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LEA 135 expression in primary invasive breast cancer
The Breast (2002) 11, 529–530 r 2002 Elsevier Science Ltd. All rights reserved. doi:10.1054/brst.2002.0440, available online at http://www.idealibrary.com on
CORRESPONDENCE
study comprised a more usual mix of size, grade and lymph node stage. Thirdly, grade was not a significant prognostic factor in the Liu et al. study. We find this surprising as grade has been widely demonstrated to be a powerful prognostic factor in primary breast carcinoma. The method used in their series is dated and may explain the unusual distribution of grade with a preponderance of grade three tumours and lack of grade one tumours. This differences in case type may also have contributed to the discrepancies seen between our study and theirs.
LEA 135 expression in primary invasive breast cancer
Sir, Luminal epithelial antigen (LEA-135) expression has been found to be an independent and favourable prognostic marker in primary breast cancer.1,2 However, studies are few and have not been validated by independent researchers. We have investigated the prognostic significance of this sialoglycoprotein in breast cancer using immunohistochemistry in formalinfixed, paraffin-embedded tissue. Ninety-eight (n=98) tumour samples were examined. All cases were treated in one unit, had mastectomy with axillary node sampling and careful long-term follow-up. Each case has been characterized according to grade,3 type,4 size, lymph node status, vascular invasion,5 Nottingham Prognostic Index6 and oestrogen receptor status. LEA expression and scoring were performed using the identical technique as previously described.1,2 Univariate analysis showed only oestrogen receptor status to be statistically significantly associated with LEA 135 expression (P=0.04) and a possible trend for local recurrence (P=0.061). No association was found with lymph node stage (P=0.47), vascular invasion (P=0.82), size (P=0.16), age (P=0.42), menopausal status (P=0.19), histological grade (P=0.09) or Nottingham Prognostic Index (NPI) (P=0.37). These results contrast sharply with those of Baltayan et al., where LEA 135 was found to be a significantly independent and favourable prognostic marker in univariate and multivariate analyses.1,2 We believe there may be several reasons for the differences observed. Firstly, patients treated in Nottingham received no adjuvant treatment and so represent a more ‘pure’ reflection of prognosis. Secondly, our
R. S. Rampaul, MBBS1 S. E. Pinder, FRCPath2 J. F. R. Robertson, MD FRCS1 I. O. Ellis, FRCPath2 Departments of 1Surgery and 2Pathology, City Hospital, University of Nottingham, Nottingham, UK References 1. Baltayan A, Taylor C R, Imam S A. Effect of LEA-135 expression on the progression of breast cancer [Abs]. The Breast 1999; 8: 223. 2. Liu D, Naritoku W Y, Tsao-Wei D, Groshen S et al. LEA.135 expression: an independent and favourable prognostic biomarker for patients with invasive breast cancer. Int J Cancer 2000; 89(3): 224–229. 3. Elston C W, Ellis I O. Pathological prognostic factors in breast cancer. I. The value of histological, grade in breast cancer: experience from a large study with long-term follow up. Histopathology 1991; 19: 403–410. 4. Ellis I O, Galea M, Broughton N, Locker A et al. Pathological prognostic factors in breast cancer. II. Histologic type. Relationship with survival in a large study with long-term follow-up. Histopathology. 1992; 20: 479–489. 5. Pinder S E, Ellis I O, Galea M, O’Rouke S et al. Pathological prognostic factors in breast cancer. III. Vascular invasion: relationship with recurrence and survival in a large study with long-term follow-up. Histopathology 1994; 24(l): 41–47. 6. Elston C W, Ellis I O et al. Confirmation of a prognostic index in primary breast cancer. Br J Cancer 1987; 56: 489–492.
doi:10.1054/brst.2002.0473, available online at http://www.idealibrary.com on
re: Is massage following dye injection necessary in sentinel node biopsy in breast cancer Sir, I am writing to you regarding the paper entitled ‘Is massage following dye injection necessary in sentinel node biopsy in breast cancer’ by V. Shenoy et al. published in the current Journal of The Breast 2003; 11: 273–274.
I read this with interest as a devotee to the triple technique in sentinel node mapping to include scintigram, blue dye and gamma probe. It is, of course, vitally important that all breast surgeons get trained in the technique of sentinel node mapping and we hope to proctor the introduction of the operation once the results of the ALMANAC Trial become known, where patients are randomly assigned to have either sentinel node mapping or routine axillary surgery. The randomised
529
CORRESPONDENCE
study comprised a more usual mix of size, grade and lymph node stage. Thirdly, grade was not a significant prognostic factor in the Liu et al. study. We find this surprising as grade has been widely demonstrated to be a powerful prognostic factor in primary breast carcinoma. The method used in their series is dated and may explain the unusual distribution of grade with a preponderance of grade three tumours and lack of grade one tumours. This differences in case type may also have contributed to the discrepancies seen between our study and theirs.
LEA 135 expression in primary invasive breast cancer
Sir, Luminal epithelial antigen (LEA-135) expression has been found to be an independent and favourable prognostic marker in primary breast cancer.1,2 However, studies are few and have not been validated by independent researchers. We have investigated the prognostic significance of this sialoglycoprotein in breast cancer using immunohistochemistry in formalinfixed, paraffin-embedded tissue. Ninety-eight (n=98) tumour samples were examined. All cases were treated in one unit, had mastectomy with axillary node sampling and careful long-term follow-up. Each case has been characterized according to grade,3 type,4 size, lymph node status, vascular invasion,5 Nottingham Prognostic Index6 and oestrogen receptor status. LEA expression and scoring were performed using the identical technique as previously described.1,2 Univariate analysis showed only oestrogen receptor status to be statistically significantly associated with LEA 135 expression (P=0.04) and a possible trend for local recurrence (P=0.061). No association was found with lymph node stage (P=0.47), vascular invasion (P=0.82), size (P=0.16), age (P=0.42), menopausal status (P=0.19), histological grade (P=0.09) or Nottingham Prognostic Index (NPI) (P=0.37). These results contrast sharply with those of Baltayan et al., where LEA 135 was found to be a significantly independent and favourable prognostic marker in univariate and multivariate analyses.1,2 We believe there may be several reasons for the differences observed. Firstly, patients treated in Nottingham received no adjuvant treatment and so represent a more ‘pure’ reflection of prognosis. Secondly, our
R. S. Rampaul, MBBS1 S. E. Pinder, FRCPath2 J. F. R. Robertson, MD FRCS1 I. O. Ellis, FRCPath2 Departments of 1Surgery and 2Pathology, City Hospital, University of Nottingham, Nottingham, UK References 1. Baltayan A, Taylor C R, Imam S A. Effect of LEA-135 expression on the progression of breast cancer [Abs]. The Breast 1999; 8: 223. 2. Liu D, Naritoku W Y, Tsao-Wei D, Groshen S et al. LEA.135 expression: an independent and favourable prognostic biomarker for patients with invasive breast cancer. Int J Cancer 2000; 89(3): 224–229. 3. Elston C W, Ellis I O. Pathological prognostic factors in breast cancer. I. The value of histological, grade in breast cancer: experience from a large study with long-term follow up. Histopathology 1991; 19: 403–410. 4. Ellis I O, Galea M, Broughton N, Locker A et al. Pathological prognostic factors in breast cancer. II. Histologic type. Relationship with survival in a large study with long-term follow-up. Histopathology. 1992; 20: 479–489. 5. Pinder S E, Ellis I O, Galea M, O’Rouke S et al. Pathological prognostic factors in breast cancer. III. Vascular invasion: relationship with recurrence and survival in a large study with long-term follow-up. Histopathology 1994; 24(l): 41–47. 6. Elston C W, Ellis I O et al. Confirmation of a prognostic index in primary breast cancer. Br J Cancer 1987; 56: 489–492.
doi:10.1054/brst.2002.0473, available online at http://www.idealibrary.com on
re: Is massage following dye injection necessary in sentinel node biopsy in breast cancer Sir, I am writing to you regarding the paper entitled ‘Is massage following dye injection necessary in sentinel node biopsy in breast cancer’ by V. Shenoy et al. published in the current Journal of The Breast 2003; 11: 273–274.
I read this with interest as a devotee to the triple technique in sentinel node mapping to include scintigram, blue dye and gamma probe. It is, of course, vitally important that all breast surgeons get trained in the technique of sentinel node mapping and we hope to proctor the introduction of the operation once the results of the ALMANAC Trial become known, where patients are randomly assigned to have either sentinel node mapping or routine axillary surgery. The randomised
529