title: Expression of aldehyde dehydrogenase 1 as a marker of mammary stem cells in benign and malignant breast lesions of Ghanaian women.
abstract: BACKGROUND
  Breast cancers that are negative for the estrogen receptor (ER), the progesterone receptor (PR), and the HER2 (human epidermal growth factor receptor 2) marker are more prevalent among African women, and the biologically aggressive nature of these triple-negative breast cancers (TNBCs) may be attributed to their mammary stem cell features. Little is known about expression of the mammary stem cell marker aldehyde dehydrogenase 1 (ALDH1) in African women. Novel data are reported regarding ALDH1 expression in benign and cancerous breast tissue of Ghanaian women.
  
  
  METHODS
  Formalin-fixed, paraffin-embedded specimens were transported from the Komfo Anoyke Teaching Hospital in Kumasi, Ghana to the University of Michigan for centralized histopathology study. Expression of ER, PR, HER2, and ALDH1 was assessed by immunohistochemistry. ALDH1 staining was further characterized by its presence in stromal versus epithelial and/or tumor components of tissue.
  
  
  RESULTS
  A total of 173 women contributed to this study: 69 with benign breast conditions, mean age 24 years, and 104 with breast cancer, mean age 49 years. The proportion of benign breast conditions expressing stromal ALDH1 (n = 40, 58%) was significantly higher than those with cancer (n = 44, 42.3%) (P = .043). Among the cancers, TNBC had the highest prevalence of ALDH1 expression, either in stroma or in epithelial cells. More than 2-fold higher likelihood of ALDH1 expression was observed in TNBC cases compared with other breast cancer subtypes (odds ratio = 2.38, 95% confidence interval 1.03-5.52, P = .042).
  
  
  CONCLUSIONS
  ALDH1 expression was higher in stromal components of benign compared with cancerous lesions. Of the ER-, PR-, and HER2-defined subtypes of breast cancer, expression of ALDH1 was highest in TNBC.
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Schwartz
authors.forename: Azadeh
authors.initials: A
authors.lastname: Stark
authors.forename: Judy
authors.initials: J
authors.lastname: Pang
authors.forename: Baffour
authors.initials: B
authors.lastname: Awuah
authors.forename: Celina G
authors.initials: CG
authors.lastname: Kleer
authors.forename: Solomon
authors.initials: S
authors.lastname: Quayson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kingman
authors.forename: Francis
authors.initials: F
authors.lastname: Aitpillah
authors.forename: Francis
authors.initials: F
authors.lastname: Abantanga
authors.forename: Evelyn
authors.initials: E
authors.lastname: Jiagge
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Oppong
authors.forename: Ernest
authors.initials: E
authors.lastname: Osei-Bonsu
authors.forename: Iman
authors.initials: I
authors.lastname: Martin
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Yan
authors.forename: Kathy
authors.initials: K
authors.lastname: Toy
authors.forename: Ernest
authors.initials: E
authors.lastname: Adjei
authors.forename: Max
authors.initials: M
authors.lastname: Wicha
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D000328:Adult; D000080924:Aldehyde Dehydrogenase 1 Family; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D005869:Ghana; D006801:Humans; D007527:Isoenzymes / Q000235:genetics* / Q000378:metabolism; D042361:Mammary Glands, Human / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000378:metabolism* / Q000473:pathology; D011230:Precancerous Conditions / Q000175:diagnosis / Q000208:ethnology / Q000235:genetics / Q000473:pathology; D050697:Retinal Dehydrogenase / Q000235:genetics* / Q000378:metabolism; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D007527:Isoenzymes; D000080924:Aldehyde Dehydrogenase 1 Family; C510223:ALDH1A1 protein, human; D050697:Retinal Dehydrogenase