TY - JOUR
T1 - A novel morphologic-molecular recurrence predictive model refines traditional prognostic tools for invasive breast carcinoma
T2 - Ni Y-B, Tsang JYS, Chan SK, et al (The Chinese Univ of Hong Kong; Kwong Wah Hosp, Hong Kong, China) Ann Surg Oncol 21:2928-2933, 2014
AU - Gilcrease, M. Z.
PY - 2015
Y1 - 2015
N2 - Background. -Histologic grade, TNM stage, and NottinghamPrognostic Index are traditional prognostic tools for breast cancer. ±IHC-molecular" classification of breast cancer can also identify patients at different recurrence risks and provides insight into cancer therapy. However, cancers in each group are heterogeneous. A model based on the comprehensive analysis of morphologic features and molecular subtype was constructed to predict recurrence and refine these traditional prognostic tools. Methods. -Morphologic features including histologic grade, fibrotic focus, extensive intraductal component, lymphocytic infiltrate, lymphovascular invasion, tumor necrosis, tumor margin and TNM stage, and molecular subtypes approximated by immunohistochemistry were analyzed in 633 patients with invasive breast carcinoma (excluding those with HER2 targeted therapy). Significant independent predictors for recurrence included: high histologic grade (p 1/4 0.004), presence of lymphovascular invasion (p1/4 0.004), fibrotic focu (p1/4 0.020), mild lymphocytic infiltrate (p1/4 0.013), high TNM stage (p > 0.001), and HER2- overexpressing (p1/4 0.004) and basallike (p > 0.001) molecular subtypes. A morphologic-molecular recurrence predictive model based on these features was useful in recurrence prediction, independent of treatment modalities, and was able to refine the traditional prognostic tools of histologic grade, TNM stage, and Nottingham prognostic index, particularly for intermediate-risk groups, and to refine the luminal group molecular subtypes. Such findings were reproducible with a validation cohort. Conclusion. -TNM stage, histologic grade, lymphovascular invasion, fibrotic focus, mild lymphocytic infiltrate, HER2-overexpressing and basallike molecular subtypes were important independent recurrence risk factors for breast cancer. This morphologicmolecular model was robust in recurrence prediction and refined recurrence risk stratified by the traditional prognostic parameters, independent of treatment modalities.
AB - Background. -Histologic grade, TNM stage, and NottinghamPrognostic Index are traditional prognostic tools for breast cancer. ±IHC-molecular" classification of breast cancer can also identify patients at different recurrence risks and provides insight into cancer therapy. However, cancers in each group are heterogeneous. A model based on the comprehensive analysis of morphologic features and molecular subtype was constructed to predict recurrence and refine these traditional prognostic tools. Methods. -Morphologic features including histologic grade, fibrotic focus, extensive intraductal component, lymphocytic infiltrate, lymphovascular invasion, tumor necrosis, tumor margin and TNM stage, and molecular subtypes approximated by immunohistochemistry were analyzed in 633 patients with invasive breast carcinoma (excluding those with HER2 targeted therapy). Significant independent predictors for recurrence included: high histologic grade (p 1/4 0.004), presence of lymphovascular invasion (p1/4 0.004), fibrotic focu (p1/4 0.020), mild lymphocytic infiltrate (p1/4 0.013), high TNM stage (p > 0.001), and HER2- overexpressing (p1/4 0.004) and basallike (p > 0.001) molecular subtypes. A morphologic-molecular recurrence predictive model based on these features was useful in recurrence prediction, independent of treatment modalities, and was able to refine the traditional prognostic tools of histologic grade, TNM stage, and Nottingham prognostic index, particularly for intermediate-risk groups, and to refine the luminal group molecular subtypes. Such findings were reproducible with a validation cohort. Conclusion. -TNM stage, histologic grade, lymphovascular invasion, fibrotic focus, mild lymphocytic infiltrate, HER2-overexpressing and basallike molecular subtypes were important independent recurrence risk factors for breast cancer. This morphologicmolecular model was robust in recurrence prediction and refined recurrence risk stratified by the traditional prognostic parameters, independent of treatment modalities.
UR - http://www.scopus.com/inward/record.url?scp=84930897139&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930897139&partnerID=8YFLogxK
U2 - 10.1016/j.breastdis.2015.04.028
DO - 10.1016/j.breastdis.2015.04.028
M3 - Article
AN - SCOPUS:84930897139
SN - 1043-321X
VL - 26
SP - 142
EP - 143
JO - Breast Diseases
JF - Breast Diseases
IS - 2
ER -