ABSTRACT
Peutz-Jeghers syndrome is a rare autosomal dominantly inherited condition, characterized by the presence of hamartomatous gastrointestinal polyps and mucocutaneous pigmentation. Patients with this syndrome can be associated with other neoplasms such as ovarian neoplasms known as sex-cord tumor with annular tubules that are associated in one third of the cases with this syndrome and other types of malignancies. We report a 42-year-old woman with a history of Peutz-Jeghers Syndrome and bilateral breast cancer that presented with abnormal uterine bleeding. Total abdominal hysterectomy with bilateral salpino-oophorectomy was done and an ovarian sex cord tumor with annular tubules was incidentally diagnosed. By reviewing literatures and in agreement with previous studies we suggest routine screening for malignancies in patients with Peutz-Jeghers syndrome.
ABSTRACT
BACKGROUND: Normal breast ducts contain at least 3 types of epithelial cells: luminal (glandular) cells, basal/myoepithelial cells and stem cells. Myoepithelial and luminal epithelia can be distinguished by their different cytokeratin expression patterns. The aim of this study is to evaluate the expression of some prognostic biomarkers (ER, PR and HER2), as well as histological grading and lymph node status in cytokeratin-based groups of breast cancer. OBJECTIVE: To evaluate the correlation between expression of basal and luminal markers and hormonal receptors, HER2/neu, age, grade and lymph node status in breast-invasive ductal carcinoma. MATERIALS AND METHODS: Sixty-seven formalin-fixed and paraffin-embedded breast cancer specimens (of invasive ductal carcinoma, 'NOS' type) which had already been studied for ER, PR and HER2/neu were selected. Data concerning age, tumor grade and lymph node status were also obtained from archives. Expression of basal (CK5/6) and luminal (CK7) cytokeratins was detected by immunohistochemistry. Stained sections were classified according to the intensity of staining and the percentage of stained cells. RESULTS: We categorized the cases into 3 distinct phenotype groups: pure luminal, basal phenotype and null. Pure basal, mixed basal and luminal groups were classified as expressing a basal phenotype. There was a significant difference in the ER and/or PR expression between those 3 groups and a significant association between ER and/or PR negativity and basal phenotype expression. There was no significant difference in HER2/neu expression, age of the patients, tumor grade and lymph node status between the 3 cytokeratin-based groups and no significant association between lymph node status and basal phenotype expression. CONCLUSION: We found that to gain a real association between basal phenotype and prognostic markers, we should use a cocktail or a panel of different biomarkers to correctly determine basal-like phenotype of breast cancers. This approach guarantees more concordance with gene expression-based studies.
Subject(s)
Biomarkers, Tumor/genetics , Breast Neoplasms/genetics , Carcinoma, Ductal/genetics , Keratin-5/genetics , Keratin-6/genetics , Keratin-7/genetics , Adult , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Carcinoma, Ductal/diagnosis , Carcinoma, Ductal/pathology , ErbB Receptors/genetics , Female , Gene Expression , Humans , Middle Aged , Phenotype , Prognosis , Receptors, Estrogen/genetics , Receptors, Progesterone/geneticsABSTRACT
BACKGROUND: Down-regulation of the epithelial cell-cell adhesion molecule E-cadherin is frequently associated with tumor formation and progression in breast cancer. The aim of this study is the assessment of relationship between E-cadherin expression and routine prognostic biomarkers as well as grading and lymph node status in breast invasive ductal carcinomas. . The associations between co-expression of E-cadherin and other biomarkers on one hand and grading, proliferating index and lymph node status on the other have also been evaluated. OBJECTIVE: To evaluate the correlation of E-cadherin expression and routine immunohistochemistry panel in breast invasive ductal carcinoma. METHODS: 108 formalin-fixed and paraffin-embedded breast cancer specimens (of invasive ductal carcinoma "NOS" type) from the pathology archive of Alzahra hospital(Isfahan, Iran) which had been studied for expression of routine molecular biomarkers were selected. E-cadherin expression was detected by immunohistochemistry. Stained sections were classified according to the intensity of staining and the percentage of cells showing E-cadherin staining. RESULTS: No association was found between E-cadherin alteration and ER, PR, p53, Ki67 and HER2/neu status of breast cancer. However, E-cadherin alteration showed a significant difference between grading and also lymph node groups. There was no association between co-expression of E-cadherin/ER, E-cadherin/PR, E-cadherin/Her-2neu, E-cadherin/p53 and Her-2neu/p53 on one hand and Ki67 status and tumor grade on the other. Co-expressions of E-cadherin/Her-2neu and E-cadherin/p53 showed significant difference in lymph node groups. CONCLUSION: We found that E-cadherin alteration in breast cancer has an association with other important prognostic factors. Evaluation of E-cadherin status can help, independently or in addition to conventional biological prognostic markers, to identify prognosis of breast cancer.
