Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
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Background: Pure mucinous carcinoma (PMC) is a rare type of breast cancer, estimated to represent 2% of invasive breast cancer. PMC is typically positive for estrogen receptors (ER) and progesterone receptors (PR) and negative for human epidermal growth factor receptor 2 (HER2). The clinicopathologic characteristics of HER2-positive PMC have not been investigated. Methods: Pathology archives were searched for PMC diagnosed from January 1999 to April 2018. Clinicopathologic data and microscopic findings were reviewed and compared between HER2-positive PMC and HER2-negative PMC. We also analyzed the differences in disease-free survival (DFS) and overall survival according to clinicopathologic parameters including HER2 status in overall PMC cases. Results: There were 21 HER2-positive cases (4.8%) in 438 PMCs. The average tumor size of HER2-positive PMC was 32.21 mm (± 26.55). Lymph node metastasis was present in seven cases. Compared to HER2-negative PMC, HER2-positive PMC presented with a more advanced T category (p < .001), more frequent lymph node metastasis (p = .009), and a higher nuclear and histologic grade (p < .001). Microscopically, signet ring cells were frequently observed in HER2-positive PMC (p < .001), whereas a micropapillary pattern was more frequent in HER2-negative PMC (p = .012). HER2-positive PMC was more frequently negative for ER (33.3% vs. 1.2%) and PR (28.6% vs. 7.2%) than HER2-negative PMC and showed a high Ki-67 labeling index. During follow-up, distant metastasis and recurrence developed in three HER2-positive PMC patients. Multivariate analysis revealed that only HER2-positivity and lymph node status were significantly associated with DFS. Conclusions: Our results suggest that HER2-positive PMC is a more aggressive subgroup of PMC. HER2 positivity should be considered for adequate management of PMC.
Abstract
Background: Pure mucinous carcinoma (PMC) is a rare type of breast cancer, estimated to represent 2% of invasive breast cancer. PMC is typically positive for estrogen receptors (ER) and progesterone receptors (PR) and negative for human epidermal growth factor receptor 2 (HER2). The clinicopathologic characteristics of HER2-positive PMC have not been investigated. Methods: Pathology archives were searched for PMC diagnosed from January 1999 to April 2018. Clinicopathologic data and microscopic findings were reviewed and compared between HER2-positive PMC and HER2-negative PMC. We also analyzed the differences in disease-free survival (DFS) and overall survival according to clinicopathologic parameters including HER2 status in overall PMC cases. Results: There were 21 HER2-positive cases (4.8%) in 438 PMCs. The average tumor size of HER2-positive PMC was 32.21 mm (± 26.55). Lymph node metastasis was present in seven cases. Compared to HER2-negative PMC, HER2-positive PMC presented with a more advanced T category (p < .001), more frequent lymph node metastasis (p = .009), and a higher nuclear and histologic grade (p < .001). Microscopically, signet ring cells were frequently observed in HER2-positive PMC (p < .001), whereas a micropapillary pattern was more frequent in HER2-negative PMC (p = .012). HER2-positive PMC was more frequently negative for ER (33.3% vs. 1.2%) and PR (28.6% vs. 7.2%) than HER2-negative PMC and showed a high Ki-67 labeling index. During follow-up, distant metastasis and recurrence developed in three HER2-positive PMC patients. Multivariate analysis revealed that only HER2-positivity and lymph node status were significantly associated with DFS. Conclusions: Our results suggest that HER2-positive PMC is a more aggressive subgroup of PMC. HER2 positivity should be considered for adequate management of PMC.
참고문헌 (21)
- Lakhani SR, "WHO classification of tumours of the breast" (2012), IARC Press
- Di Saverio S, "A retrospective review with long term follow up of 11, 400 cases of pure mucinous breast carcinoma", Breast Cancer Res Treat, 111, pp.541~547 (2008)
- Barkley CR, "Mucinous breast carcinoma : a large contemporary series", Am J Surg, 196, pp.549~551 (2008)
- Lacroix-Triki M, "Mucinous carcinoma of the breast is genomically distinct from invasive ductal carcinomas of no special type", J Pathol, 222, pp.282~298 (2010)
- Loibl S, "HER2-positive breast cancer", Lancet, 389, pp.2415~2429 (2017)
- Soo Youn Bae, "Mucinous Carcinoma of the Breast in Comparison with Invasive Ductal Carcinoma: Clinicopathologic Characteristics and Prognosis", Journal of Breast Cancer, 14(4), pp.308~313 (2011), 한국유방암학회
- Pan B, "Prognosis of subtypes of the mucinous breast carcinoma in Chinese women : a population-based study of 32-year experience(1983-2014)", Oncotarget, 7, pp.38864~38875 (2016)
- Ranade A, "Clinicopathological evaluation of 100 cases of mucinous carcinoma of breast with emphasis on axillary staging and special reference to a micropapillary pattern", J Clin Pathol, 63, pp.1043~1047 (2010)
- Hammond ME, "American Society of Clinical Oncology", College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer, 2010, pp.28, 2784~2795
- Wolff AC, "Recommendations for human epidermal growth factor receptor 2 testing in breast cancer : American Society of Clinical Oncology", College of American Pathologists clinical practice guideline update, 2013, pp.31, 3997~4013
- Fu J, "Clinical nomogram for predicting survival outcomes in early mucinous breast cancer", PLoS One, 11, pp.e0164921~ (2016)
- Avisar E, "Pure mucinous carcinoma of the breast : a clinicopathologic correlation study", Ann Surg Oncol, 5, pp.447~451 (1998)
- Burstein HJ, "The distinctive nature of HER2-positive breast cancers", N Engl J Med, 353, pp.1652~1654 (2005)
- Gwark SC, "Clinical implication of HER2 status in hormone receptor-positive mucinous breast cancer", Ann Surg Oncol, 26, pp.2166~2174 (2019)
- 장윤정, "Human Epidermal Growth Factor Receptor 2-positive Mucinous Carcinoma with Signet Ring Cell Differentiation, Which Showed Complete Response after Neoadjuvant Chemotherapy", Journal of Breast Cancer, 22(2), pp.336~340 (2019), 한국유방암학회[DOI]
- 김혜민, "Mucinous Carcinoma with Extensive Signet Ring Cell Differentiation: A Case Report", Journal of Pathology and Translational Medicine, 51(2), pp.176~179 (2017), 대한병리학회[DOI]
- Leung KM, "Ductal type signet ring cell carcinoma of breast with growth pattern of pure mucinous carcinoma", Pathology, 43, pp.282~284 (2011)
- Varga Z, "Preferential HER-2", neu overexpression and, Histopathology, pp.2004, 44[DOI]
- Barbashina V, "Mucinous micropapillary carcinoma of the breast : an aggressive counterpart to conventional pure mucinous tumors", Hum Pathol, 44, pp.1577~1585 (2013)
- 김현정, "Prognostic Significance of a Micropapillary Pattern in Pure Mucinous Carcinoma of the Breast: Comparative Analysis with Micropapillary Carcinoma", Journal of Pathology and Translational Medicine, 51(4), pp.403~409 (2017), 대한병리학회[DOI]
- Xu X, "Micropapillary pattern in pure mucinous carcinoma of the breast : does it matter or not", Histopathology, 74, pp.248~255 (2019)