Assessment of stromal tumor infiltrating lymphocytes and immunohistochemical features in invasive micropapillary breast carcinoma with long-term outcomes
- 12 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Breast Cancer Research and Treatment
- Vol. 184 (3), 985-998
- https://doi.org/10.1007/s10549-020-05913-x
Abstract
Purpose We studied the long-term outcomes of invasive micropapillary carcinoma (IMPCs) of the breast in relation to stromal tumor infiltrating lymphocytes (sTILs), prognostic biomarkers and clinicopathological features. Methods Stage I-III IMPCs treated with upfront surgery at our institution (January 2000 and December 2016) were included. Central pathology review was performed and sTILs (including zonal distribution and hot spot analysis) and tumor-associated plasma cells (TAPC) were evaluated. Expression of P53, BCL2, FOXP3, and WT1, which are variably linked to breast cancer prognosis, was measured by immunohistochemistry using tissue microarrays. Time-to-event endpoints were distant recurrence free interval (DRFI) and breast cancer-specific survival (BCSS). Results We included 111 patients of whom 59% were pure IMPCs. Standard clinicopathological features were comparable between pure and non-pure IMPCs. Overall, the mean sTILs level was 20% with higher proportion of sTILs present at the invasive front. There were no significant differences between pure- and non-pure IMPCs in sTILs levels, nor in the spatial distribution of the hot spot regions or in the distribution of TAPC. Higher sTILs correlated with worse DRFI (HR = 1.55; p = 0.0172) and BCSS (HR = 2.10; p < 0.001). Conclusions Clinicopathological features, geographical distribution of sTILs and TAPC are similar between pure and non-pure IMPCs. Despite a high proportion of grade 3 tumors and lymph node involvement, we observed a low rate of distant recurrences and breast cancer-related death in this cohort of stage I-III IMPCs treated with primary surgery. Caution in interpretation of the observed prognostic correlations is required given the very low number of events, warranting validation in other cohorts.Keywords
This publication has 52 references indexed in Scilit:
- Distinct tumor protein p53 mutants in breast cancer subgroupsInternational Journal of Cancer, 2012
- BCL2 in breast cancer: a favourable prognostic marker across molecular subtypes and independent of adjuvant therapy receivedBritish Journal of Cancer, 2010
- Mixed micropapillary–ductal carcinomas of the breast: a genomic and immunohistochemical analysis of morphologically distinct componentsThe Journal of Pathology, 2009
- WT1 immunoreactivity in breast carcinoma: selective expression in pure and mixed mucinous subtypesLaboratory Investigation, 2008
- Tumor infiltrating lymphocytes differ in invasive micropapillary carcinoma and medullary carcinoma of breastLaboratory Investigation, 2008
- Genomic and immunophenotypical characterization of pure micropapillary carcinomas of the breastThe Journal of Pathology, 2008
- Breast Carcinoma With Micropapillary Features: Clinicopathologic Study and Long-Term Follow-Up of 100 CasesInternational Journal of Surgical Pathology, 2008
- The expression of Wilms’ tumour‐1 and Ca125 in invasive micropapillary carcinoma of the breastHistopathology, 2007
- Invasive Micropapillary Carcinoma of the BreastAmerican Journal of Clinical Pathology, 2006
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999