/2 familial tumors using immunohistochemistry assays. We extended this study to the other classes of familial breast cancer (FBC), including 62 tumors (18 BRCA1, 16 BRCA2 and 28 non-BRCA1/2), with the same panel of 25 immunohistochemical (IHC) markers and histological grade obtaining a similar classification. We combined these data with results generated by a 1 Mb BAC array-based CGH study to evaluate the genomic aberrations of each group. We found that BRCA1-related tumors are preferentially basal-like, whereas non-BRCA1/2 familial tumors are mainly luminal A subtype. We described distinct GAPs related to each IHC subtype. Basal tumors had a greater number of gains/losses, while luminal B tumors had more high-level DNA amplifications. Our data are similar to those obtained in SBC studies, highlighting the existence of distinct genetic pathways of tumor evolution, common to both SBC and FBC.

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Section: Resultsmentioning

confidence: 54%

Distinct genomic aberration patterns are found in familial breast cancer associated with different immunohistochemical subtypes

et al. 2007

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“…17,18 Immunohistochemical marker panels that have been proposed to define basal-like breast cancers include: (1) lack of ER, PR, and HER2 expression ('triple-negative' immunophenotype); (2) expression of one or more high-molecular-weight/ basal cytokeratins (CK5/6, CK14, and CK17); (3) lack of expression of ER and HER2 in conjunction with expression of CK5/6 and/or epidermal growth factor receptor (EGFR); 17 and (4) lack of expression of ER, PR, and HER2 in conjunction with expression of CK5/6 and/or EGFR. 19 Despite the different definitions for basal-like breast cancers, it has been demonstrated that these tumors have distinctive clinical presentations, 20 histological features, 18,21 response to chemotherapy, [22][23][24][25][26][27][28] sites of distant relapse, and outcome. 7,9,[29][30][31] In brief, basal-like tumors comprise a heterogeneous group that accounts for up to 15% of all breast cancers, affect younger patients, are more prevalent in African-American women, and often present as interval cancers.…”

Section: What Is a Basal-like Breast Cancer?mentioning

confidence: 99%

Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists

et al. 2011

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Breast cancer is a heterogeneous disease encompassing a variety of entities with distinct morphological features and clinical behaviors. Although morphology is often associated with the pattern of molecular aberrations in breast cancers, it is also clear that tumors of the same histological type show remarkably different clinical behavior. This is particularly true for 'basal-like cancer', which is an entity defined using gene expression analysis. The purpose of this article was to review the current state of knowledge of basal-like breast cancers, to discuss the relationship between basal-like and triple-negative breast cancers, and to clarify practical implications of these diagnoses for pathologists and oncologists.

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“…Recently, cDNA microarrays of 496 genes of breast cancer tissue identified different prognostic subgroups based on differences in gene expression profiles [22][23][24]. This prognostic subgroup classification of breast cancers seems closely, but not completely, related to the immunohistochemical (IHC) classification of tumors according to their combined expression of hormone receptors and HER-2 [22,25,26]. The partial inconsistency between IHC ''phenotype'' and microarray ''genotype'' is not fully understood and might be partially related to technical issues of receptor determination.…”

Section: Introductionmentioning

confidence: 99%

Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

Brouckaert

Pintens

Belle

et al. 2008

Breast Cancer Res Treat

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Introduction Prognostic subgroup classification of operable breast cancers using cDNA clustering of breast cancer-related genes resembles the classification based on the combined immunohistochemical (IHC) expression of the hormone and HER-2 receptors. We here report the shortterm disease-free interval (DFI) of operable breast cancers by their joint hormone receptor/HER-2 phenotype. Patients and methods Short-term follow-up (FU) of a prospective cohort of 1,958 breast-cancer patients primary operated at our institution between 2000 and 2005. Receptors were evaluated using IHC. Steroid receptors were considered positive for any nuclear staining; HER-2 for strong (3+) membrane staining or positive fluorescence in situ hybridization (FISH). Kaplan-Meier (KM) DFI curves were calculated for any relapse defined as a local, regional, contralateral, or distant breast cancer event for the six predefined breast cancer subgroups: ER + PR + HER-2 -(PPN), ER + PR -HER-2 -(PNN), ER + PR + HER-2 + (PPP), ER -PR -HER-2 -(NNN), ER -PR -HER-2 + (NNP), and ER + PR -HER-2 + (PNP). P-values were calculated for comparison of the six different survival curves using two possible adaptations for multiple testing. A multivariate model for the receptors predicting DFI did incorporate local and systemic adjuvant therapy. Results Median patient age was 57 years (ranges 26-96) and median FU was 3.35 years. Overall, DFI at median FU was 91%; 94% for PPN, 89% for PNN, 86% for NNN, 81% for PPP, 80% for PNP, and 76% for NNP cases. Some receptor subgroups had a significantly better DFI than others based on multiple testing, especially when the PPN group was compared against the four most frequent subtypes. The multivariate model with local and systemic adjuvant therapy confirmed the prognostic value of ER, PR, and HER-2 for short-term DFI. Conclusion It is possible to distinguish short-term prognostic breast cancer subgroups only on the basis of ER, PR, and HER-2 even when stratified for local and systemic adjuvant therapy. While gene expression profiles based on microarray data of over hundreds of genes will probably teach us much about breast cancer biology, heterogeneity, and prognosis, we emphasize the important short-term prognostic value of currently used IHC markers for ER, PR, and HER-2.

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Race, Breast Cancer Subtypes, and Survival in the Carolina Breast Cancer Study

Cited by 3,343 publications

References 45 publications

Distinct genomic aberration patterns are found in familial breast cancer associated with different immunohistochemical subtypes

Distinct genomic aberration patterns are found in familial breast cancer associated with different immunohistochemical subtypes

Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists

Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

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