title: Molecular analysis of metaplastic breast carcinoma: high EGFR copy number via aneusomy.
abstract: Metaplastic breast carcinoma, a rare tumor composed of adenocarcinomatous and nonglandular growth patterns, is characterized by a propensity for distant metastases and resistance to standard anticancer therapies. We sought confirmation that this tumor is a basal-like breast cancer, expressing epidermal growth factor receptor (EGFR) and stem cell factor receptor (KIT). EGFR activating mutations and high copy number (associated with response to tyrosine kinase inhibitor gefitinib) and KIT activating mutations (associated with imatinib sensitivity) were then investigated. Seventy-seven metaplastic cases were identified (1976-2006); 38 with tumor blocks available underwent pathologic confirmation before EGFR and KIT immunohistochemical analyses. A tissue microarray of malignant glandular and metaplastic elements was constructed and analyzed immunohistochemically for cytokeratin 5/6, estrogen receptor, progesterone receptor, and p63, and by fluorescence in situ hybridization for EGFR and HER-2/neu. DNA isolated from individual elements was assessed for EGFR and KIT activating mutations. All assessable cases were negative for estrogen receptor, progesterone receptor, and (except one) HER2. The majority were positive for cytokeratin 5/6 (58%), p63 (59%), and EGFR overexpression (66%); 24% were KIT positive. No EGFR or KIT activating mutations were present; 26% of the primary metaplastic breast carcinomas were fluorescence in situ hybridization-positive, displaying high EGFR copy number secondary to aneusomy (22%) and amplification (4%). We report here that metaplastic breast carcinoma is a basal-like breast cancer lacking EGFR and KIT activating mutations but exhibiting high EGFR copy number (primarily via aneusomy), suggesting that EGFR tyrosine kinase inhibitors should be evaluated in this molecular subset of breast carcinomas.
authors.affiliation: Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Gilbert
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Goetz
authors.forename: Carol A
authors.initials: CA
authors.lastname: Reynolds
authors.forename: James N
authors.initials: JN
authors.lastname: Ingle
authors.forename: Karin F
authors.initials: KF
authors.lastname: Giordano
authors.forename: Vera J
authors.initials: VJ
authors.lastname: Suman
authors.forename: Hilary E
authors.initials: HE
authors.lastname: Blair
authors.forename: Robert B
authors.initials: RB
authors.lastname: Jenkins
authors.forename: Wilma L
authors.initials: WL
authors.lastname: Lingle
authors.forename: Monica M
authors.initials: MM
authors.lastname: Reinholz
authors.forename: Alex A
authors.initials: AA
authors.lastname: Adjei
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Ames
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology; D015331:Cohort Studies; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D005784:Gene Amplification; D018628:Gene Dosage; D006801:Humans; D007124:Immunoenzyme Techniques; D017404:In Situ Hybridization, Fluorescence; D008679:Metaplasia / Q000235:genetics* / Q000473:pathology; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009364:Neoplasm Recurrence, Local; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics; D046888:Tissue Array Analysis
chemical_list: D066246:ErbB Receptors; D019009:Proto-Oncogene Proteins c-kit