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1899 Correlation between Ki-67 and FISH testing of HER2 IHC 1+ early invasive breast cancer
Abstracts postmenopausal) were used as material for the study. Populations and subpopulations of lymphocytes were determined in tissue homogenates using FACSCantoII (BD) flow cytometer. Of the total number of CD45+ lymphocytes, the percentage of lymphocytes expressing CD3, CD4, CD8, CD19, CD16/56 markers was calculated. Results: There were no statistically significant differences in CD3+ levels in tumor tissues in dependence on the reproductive status of the patients, though T-lymphocyte subpopulations differed in the reproductive and menopausal groups. A higher content of CD3+CD8+ was observed in tumors of patients of the reproductive group in comparison with the perimenopausal and postmenopausal groups (56.5±7.3, 37.2±2.95 and 37.4±2.1%, respectively; p < 0.05). Level of CD3+CD4+ cells was lower in patients with maintained ovarian-menstrual function (34.6±6.4% against 50.3±3.2% in perimenopausal and 45.4±1.55% in postmenopausal patients). The postmenopausal group was characterized by a lower content of NK cells in tumor in comparison with the reproductive group, except for luminal A breast cancer in which levels of NK cells did not differ in postmenopausal and reproductive patients. The other differences were observed in all biological subtypes of BC (luminal A, luminal B, HER2-neu+ and triple negative BC). Conclusions: Lymphocytic content in BC tissue depends on the reproductive status of patients. No conflict of interest. 1899 POSTER Correlation between Ki-67 and FISH testing of HER2 IHC 1+ early invasive breast cancer A.C. Latorre1 , L. Caldarola2 , S. Petroni2 , F. Giotta1 , V. Lorusso1 , I. Trotti2 , G. Simone2 . 1 IRCCS Onc. Pap Giovanni Paolo II, Medical Oncology Unit, Bari, Italy; 2 IRCCS Onc. Pap Giovanni Paolo II, Pathology Department, Bari, Italy. Background: HER2 gene amplification or overexpression in invasive breast cancer (IBC) has been demonstrated to be a parameter for bad prognosis. Diagnostic assays for HER2 expression have a high predictive value because HER2 positive tumors can benefit from target therapy with trastuzumab.The aim of the present study is to analyze the incidence of HER2 gene amplification and to assess if it would be clinically useful to test HER2 gene amplification in selected tumors with adverse prognostic features scoring 1+ by immunohistochemistry (IHC). Material and Methods: Seventy-five cases of early IBC in women who underwent elective surgery in 2013 entered the study. According to the histotype, 61 tumors were classified as infiltrating ductal carcinoma (IDC) and 14 as infiltrating lobular carcinoma (ILC) and received a HER2 score of 1+ by IHC. Among these, 48 IBC with unfavorable prognostic tumor characteristics were selected and tested by FISH. HER2 amplification was evaluated using the Vysis HER2/Cep17 probe (Path Vysion HER2 DNA Probe Kit® , Abbott Molecular, IL). In agreement with the ASCO/CAP/SIAPEC guidelines, HER2 ratio–based amplification was considered. Gene amplification was evaluated as present when the HER2/Cep17 ratio was 2 or more or when the mean HER2 copy number was more than 6. Results: In 2013, 331 consecutive IBC were tested by IHC for HER2 and 102 cases were scored (31%) 1+. We selected 75 patients, 61 IDC and 14 ILC (81% and 19% respectively), out of 102 cases scoring 1+ who had undergone radical elective surgery. Forty-eight IBC samples out of 75 (64%) (42 IDC and 6 ILC) were selected according to one or more unfavorable prognostic tumor characteristics (histological grade, proliferative index, absent hormone receptor expression, node positivity and vascular invasion); 22 (46%) showed high histological grade (G3), 23 (48%) had a high proliferative index (Ki-6730%), 32 (67%) were nodepositive, 27 (56%) showed vascular invasion; regarding hormone receptors expression, 3 (6%) showed no ER expression and 10 (21%) showed no PgR expression. FISH was performed on 48 IBC scoring 1+ by IHC and 7 IDC out of 48 (14.6%) showed HER2 amplification; all 7 samples showed a high proliferative index. In this subgroup, the statistical analysis with Fisher’s exact test evidenced a significant association between the presence of gene amplification and high proliferative index (P = 0.0094). Conclusions: Our retrospective data suggest that early IDC patients scoring HER2 1+ by IHC who show Ki-6730% must be tested by FISH because there is a significant association between HER2 amplification and high proliferative index. In this subgroup of patients Ki-6730% would represent a predictive factor of HER2 amplification. No conflict of interest.
S299 1900 POSTER Real-time RT-PCR quantification of human telomerase reverse transcriptase in breast cancer H. Abdel Raouf Shaban1 , K. Amr2 , M. Afify3 . 1 National Research Center, Immunogenetics, Giza, Egypt; 2 National Research Center, Medical Molecular Genetics, Giza, Egypt; 3 National Research Center, Biochemistry, Giza, Egypt Background: Telomerase is a cellular ribonucleoprotein reverse transcriptase (TERT), and telomerase RNA segments act as templates for the synthesis of telomeric DNA onto chromosomal ends. The enzyme telomerase catalyzes the de novo synthesis of telomere repeats, thereby maintaining telomere length, which is necessary for unlimited cellular proliferation. Human TERT is often detectable in cancerous cells but not in normal somatic cells Thus, hTERT has been proposed as a marker with diagnostic and prognostic potential in breast cancer. This study aimed to investigate expression of hTERT mRNA in peripheral blood and tissue of breast cancer patients and to present strategies for early detection screen test. Methods: Twenty-two breast cancer patients and twelve healthy individuals were studied. Expression of hTERT mRNA and GAPDH (RNA, as reference gene) were analyzed using quantitative real-time reverse transcriptasepolymerase chain reaction (RT-PCR) on total RNA from blood and tissue of breast cancer patients. An expression index (EI) was calculated for telomerase expression. Results: According to RT-qPCR results, the mean values of hTERT expression in the blood and tissue samples of the breast cancer patient were (5.74 EI & 59.66 EI) respectively where in healthy donors was (1.87 EI). The results also demonstrated that, hTERT expression in breast cancer patient showed 3.07 fold increases in relation to control. Conclusion: These results indicated that, telomerase activity could be a promising tumor marker for breast cancer. Also, the present results suggest the feasibility of using RT-PCR in routine screening of telomerase activity in blood specimens. However, more investigations with larger numbers of samples are needed to verify these results. No conflict of interest. 1901 POSTER Mammary tuberculosis in females: Simulating malignant lesion of the breast A. Setia1 , Sciences, Sciences, Sciences,
S.B. Sharma2 , G. Nirwal3 . 1 National institute of Medial General Surgery, Jaipur, India; 2 National Institute of Medical General Surgery, Jaipur, India; 3 National Institute of Medical General Seurgery, Jaipur, India
Background: Mammary tuberculosis is a rare entity and may be mistaken for malignant lesion of the breast. Our study analyses the clinical presentation of mammary tuberculosis mimicking malignancy of breast and the methodical diagnostic modalities in 5 such patients. Materials and Methods: In the year 2012–2014, five patients of Mammary Tuberculosis were treated at NIMS medical college, Jaipur, India and were included in this study. All the patients underwent an elaborate clinical examination, blood investigations, FNAC (Fine needle aspiration cytology) and/or Core biopsy and Ultrasonography. Results: Four patients presented with a lump, one of these had secondary skin changes, and fifth patient presented with diffuse swelling of the entire breast (n = 4+1). Associated pain was present in two patients and constitutional symptoms in three and two patients gave history of current or recent Lactation. Demonstration of Acid fast bacilli on staining and/or giant cells, Epithelioid granuloma and/or necrosis on histopathology clenched the diagnosis. Anti-tubercular therapy initiated after confirmation was the mainstay of treatment and resulted in complete resolution of the lump. Conclusion: Mammary Tuberculosis can mimic malignancy of breast clouding the clinical diagnosis. A step-wise approach in the form of clinical examination, radiological studies and histopathology and staining should be followed. USG is usually inconclusive but is very useful in obtaining core biopsy tissue samples. Unnecessary open biopsies should be avoided as far as possible. Anti-tubercular therapy should be initiated immediately after confirmation of the diagnosis. Surgical interventions can also be resorted to in non-responsive cases. No conflict of interest.
S299 1900 POSTER Real-time RT-PCR quantification of human telomerase reverse transcriptase in breast cancer H. Abdel Raouf Shaban1 , K. Amr2 , M. Afify3 . 1 National Research Center, Immunogenetics, Giza, Egypt; 2 National Research Center, Medical Molecular Genetics, Giza, Egypt; 3 National Research Center, Biochemistry, Giza, Egypt Background: Telomerase is a cellular ribonucleoprotein reverse transcriptase (TERT), and telomerase RNA segments act as templates for the synthesis of telomeric DNA onto chromosomal ends. The enzyme telomerase catalyzes the de novo synthesis of telomere repeats, thereby maintaining telomere length, which is necessary for unlimited cellular proliferation. Human TERT is often detectable in cancerous cells but not in normal somatic cells Thus, hTERT has been proposed as a marker with diagnostic and prognostic potential in breast cancer. This study aimed to investigate expression of hTERT mRNA in peripheral blood and tissue of breast cancer patients and to present strategies for early detection screen test. Methods: Twenty-two breast cancer patients and twelve healthy individuals were studied. Expression of hTERT mRNA and GAPDH (RNA, as reference gene) were analyzed using quantitative real-time reverse transcriptasepolymerase chain reaction (RT-PCR) on total RNA from blood and tissue of breast cancer patients. An expression index (EI) was calculated for telomerase expression. Results: According to RT-qPCR results, the mean values of hTERT expression in the blood and tissue samples of the breast cancer patient were (5.74 EI & 59.66 EI) respectively where in healthy donors was (1.87 EI). The results also demonstrated that, hTERT expression in breast cancer patient showed 3.07 fold increases in relation to control. Conclusion: These results indicated that, telomerase activity could be a promising tumor marker for breast cancer. Also, the present results suggest the feasibility of using RT-PCR in routine screening of telomerase activity in blood specimens. However, more investigations with larger numbers of samples are needed to verify these results. No conflict of interest. 1901 POSTER Mammary tuberculosis in females: Simulating malignant lesion of the breast A. Setia1 , Sciences, Sciences, Sciences,
S.B. Sharma2 , G. Nirwal3 . 1 National institute of Medial General Surgery, Jaipur, India; 2 National Institute of Medical General Surgery, Jaipur, India; 3 National Institute of Medical General Seurgery, Jaipur, India
Background: Mammary tuberculosis is a rare entity and may be mistaken for malignant lesion of the breast. Our study analyses the clinical presentation of mammary tuberculosis mimicking malignancy of breast and the methodical diagnostic modalities in 5 such patients. Materials and Methods: In the year 2012–2014, five patients of Mammary Tuberculosis were treated at NIMS medical college, Jaipur, India and were included in this study. All the patients underwent an elaborate clinical examination, blood investigations, FNAC (Fine needle aspiration cytology) and/or Core biopsy and Ultrasonography. Results: Four patients presented with a lump, one of these had secondary skin changes, and fifth patient presented with diffuse swelling of the entire breast (n = 4+1). Associated pain was present in two patients and constitutional symptoms in three and two patients gave history of current or recent Lactation. Demonstration of Acid fast bacilli on staining and/or giant cells, Epithelioid granuloma and/or necrosis on histopathology clenched the diagnosis. Anti-tubercular therapy initiated after confirmation was the mainstay of treatment and resulted in complete resolution of the lump. Conclusion: Mammary Tuberculosis can mimic malignancy of breast clouding the clinical diagnosis. A step-wise approach in the form of clinical examination, radiological studies and histopathology and staining should be followed. USG is usually inconclusive but is very useful in obtaining core biopsy tissue samples. Unnecessary open biopsies should be avoided as far as possible. Anti-tubercular therapy should be initiated immediately after confirmation of the diagnosis. Surgical interventions can also be resorted to in non-responsive cases. No conflict of interest.