- Volume 13 Issue 9
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Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis
- Ch'ng, Ewe Seng (Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia) ;
- Sharif, Sharifah Emilia Tuan (Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia) ;
- Jaafar, Hasnan (Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia)
- Published : 2012.09.30
Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.
Supported by : Universiti Sains Malaysia
- Acenero MJF, Gallego MG, Ballesteros PA, Gonzalez JF (1998). Vascular density as a prognostic indicator for invasive ductal breast carcinoma. Virchows Arch, 432, 113-7. https://doi.org/10.1007/s004280050143
- Anderson TJ, Alexander FE, Lamb J, et al (2000). Pathology characteristics that optimize outcome prediction of a breast screening trial. Br J Cancer, 83, 487-92. https://doi.org/10.1054/bjoc.2000.1286
- Benoy IH, Salgado R, Elst H, et al (2005). Relative microvessel area of the primary tumour, and not lymph node status, predicts the presence of bone marrow micrometastases detected by reverse transcriptase polymerase chain reaction in patients with clinically non-metastatic breast cancer. Breast Cancer Res, 7, 210-9. https://doi.org/10.1186/bcr980
- Bhoo PN, Yip CH, Taib NA, et al (2011). Breast cancer in a multiethnic Asian setting: Results from the Singapore-Malaysia hospital-based breast cancer registry. The Breast, 20, 75-80.
- Bolat F, Kayaselcuk F, Nursal TZ, et al (2006). Microvessel density, VEGF expression, and tumor-associated macrophages in breast tumors: correlations with prognostic parameters. J Exp Clin Cancer Res, 25, 365-72.
- Dabrosin C (2005). Positive correlation between Estradiol and Vascular endothelial growth factor (VEGF) but not fibroblast growth factor-2 in normal human breast tissue in vivo. Clin Cancer Res, 11, 8036-41. https://doi.org/10.1158/1078-0432.CCR-05-0977
- Dako (2010). HercepTestTM Interpretation Manual - Breast. 1-49.
- Department of Statistics Malaysia (2011). Population Distribution and Basic Demographic Characteristics 2010, Department of Statistics Malaysia.
- Dhakal HP, Bassarova A, Naume B, et al (2009). Breast carcinoma vascularity: a comparison of manual microvessel count and Chalkley count. Histol Histopathol, 24, 1049-59.
- Dhillon HK, Singh HJ, Shuib R, et al (2006). Prevalence of menopausal symptoms in women in Kelantan, Malaysia. Maturitas, 54, 213-21. https://doi.org/10.1016/j.maturitas.2005.11.001
- Elston CW, Ellis IO (1991). pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term followup. Histopathology, 19, 403-10. https://doi.org/10.1111/j.1365-2559.1991.tb00229.x
- Folkman J (2002). Role of angiogenesis in tumor growth and metastasis. Semin Oncol, 29, 15-8.
- Foulkes WD, Smith IE, Reis-Filho JS (2010). Triple-Negative Breast Cancer. N Engl J Med, 363, 1938-48. https://doi.org/10.1056/NEJMra1001389
- Fox SB (2006), Quantitative Angiogenesis in Breast Cancer, in 'Breast Cancer Researh Protocols', eds S A. Brooks and A Harris, Humana Press, Totowa, New Jersey, pp. 161-87.
- Fox SB, Leek RD, Bliss J, et al (1997). Association of tumor angiogenesis with bone marrow micrometastases in breast cancer patients. J Natl Cancer Inst, 89, 1044-9. https://doi.org/10.1093/jnci/89.14.1044
- Francis GD, Dimech M, Giles L, Hopkins A (2007). Frequency and reliability of oestrogen receptor, progesterone receptor and HER2 in breast carcinoma determined by immunohistochemistry in Australasia: results of the RCPA Quality Assurance Program. J Clin Pathol, 60, 1277-83. https://doi.org/10.1136/jcp.2006.044701
- Fridman V, Humblet C, Bonjean K, Boniver J (2000). Assessment of tumor angiogenesis in invasive breast carcinomas: absence of correlation with prognosis and pathological factors. Virchows Arch, 437, 611-7. https://doi.org/10.1007/s004280000292
- Fuckar D, Dekanic A, Stifter S, et al (2006). VEGF Expression is Associated with Negative Estrogen Receptor Status in Patients with Breast Cancer. Int J Surgical Pathology, 14, 49-55. https://doi.org/10.1177/106689690601400109
- Gasparini G, Fox SB, Verderio P, et al (1996). Determination of angiogenesis adds information to estrogen receptor status in predicting the efficacy of adjuvant tamoxifen in nodepositive breast cancer patients. Clin Cancer Res, 2, 1191-8.
- Giatromanolaki A, Sivridis E, Koukourakis MI (2004). Tumour angiogenesis: vascular growth and survival. APMIS, 112, 431-40. https://doi.org/10.1111/j.1600-0463.2004.apm11207-0804.x
- Giatromanolaki A, Sivridis E, Simopoulos C, et al (2002). Differential assessment of angiogenic activity and of vascular survival ability (VSA) in breast cancer. Clin Exp Metastasis, 19, 673-9. https://doi.org/10.1023/A:1021354028685
- Grann VR, Troxel AB, Zojwalla NJ, et al (2005). Hormone receptor status and survival in a population-based cohort of patients with breast carcinoma. Cancer, 103, 2241-51. https://doi.org/10.1002/cncr.21030
- Hanahan D, Weinberg Robert A (2011). Hallmarks of Cancer: The Next Generation. Cell, 144, 646-74. https://doi.org/10.1016/j.cell.2011.02.013
- Koukourakis MI, Manolas C, Minopoulos G, et al (2003). Angiogenesis relates to estrogen receptor negativity, c-erbB-2 overexpression and early relapse in node-negative ductal carcinoma of the breast. Int J Surgical Pathol, 11, 29-34. https://doi.org/10.1177/106689690301100107
- Lal P, Tan LK, Chen B (2005). Correlation of HER-2 Status with estrogen and progesterone receptors and histologic features in 3,655 invasive breast carcinomas. Am J Clin Pathol, 123, 541-46. https://doi.org/10.1309/YMJ3A83TB39MRUT9
- Lee JS, Kim HS, Jung JJ, et al (2002). Expression of vascular endothelial growth factor (VEGF) in invasive ductal carcinoma of the breast and the relation to angiogenesis and p53 and HER-2/neu protein expression. Appl Immunohistochem Mol Morphol, 10, 289.
- Lester SC, Bose S, Chen YY, et al (2009). Protocol for the examination of specimens from patients with invasive carcinoma of the breast. Arch Pathol Lab Med, 133, 1515-38.
- Lim S-E, Back M, Quek E, et al (2007). Clinical Observations from a Breast Cancer Registry in Asian Women. World J Surg, 31, 1387-92. https://doi.org/10.1007/s00268-007-9086-3
- Ludovini V, Sidoni A, Pistola L, et al (2003). Evaluation of the Prognostic Role of Vascular Endothelial Growth Factor (VEGF) and Microvessel Density in Stages I and II Breast Cancer Patients. Breast Cancer Res Treat, 81, 159-68. https://doi.org/10.1023/A:1025755717912
- Marinho A, Soares R, Ferro J, et al (1997). Angiogenesis in breast cancer is related to age but not to other prognostic parameters. Pathol Res Pract, 193, 267. https://doi.org/10.1016/S0344-0338(97)80003-9
- Miliaras D, Kamas A, Kalekou H (1995). Angiogenesis in invasive breast carcinoma: is it associated with parameters of prognostic significance? Histopathology, 26, 165-9. https://doi.org/10.1111/j.1365-2559.1995.tb00647.x
- Ministry of Health Malaysia and Academy of Medicine Malaysia (2010). Clinical Practice Guidelines on Management of Breast Cancer, 2nd edn, Ministry of Health Malaysia, Putrajaya.
- Mohd Taib NA, Yip CH, Mohamed I (2008). Survival analysis of Malaysian women with breast cancer: results from the University of Malaya Medical Centre. Asian Pac J Cancer Prev, 9, 197-202.
- Mohd NF, Mohd SH, Abdullah N, Mohamed ML, et al (2006). Kelantan Cancer Registry Report 1999-2003, Kelantan Cancer Registry, Kota Bharu.
- NHSBSP (2005). Publication No 58 Pathology Reporting of Breast Disease, NHS Cancer Screening Programmes and The Royal College of Pathologists, Sheffield.
- Norsa'adah B, Rampal K, Rahmah M, et al (2011). Diagnosis delay of breast cancer and its associated factors in Malaysian women. BMC Cancer, 11, 141. https://doi.org/10.1186/1471-2407-11-141
- Offersen BV, Alsner J, Olsen KE, et al (2008). A comparison among HER2, TP53, PAI-1, angiogenesis, and proliferation activity as prognostic variables in tumours from 408 patients diagnosed with early breast cancer. Acta Oncol, 47, 618-32. https://doi.org/10.1080/02841860801958295
- Omar ZA, Ali ZM, Tamin NSI, et al (2010). Malaysian Cancer Statistics - Data and Figure Peninsular Malaysia 2006, National Cancer Registry, Kuala Lumpur.
- Parentes-Vieira JB, Lopes-Costa PV, Pires CG, et al (2007). Quantification of angiogenesis in estrogen receptor-positive and negative breast carcinoma. Int Seminars Surg Oncology, 4, 22. https://doi.org/10.1186/1477-7800-4-22
- Rakha E, Reis-Filho J, Baehner F, et al (2010). Breast cancer prognostic classification in the molecular era: the role of histological grade. Breast Cancer Res, 12, 207.
- Rakha EA, Ellis IO (2011). Modern classification of breast cancer: should we stick with morphology or convert to molecular profile characteristics. Adv Anat Pathol, 18, 255-67. https://doi.org/10.1097/PAP.0b013e318220f5d1
- Rhodes A, Jasani B, Balaton AJ, et al (2000). Frequency of oestrogen and progesterone receptor positivity by immunohistochemical analysis in 7016 breast carcinomas: correlation with patient age, assay sensitivity, threshold value, and mammographic screening. J Clin Pathol, 53, 688-96. https://doi.org/10.1136/jcp.53.9.688
- Sharifah NA, Lee BR, Clarence-Ko CH, et al (2008). C-erbB-2 onco-protein expression in breast cancer: relationship to tumour characteristics and short-term survival in Universiti Kebansaan Malaysia Medical Centre. Asian Pac J Cancer Prev, 9, 663-70.
- Sopel M, Kasprzyk I, Berdowska I (2005). Maspin and c-erbB-2 expression in correlation with microvessel density in invasive ductal breast cancer. Folia Histochem Cytobiol, 43, 109-16.
- Tan GH, Choo WY, Taib NA, Yip CH (2009a). Factors associated with her2 overexpression in breast cancer: experience in an Asian developing country. Asian Pac J Cancer Prev, 10, 837-40.
- Tan GH, Taib NA, Choo WY, et al (2009b). Clinical characteristics of triple-negative breast cancer: experience in an Asian developing country. Asian Pac J Cancer Prev, 10, 395-8.
- Tan YO, Han S, Lu Y-S, et al (2010). The prevalence and assessment of ErbB2-positive breast cancer in Asia. Cancer, 116, 5348-57. https://doi.org/10.1002/cncr.25476
- Teo NB, Shoker BS, Jarvis C, et al (2003). Angiogenesis and invasive recurrence in ductal carcinoma in situ of the breast. Eur J Cancer, 39, 38-44. https://doi.org/10.1016/S0959-8049(02)00248-4
- Teoh KH, Looi LM, Sabaratnam S, et al (2011). An analysis of predictive biomarkers in routine histopathological reporting of infiltrating ductal breast carcinoma in a tertiary hospital in Malaysia with a focus on limitations and directions for future development. Malays J Pathol, 33, 35-42.
- Thielemann A, Kopczynski Z, Filas V, et al (2008). The determination of VEGF and MVD, among patients with primary breast cancer. Pathol Oncol Res, 14, 137-44. https://doi.org/10.1007/s12253-008-9040-1
- Thorat MA, Mehrotra S, Morimiya A, Badve S (2009). COX-2 expression does not correlate with microvessel density in breast cancer. Pathobiology, 76, 39-44. https://doi.org/10.1159/000178154
- Uzzan B, Nicolas P, Cucherat M, Perret GY (2004). Microvessel density as a prognostic factor in women with breast cancer: a systematic review of the literature and meta-analysis. Cancer Res, 64, 2941-55. https://doi.org/10.1158/0008-5472.CAN-03-1957
- Valkovic T, Dobrila F, Melato M, et al (2002). Correlation between vascular endothelial growth factor (VEGF), angiogenesis, and tumor-associated macrophages in invasive ductal breast carcinoma. Virchows Arch, 440, 583-8. https://doi.org/10.1007/s004280100458
- Vogl G, Bartel H, Dietze O, Hauser-Kronberger C (2006). HER2 Is Unlikely to Be Involved in Directly Regulating Angiogenesis in Human Breast Cancer. Appl Immunohistochem Mol Morphol, 14, 138-45 https://doi.org/10.1097/01.pai.0000168591.58721.a6
- Weidner N, Semple JP, Welch WR, Folkman J (1991). Tumor angiogenesis and metastasis--correlation in invasive breast carcinoma. N Engl J Med, 324, 1-8. https://doi.org/10.1056/NEJM199101033240101
- Xie XD, Qu SX, Liu ZZ, et al (2009). Study on relationship between angiogenesis and micrometastases of peripheral blood in breast cancer. J Cancer Res Clin Oncol, 135, 413-9. https://doi.org/10.1007/s00432-008-0473-4
- Yip CH, Bhoo Pathy N, Uiterwaal CS, et al (2011). Factors affecting estrogen receptor status in a multiracial Asian country: An analysis of 3557 cases. The Breast, 20, 60-4.
- Zhou S, Wang G-P, Liu C, Zhou M (2006). Eukaryotic Initiation Factor 4E (eIF4E) and angiogenesis: prognostic markers for breast cancer. BMC Cancer, 6, 231. https://doi.org/10.1186/1471-2407-6-231
- In human invasive breast ductal carcinoma, tumor stromal macrophages and tumor nest macrophages have distinct relationships with clinicopathological parameters and tumor angiogenesis vol.462, pp.3, 2013, https://doi.org/10.1007/s00428-012-1362-4
- Triple Negative Breast Cancer vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2427
- Molecular essence and endocrine responsiveness of estrogen receptor-negative, progesterone receptor-positive, and HER2-negative breast cancer vol.13, pp.1, 2015, https://doi.org/10.1186/s12916-015-0496-z
- Expression of cluster of differentiationï¿½34 and vascular endothelial growth factor in breast cancer, and their prognostic significance pp.1792-1082, 2015, https://doi.org/10.3892/ol.2015.3348
- St Gallen molecular subtypes in feline mammary carcinoma and paired metastases—disease progression and clinical implications from a 3-year follow-up study vol.37, pp.3, 2016, https://doi.org/10.1007/s13277-015-4251-z