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Rev Bras Ginecol Obstet 2016; 38(10): 512-517
DOI: 10.1055/s-0036-1593854
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

The Apocrine Profile of Triple-negative Breast Carcinomas in Patients Aged 45 Years or Younger: favorable but rare features

Perfil apócrino em carcinomas mamários triplo-negativos de pacientes até 45 anos: característica favorável, ainda que rara
Sergio Mitsuo Masili-Oku
1   Departament of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
2   Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
Carlos Eduardo Bacchi
3   Consultoria em Patologia, Botucatu, SP, Brazil
,
Felipe Seabra Fernandes
1   Departament of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
José Roberto Filassi
2   Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
Edmund C. Baracat
4   Gynecology Discipline, Department of Gynecology and Obstetrics, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
Filomena Marino Carvalho
1   Departament of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

01 May 2016

20 September 2016

Publication Date:
03 November 2016 (online)

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Abstract

Objective Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype.

Methods A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression.

Results An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p = 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p = 0.06).

Conclusions The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.

Resumo

Objetivo Carcinomas mamários triplo-negativos representam um grupo heterogêneo de neoplasias, embora geralmente exibam fenótipo clinicamente mais agressivo e sejam mais prevalentes em mulheres jovens. Até o presente, terapias-alvo para esses grupos não foram definidas. O objetivo deste estudo foi avaliar a frequência do subtipo apócrino em carcinomas mamários triplo-negativos de mulheres na pré-menopausa, definido pela expressão imuno-histoquímica do receptor de androgênio, e sua associação com tipo histológico, grau histológico, atividade proliferativa, expressão do receptor do fator de crescimento epidérmico (EGFR) e o fenótipo basal-símile.

Métodos Foram selecionadas 118 amostras de tecido tumoral de pacientes com até 45 anos de idade. As amostras foram revisadas quanto a tipo e grau histológicos e expressão do Ki-67. A expressão imuno-histoquímica de receptor de androgênio, citoqueratina basal ⅚, e do EGFR foram analisadas em amostras de microarranjos de tecido. O subtipo apócrino foi definido pela positividade do receptor de androgênio. O fenótipo basal-símile foi caracterizado pela expressão da citoqueratina ⅚ e/ou do EGFR.

Resultados O perfil apócrino foi identificado em 6/118 (5,1%) casos. Este subgrupo apresentou menor fração de expressão do Ki-67 (17,5% versus 70,0%, p = 0,02) e uma tendência a menor grau histológico (66,7% versus 27,9%, p = 0,06).

Conclusões O subtipo apócrino dos carcinomas mamários triplo-negativos é raro em mulheres na pré-menopausa, e tende a se apresentar como carcinomas de menor grau e menor atividade proliferativa, sugerindo fenótipo biológico menos agressivo.

Keywords

breast cancer - triple-negative - apocrine - immunohistochemistry - androgen receptor - epidermal growth factor receptor Ki-67

Palavras-chave

câncer de mama - triplo-negativo - apócrino - imuno-histoquímica - receptor de androgênio - receptor do fator de crescimento epidérmico - Ki-67
 

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