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Clinical and pathological correlations in male breast cancer: intratumoral aromatase expression via tissue microarray.
Breast Cancer Res Treat. 2007 Oct; 105(2):169-75.BC

Abstract

BACKGROUND

Male breast cancer (MBC) commonly expresses hormone receptors and there is anecdotal evidence of disease responsivity to aromatase inhibitors in the metastatic setting. Our objectives were to: (i) assess clinical-pathologic characteristics in a consecutive cohort of MBC (ii) evaluate intratumoral aromatase (ITA) expression via tissue microarray (TMA) and (iii) assess the prognostic impact of ITA METHODS: A retrospective review was conducted to identify all cases of MBC seen at the Nova Scotia Cancer Center between 1985 and 2005. Specimens were reviewed for standard pathologic characteristics and tumor blocks were incorporated into three TMA's (four 1 mm cores per tumor). Immunohistochemistry (IHC) for ER, PR, Her2-neu and ITA was performed blinded to clinical outcomes. ITA staining intensity was compared to control, benign hepatic tissue and if greater than or equal to liver was scored positive and if less than liver was scored negative. The log-rank test was used for survival comparisons and Kaplan-Meyer curves were used to estimate 3- and 5-year progression-free and overall survival probabilities.

RESULTS

Fifty-four cases were identified with a median age of 64 (31-85 years). Median tumor size was 2.6 cm (0.3-8.0 cm) and 22(41%) had nodal metastases. Forty-five cases had tissue available for IHC. Of these, 40 (89%) were ER and 33 (73%) were PR positive. Her2-neu was overexpressed in four cases (10%) and 12 (27%) were positive for ITA expression. ITA positive tumors were less likely to be grade 3, have lymphovascular invasion or nodal metastases and were more likely to be of favorable histology compared to ITA negative tumors. In univariate analysis strong (versus weak) ITA expression was associated with improved 5 year overall (92% vs. 49%, P = 0.038) but not progression-free (82% vs. 76% P = 0.44) survival rates.

CONCLUSIONS

Tumors with strong ITA expression may have a less aggressive phenotype compared to those with negative/weak ITA expression. Further investigation of ITA as a relevant prognostic factor as well as a potential therapeutic target in MBC is warranted.

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Authors+Show Affiliations

Dakin Haché K
Department of Pathology, Queen Elizabeth II Health Sciences Centre, 7th Floor, Mackenzie Building, 5788 University Avenue, Halifax, NS, Canada, B3H 1V8.
Gray S
No affiliation info available
Barnes PJ
No affiliation info available
Dewar R
No affiliation info available
Younis T
No affiliation info available
Rayson D
No affiliation info available

MeSH

AdultAgedAged, 80 and overAromataseBreast Neoplasms, MaleDisease ProgressionHumansImmunoenzyme TechniquesLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessPrognosisReceptors, EstrogenReceptors, ProgesteroneRetrospective StudiesSurvival RateTissue Array Analysis

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17268818

Citation

Dakin Haché, Kelly, et al. "Clinical and Pathological Correlations in Male Breast Cancer: Intratumoral Aromatase Expression Via Tissue Microarray." Breast Cancer Research and Treatment, vol. 105, no. 2, 2007, pp. 169-75.
Dakin Haché K, Gray S, Barnes PJ, et al. Clinical and pathological correlations in male breast cancer: intratumoral aromatase expression via tissue microarray. Breast Cancer Res Treat. 2007;105(2):169-75.
Dakin Haché, K., Gray, S., Barnes, P. J., Dewar, R., Younis, T., & Rayson, D. (2007). Clinical and pathological correlations in male breast cancer: intratumoral aromatase expression via tissue microarray. Breast Cancer Research and Treatment, 105(2), 169-75.
Dakin Haché K, et al. Clinical and Pathological Correlations in Male Breast Cancer: Intratumoral Aromatase Expression Via Tissue Microarray. Breast Cancer Res Treat. 2007;105(2):169-75. PubMed PMID: 17268818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and pathological correlations in male breast cancer: intratumoral aromatase expression via tissue microarray. AU - Dakin Haché,Kelly, AU - Gray,Samantha, AU - Barnes,Penny J, AU - Dewar,Ron, AU - Younis,Tallal, AU - Rayson,Daniel, Y1 - 2007/02/01/ PY - 2006/10/27/received PY - 2006/10/31/accepted PY - 2007/2/3/pubmed PY - 2008/1/11/medline PY - 2007/2/3/entrez SP - 169 EP - 75 JF - Breast cancer research and treatment JO - Breast Cancer Res Treat VL - 105 IS - 2 N2 - BACKGROUND: Male breast cancer (MBC) commonly expresses hormone receptors and there is anecdotal evidence of disease responsivity to aromatase inhibitors in the metastatic setting. Our objectives were to: (i) assess clinical-pathologic characteristics in a consecutive cohort of MBC (ii) evaluate intratumoral aromatase (ITA) expression via tissue microarray (TMA) and (iii) assess the prognostic impact of ITA METHODS: A retrospective review was conducted to identify all cases of MBC seen at the Nova Scotia Cancer Center between 1985 and 2005. Specimens were reviewed for standard pathologic characteristics and tumor blocks were incorporated into three TMA's (four 1 mm cores per tumor). Immunohistochemistry (IHC) for ER, PR, Her2-neu and ITA was performed blinded to clinical outcomes. ITA staining intensity was compared to control, benign hepatic tissue and if greater than or equal to liver was scored positive and if less than liver was scored negative. The log-rank test was used for survival comparisons and Kaplan-Meyer curves were used to estimate 3- and 5-year progression-free and overall survival probabilities. RESULTS: Fifty-four cases were identified with a median age of 64 (31-85 years). Median tumor size was 2.6 cm (0.3-8.0 cm) and 22(41%) had nodal metastases. Forty-five cases had tissue available for IHC. Of these, 40 (89%) were ER and 33 (73%) were PR positive. Her2-neu was overexpressed in four cases (10%) and 12 (27%) were positive for ITA expression. ITA positive tumors were less likely to be grade 3, have lymphovascular invasion or nodal metastases and were more likely to be of favorable histology compared to ITA negative tumors. In univariate analysis strong (versus weak) ITA expression was associated with improved 5 year overall (92% vs. 49%, P = 0.038) but not progression-free (82% vs. 76% P = 0.44) survival rates. CONCLUSIONS: Tumors with strong ITA expression may have a less aggressive phenotype compared to those with negative/weak ITA expression. Further investigation of ITA as a relevant prognostic factor as well as a potential therapeutic target in MBC is warranted. SN - 0167-6806 UR - https://www.unboundmedicine.com/medline/citation/17268818/Clinical_and_pathological_correlations_in_male_breast_cancer:_intratumoral_aromatase_expression_via_tissue_microarray_ L2 - https://doi.org/10.1007/s10549-006-9448-9 DB - PRIME DP - Unbound Medicine ER -