title: Defining lymphocyte-predominant breast cancer by the proportion of lymphocyte-rich stroma and its significance in routine histopathological diagnosis.
abstract: Lymphocyte-predominant breast cancer (LPBC) defined by the density of stromal lymphocytes shows favorable behavior. However, considerable distribution heterogeneity of lymphocytes is a major problem. The present study defined LPBC by the proportion of lymphocyte-rich stroma with the cut-off values of 30, 50, and 75%, and clinicopathologically analyzed mainly LPBC (area > 30%) defined by the cut-off value of 30%. LPBCs (area > 30%), 39 cases in total, were composed mainly of triple-negative and HER2(+) /ER(-) subtypes, without any luminal A-like subtype. LPBCs were composed predominantly of histological grade 3 tumors, without any grade 1 lesions. Multivariate analyses on 477 consecutive tumors revealed that ER-negativity and grade 3 status associated significantly with LPBC. LPBC (area > 30%) showed better disease-free survival than grade-matched controls, and it was a good indicator of complete pathological remission after pre-operative chemotherapy. Patients with LPBC with the cut-off value of 50% and that of 75% showed 100% disease-free survival. These results demonstrated the validity of our definition of LPBC. Our data also suggest that de-differentiated cancers without TILs could be regarded as high-grade cancer without lymphocyte-mediated responses. In conclusion, the definition of LPBC by the proportion of lymphoid stroma is useful for prognostication of high grade breast cancer in routine diagnosis.
authors.affiliation: Department of Pathology, Mito Saiseikai General Hospital, Mito, Japan.|Department of Pathology, Mito Medical Center, National Hospital Organization, Ibaraki, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Ohtani
authors.affiliation: Department of Surgery, Mito Medical Center, National Hospital Organization, Ibaraki, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Mori-Shiraishi
authors.affiliation: Department of Surgery, Mito Medical Center, National Hospital Organization, Ibaraki, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, Mito Medical Center, National Hospital Organization, Ibaraki, Japan.
authors.forename: Hamaichi
authors.initials: H
authors.lastname: Ueki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000145:classification* / Q000378:metabolism / Q000473:pathology; D054337:Cell Dedifferentiation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D017154:Stromal Cells / Q000473:pathology
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human
keywords: anti-tumor immunity; invasive breast cancer; lymphocyte-predominant breast cancer; tumor-infiltrating lymphocytes