[Basal and myoepithelial phenotype of metastatic mammary carcinomas. A prognostic factor in the palliative situation?].
OBJECTIVE
The aim of the present study was to evaluate the prognostic impact of basal and myoepithelial phenotype in breast carcinomas (BBC and MBC) in the palliative situation.


METHODS
Paraffin-embedded material from 244 primary breast carcinomas of patients with subsequent metastatic disease was stained immunohistochemically for CK 5/6, CK14, smooth-muscle actin, p63, estrogen receptor and progesterone receptor. BBC was defined as positive for CK5/6 and/or CK14 and MBC as positive for SMA and/or p63. Clinical and pathological data were available for all patients and follow-up data for 96.3% (range 5 days-151 months).


RESULTS
Until the end of the follow-up period 90.2% of patients died and 6.1% are still alive. Of the tumours 28.7% could be classified as BBC and 8.2% as MBC. Kaplan Meier analysis revealed a trend for reduced survival after first diagnosis of metastasis (OASM) for BBC and MBC. Differences in survival were significant for BBC (log-rank =5.0; p=0.025), but not for MBC. CK5/6+ and CK14+ double positive tumours (n=18; 7.4%) were identified as a subgroup of BBC associated with reduced OASM (log-rank=8,6; p=0.003). This subgroup, but not BBC or MBC was an independent negative prognostic factor in a multivariate analysis including age, typing, tumour size, grading, axillary nodes, HR, Her2/neu, site of first metastasis and disease-free interval.


CONCLUSIONS
The association of BBC and MBC with reduced OASM in metastatic breast carcinomas is not independent from established prognostic factors. CK5/6+ CK14+ double positive tumours may be a subgroup of BBC with particularly unfavourable outcome.
Mainka
P
P
Pathologisches Institut der LMU München, Thalkirchner Str. 36, 80337 München. p.mainka@yahoo.de
Kahlert
S
S
Kirchner
T
T
Mayr
D
D
Diebold
J
J
D014408:Biomarkers, Tumor / Q000032:analysis*; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D044584:Carcinoma, Ductal / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053547:Keratin-14 / Q000032:analysis; D053555:Keratin-5 / Q000032:analysis; D053553:Keratin-6 / Q000032:analysis; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009208:Myoepithelioma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D010166:Palliative Care; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*
D014408:Biomarkers, Tumor; D053547:Keratin-14; D053555:Keratin-5; D053553:Keratin-6; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone