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A study of high-nuclear-grade breast cancer in Thailand: subclassification and correlation with prognostic factors and immunohistochemical study.
Breast Cancer. 2010; 17(1):35-41.BC

Abstract

OBJECTIVES

To classify high-nuclear-grade breast cancer (BC) into typical medullary carcinoma (TMC), atypical medullary carcinoma (AMC), and non-medullary carcinoma (NMC), and luminal A, luminal B, and HER2, and to correlate these tumors with other prognostic factors.

MATERIALS AND METHODS

A retrospective study reviewing high-nuclear-grade BCs. The patients' age, histologic types, various histologic features, axillary lymph node (ALN) status, and results of immunohistochemical (IHC) study were recorded and analyzed.

RESULTS

One-hundred and eighty-one cases of high-nuclear-grade BCs were reviewed and categorized into IDC, NOS (140, 77.3%), TMC (1, 0.6%), AMC (21, 11.6%), and others (19, 10.5%). The median age was younger in AMC than in NMC patients. NMC patients had a higher incidence of LVI and ALN metastasis with involvement of more than four lymph nodes (p = 0.006) whereas AMC patients had a higher mitotic index. Forty-six (35.9%) cases were triple-negative (TN), including 1 (100%), 7 (53.9%) and 38 (33.3%) cases of TMC, AMC, and NMC, respectively. AMC had a significantly lower number of node metastases (p = 0.006) than NMC; whereas TN had higher MI (p = 0.001) than non-TN. The non-TN group was subclassified into luminal A, luminal B, and HER2. Of these, TN and luminal B occurred at younger age (p = 0.01) whereas TN and luminal A had a higher mitotic count. TN had lower incidence of LNM including higher number of LNM.

CONCLUSION

Overall, AMC-TN group showed a basal-like prognostic factor expression. NMC may be separated into TN and non-TN, with possibly different behavior. These sub-groupings should continue to be used. Interestingly, luminal A in our study tended to correlate with poor prognostic factors, thus, luminal A with high nuclear grade may not be representative of the usual luminal group profiles.

Authors+Show Affiliations

Department of Pathology, Chiangmai University, Thailand. bchaiwun_a@yahoo.co.thNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19789946

Citation

Chaiwun, Benjaporn, et al. "A Study of High-nuclear-grade Breast Cancer in Thailand: Subclassification and Correlation With Prognostic Factors and Immunohistochemical Study." Breast Cancer (Tokyo, Japan), vol. 17, no. 1, 2010, pp. 35-41.
Chaiwun B, Nakrungsee S, Sukhamwang N, et al. A study of high-nuclear-grade breast cancer in Thailand: subclassification and correlation with prognostic factors and immunohistochemical study. Breast Cancer. 2010;17(1):35-41.
Chaiwun, B., Nakrungsee, S., Sukhamwang, N., & Srisukho, S. (2010). A study of high-nuclear-grade breast cancer in Thailand: subclassification and correlation with prognostic factors and immunohistochemical study. Breast Cancer (Tokyo, Japan), 17(1), 35-41. https://doi.org/10.1007/s12282-009-0174-0
Chaiwun B, et al. A Study of High-nuclear-grade Breast Cancer in Thailand: Subclassification and Correlation With Prognostic Factors and Immunohistochemical Study. Breast Cancer. 2010;17(1):35-41. PubMed PMID: 19789946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A study of high-nuclear-grade breast cancer in Thailand: subclassification and correlation with prognostic factors and immunohistochemical study. AU - Chaiwun,Benjaporn, AU - Nakrungsee,Saranyu, AU - Sukhamwang,Neelaya, AU - Srisukho,Songphol, PY - 2009/05/22/received PY - 2009/08/12/accepted PY - 2009/10/1/entrez PY - 2009/10/1/pubmed PY - 2010/3/3/medline SP - 35 EP - 41 JF - Breast cancer (Tokyo, Japan) JO - Breast Cancer VL - 17 IS - 1 N2 - OBJECTIVES: To classify high-nuclear-grade breast cancer (BC) into typical medullary carcinoma (TMC), atypical medullary carcinoma (AMC), and non-medullary carcinoma (NMC), and luminal A, luminal B, and HER2, and to correlate these tumors with other prognostic factors. MATERIALS AND METHODS: A retrospective study reviewing high-nuclear-grade BCs. The patients' age, histologic types, various histologic features, axillary lymph node (ALN) status, and results of immunohistochemical (IHC) study were recorded and analyzed. RESULTS: One-hundred and eighty-one cases of high-nuclear-grade BCs were reviewed and categorized into IDC, NOS (140, 77.3%), TMC (1, 0.6%), AMC (21, 11.6%), and others (19, 10.5%). The median age was younger in AMC than in NMC patients. NMC patients had a higher incidence of LVI and ALN metastasis with involvement of more than four lymph nodes (p = 0.006) whereas AMC patients had a higher mitotic index. Forty-six (35.9%) cases were triple-negative (TN), including 1 (100%), 7 (53.9%) and 38 (33.3%) cases of TMC, AMC, and NMC, respectively. AMC had a significantly lower number of node metastases (p = 0.006) than NMC; whereas TN had higher MI (p = 0.001) than non-TN. The non-TN group was subclassified into luminal A, luminal B, and HER2. Of these, TN and luminal B occurred at younger age (p = 0.01) whereas TN and luminal A had a higher mitotic count. TN had lower incidence of LNM including higher number of LNM. CONCLUSION: Overall, AMC-TN group showed a basal-like prognostic factor expression. NMC may be separated into TN and non-TN, with possibly different behavior. These sub-groupings should continue to be used. Interestingly, luminal A in our study tended to correlate with poor prognostic factors, thus, luminal A with high nuclear grade may not be representative of the usual luminal group profiles. SN - 1880-4233 UR - https://www.unboundmedicine.com/medline/citation/19789946/A_study_of_high_nuclear_grade_breast_cancer_in_Thailand:_subclassification_and_correlation_with_prognostic_factors_and_immunohistochemical_study_ L2 - https://dx.doi.org/10.1007/s12282-009-0174-0 DB - PRIME DP - Unbound Medicine ER -