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Predictive relevance of tumor-infiltrating lymphocytes in breast cancer
S60
Pathology (2014), 46(S2)
PATHOLOGY 2014 ABSTRACT SUPPLEMENT
Breast Pathology: Poster#057 PHYLLODES TUMOR AND PERIDUCTAL STROMAL TUMOR OF THE BREAST – ONE OR TWO ENTITIES? Alesˇ Rysˇ ka, Miroslav Podhola and Dimitar Hadzˇi Nikolov The Fingerland Department of Pathology, Charles University Medical Faculty Hospital, Hradec Kra´love´, Czech Republic Periductal stromal tumor (PST) is a recently described fibroepithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. The cytologic characteristics of the mesenchymal elements are virtually identical to those seen in phyllodes tumors (PT), with epithelial cells are lining cleft-like spaces. The main difference of the two above mentioned entities is thus the shape and demarcation of the neoplasm (encapsulated or at least well demarcated in PT versus infiltrative uncircumscribed in PST) and in their growth pattern. Despite their close resemblance are PT and PST regarded as two separate entities. Case report: A 40-year-old female underwent 9 operations of her right breast. In the initial surgery in 1996, a classical low-grade PT, 35 mm in diameter was removed with positive resection margin. During the follow up period of 18 years, the lesion recurred 8 times; 7 times as a typical PST and once (4th recurrence) as PT. The microscopic appearance of the stromal component of all lesions had the same features: primitive mesenchymal tissue with elongated/spindled cells with oval nuceli and inconspicuous cytoplasm were haphazardly distributed in myxoid intercellular matrix. Sometimes, fascicular growth was seen. Mitotic activity was moderate with 2–11 mitoses per 10 HPF. No heterologous component was identified. Immunohistochemically, the stromal elements in PT and PST were identical. Conclusion: This case suggests that PT and PST are not two separate entities but merely two growth patterns of the same lesion. Breast Pathology: Poster#058 PREDICTIVE RELEVANCE OF TUMOR-INFILTRATING LYMPHOCYTES IN BREAST CANCER Tanin Titipungul1, Nipon Chaisuriya2, Sakda Waraasawapati2, Supinda Koonmee2 and Sakkarn Sangkhamanon2 1Department of Pathology, Mahasarakham Hospital, Mahasarakham, Thailand, and 2Department of Pathology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Tumor-infiltrating lymphocytes (TILs) are considered to be a manifestation of the host anti-tumor response. We aim to evaluate the prognostic significance of the immunophenotype, density and distribution of TILs in breast cancer samples. This was a retrospective study, using paraffin-embedded samples obtained from 43 breast cancer patients, treated at Mahasarakham Hospital between 2012 and 2013. TILs and prognostic markers were evaluated by immunohistochemical staining of tissue microarray cores, employing monoclonal antibodies to lymphocyte markers (i.e., CD3, CD4, CD8 and CD20) and markers for breast cancer (i.e., ER, PR, HER2 and Ki-67). TILs were categorized into: 1) intratumoral lymphocytes (ITLs) when found within tumor cell nests), and
2) peritumoral lymphocytes (PTLs) when infiltrating into the stroma, adjacent to the invasive front of tumor. Results: A positive correlation was found between high density CD8þ PTLs and breast carcinoma without lymph node metastasis ( p ¼ 0.044), and an inverse correlation was found between the density of CD4þ PTLs and estrogen receptor expression ( p ¼ 0.027). The density of CD8þ PTLs as well as the number of CD20þ ITLs were independently, positively correlated with tumor size. Breast Pathology: Poster#059 PREDICTORS OF SURVIVAL IN YOUNG VERSUS POSTMENOPAUSAL PATIENTS WITH BREAST CANCER Eva K. Drinka, Abenaa Brewster, Roland L. Bassett, Dawen Sui and Mary E. Edgerton UT MD Anderson Cancer Center, USA 464 yount patients (YP; 20–35 years old) and 748 postmenopausal patients (PMP; 65–75 years old) with breast cancer during 1999– 2005 and with complete data for ER, PR, Her2neu, nuclear grade, stage, lymphovascular invasion (LVI), nodal status, treatment details, and race were analyzed. Patients were divided into Luminal A (ER/PR positive, Her2neu negative), Luminal B (ER/PR positive, Her2neu positive), Her2neu (ER/PR negative, Her2neu positive), and triple negative (ER/PR negative, Her2neu negative) categories. Univariate and multivariate analysis was performed using overall survival (OS). All of the previously listed variables showed significant difference between the YP and the PMP except for the percentage of patients receiving radiation ( p < 0.0001). In multivariate analysis of OS for both groups taken together, age was not a significant predictor. However, breast cancer subtype, stage, LVI, nodal status, chemotherapy, and type of surgical procedure are significant predictors of OS. For YP alone, OS is dependent upon breast cancer subtype, nuclear grade, stage, LVI, and type of surgical procedure. For PMP alone OS is breast cancer subtype and nodal status. We conclude that the higher prevalence of more aggressive breast cancer, and the prevalence of higher stage due to lack of screening, in younger women accounts for these differences. Breast Pathology: Poster#060 REPRODUCIBILITY IN THE ASSESSMENT OF HER2 DISH IN BREAST CANCER Tauangtham Anekpuritanang1, Thiamjit Chaichana1 and Shanop Shuangshoti2 1Department of Pathology, and 2Chulalongkorn GenePRO Center, Research affair, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand HER2 gene status is an important biological marker that determines both the prognosis and response to Trastuzumab in patients with breast cancers. Although FISH assay has long been used to determine HER2 gene copy number, DISH is gaining popularity since it can be assessed with a conventional microscope. Because the DISH test relies on an individual inspection, inter-observer variation might be an issue. In the current study, reproducibility in the assessment of HER2 DISH test was evaluated in 69 breast cancer
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
Pathology (2014), 46(S2)
PATHOLOGY 2014 ABSTRACT SUPPLEMENT
Breast Pathology: Poster#057 PHYLLODES TUMOR AND PERIDUCTAL STROMAL TUMOR OF THE BREAST – ONE OR TWO ENTITIES? Alesˇ Rysˇ ka, Miroslav Podhola and Dimitar Hadzˇi Nikolov The Fingerland Department of Pathology, Charles University Medical Faculty Hospital, Hradec Kra´love´, Czech Republic Periductal stromal tumor (PST) is a recently described fibroepithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. The cytologic characteristics of the mesenchymal elements are virtually identical to those seen in phyllodes tumors (PT), with epithelial cells are lining cleft-like spaces. The main difference of the two above mentioned entities is thus the shape and demarcation of the neoplasm (encapsulated or at least well demarcated in PT versus infiltrative uncircumscribed in PST) and in their growth pattern. Despite their close resemblance are PT and PST regarded as two separate entities. Case report: A 40-year-old female underwent 9 operations of her right breast. In the initial surgery in 1996, a classical low-grade PT, 35 mm in diameter was removed with positive resection margin. During the follow up period of 18 years, the lesion recurred 8 times; 7 times as a typical PST and once (4th recurrence) as PT. The microscopic appearance of the stromal component of all lesions had the same features: primitive mesenchymal tissue with elongated/spindled cells with oval nuceli and inconspicuous cytoplasm were haphazardly distributed in myxoid intercellular matrix. Sometimes, fascicular growth was seen. Mitotic activity was moderate with 2–11 mitoses per 10 HPF. No heterologous component was identified. Immunohistochemically, the stromal elements in PT and PST were identical. Conclusion: This case suggests that PT and PST are not two separate entities but merely two growth patterns of the same lesion. Breast Pathology: Poster#058 PREDICTIVE RELEVANCE OF TUMOR-INFILTRATING LYMPHOCYTES IN BREAST CANCER Tanin Titipungul1, Nipon Chaisuriya2, Sakda Waraasawapati2, Supinda Koonmee2 and Sakkarn Sangkhamanon2 1Department of Pathology, Mahasarakham Hospital, Mahasarakham, Thailand, and 2Department of Pathology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Tumor-infiltrating lymphocytes (TILs) are considered to be a manifestation of the host anti-tumor response. We aim to evaluate the prognostic significance of the immunophenotype, density and distribution of TILs in breast cancer samples. This was a retrospective study, using paraffin-embedded samples obtained from 43 breast cancer patients, treated at Mahasarakham Hospital between 2012 and 2013. TILs and prognostic markers were evaluated by immunohistochemical staining of tissue microarray cores, employing monoclonal antibodies to lymphocyte markers (i.e., CD3, CD4, CD8 and CD20) and markers for breast cancer (i.e., ER, PR, HER2 and Ki-67). TILs were categorized into: 1) intratumoral lymphocytes (ITLs) when found within tumor cell nests), and
2) peritumoral lymphocytes (PTLs) when infiltrating into the stroma, adjacent to the invasive front of tumor. Results: A positive correlation was found between high density CD8þ PTLs and breast carcinoma without lymph node metastasis ( p ¼ 0.044), and an inverse correlation was found between the density of CD4þ PTLs and estrogen receptor expression ( p ¼ 0.027). The density of CD8þ PTLs as well as the number of CD20þ ITLs were independently, positively correlated with tumor size. Breast Pathology: Poster#059 PREDICTORS OF SURVIVAL IN YOUNG VERSUS POSTMENOPAUSAL PATIENTS WITH BREAST CANCER Eva K. Drinka, Abenaa Brewster, Roland L. Bassett, Dawen Sui and Mary E. Edgerton UT MD Anderson Cancer Center, USA 464 yount patients (YP; 20–35 years old) and 748 postmenopausal patients (PMP; 65–75 years old) with breast cancer during 1999– 2005 and with complete data for ER, PR, Her2neu, nuclear grade, stage, lymphovascular invasion (LVI), nodal status, treatment details, and race were analyzed. Patients were divided into Luminal A (ER/PR positive, Her2neu negative), Luminal B (ER/PR positive, Her2neu positive), Her2neu (ER/PR negative, Her2neu positive), and triple negative (ER/PR negative, Her2neu negative) categories. Univariate and multivariate analysis was performed using overall survival (OS). All of the previously listed variables showed significant difference between the YP and the PMP except for the percentage of patients receiving radiation ( p < 0.0001). In multivariate analysis of OS for both groups taken together, age was not a significant predictor. However, breast cancer subtype, stage, LVI, nodal status, chemotherapy, and type of surgical procedure are significant predictors of OS. For YP alone, OS is dependent upon breast cancer subtype, nuclear grade, stage, LVI, and type of surgical procedure. For PMP alone OS is breast cancer subtype and nodal status. We conclude that the higher prevalence of more aggressive breast cancer, and the prevalence of higher stage due to lack of screening, in younger women accounts for these differences. Breast Pathology: Poster#060 REPRODUCIBILITY IN THE ASSESSMENT OF HER2 DISH IN BREAST CANCER Tauangtham Anekpuritanang1, Thiamjit Chaichana1 and Shanop Shuangshoti2 1Department of Pathology, and 2Chulalongkorn GenePRO Center, Research affair, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand HER2 gene status is an important biological marker that determines both the prognosis and response to Trastuzumab in patients with breast cancers. Although FISH assay has long been used to determine HER2 gene copy number, DISH is gaining popularity since it can be assessed with a conventional microscope. Because the DISH test relies on an individual inspection, inter-observer variation might be an issue. In the current study, reproducibility in the assessment of HER2 DISH test was evaluated in 69 breast cancer
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.