Lymphocyte-predominant triple-negative breast carcinomas in premenopausal patients: Lower expression of basal immunohistochemical markers.
OBJECTIVE
Triple-negative breast carcinomas (TNBCs) correspond to a molecular heterogeneous disease defined by lack of estrogen and progesterone receptor expression, and the absence of overexpression and/or amplification of HER2. Recent data indicate that clinical outcome in TNBC is affected by tumor-infiltrating lymphocytes, suggesting that they can benefit from immunotherapies. We selected 116 consecutive premenopausal patients with TNBC to compare the immunohistochemical profile of the group rich in tumor-infiltrating lymphocytes with those without this characteristic.


METHODS
We reviewed all the original histological sections to assess pathological features, and to select a representative area for tissue microarrays and immunohistochemical study. Estrogen and progesterone receptors, HER2 and Ki-67 were evaluated in whole histological sections. The following markers were analyzed in tissue microarrays sections: androgen receptor, cytokeratin 5/6, cytokeratin 14, epidermal growth factor receptor (EGFR), vimentin, p16, claudin-3, -4, and -7, p63, and aldehyde dehydrogenase isoform 1 (ALDH1). Lymphocyte-predominant breast cancer (LPBC) was defined by the presence of more than 50% of lymphocytes in the intratumoral stroma.


RESULTS
Twenty-six (22.4%) patients present tumors classified as LPBC and 90 (77.6%) as non-LPBC. The two groups were similar regarding age of patients, tumor grade and Ki-67 positive cells. LPBC cases presented lower frequency of expression of the basal cytokeratins, EGFR, and basal-like immunoprofile. There was a trend to higher expression of ALDH1 by stromal intratumoral cells. The expression of all other markers were similar in the two groups.


CONCLUSIONS
Lymphocyte-predominant TNBC in premenopausal patients are mostly of non-basal phenotype.
Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Instituto do Cancer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Sergio Mitsuo
SM
Masili-Oku
Laboratory of Pathology, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
Bernardo Gomes Lacerda de
BGL
Almeida
Consultoria em Patologia, Botucatu, SP, Brazil.
Carlos Eduardo
CE
Bacchi
Instituto do Cancer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Jose Roberto
JR
Filassi
Division of Gynecologic Clinic, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Edmund Chada
EC
Baracat
Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: filomena@usp.br.
Filomena Marino
FM
Carvalho
D000328:Adult; D000080924:Aldehyde Dehydrogenase 1 Family; D014408:Biomarkers, Tumor / Q000032:analysis; D001938:Brazil; D002277:Carcinoma / Q000737:chemistry / Q000473:pathology*; D057167:Claudins / Q000032:analysis; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007527:Isoenzymes / Q000032:analysis; D007633:Keratins / Q000032:analysis; D016246:Lymphocytes, Tumor-Infiltrating / Q000378:metabolism*; D008565:Membrane Proteins / Q000032:analysis; D008875:Middle Aged; D017697:Premenopause; D011944:Receptors, Androgen / Q000032:analysis; D050697:Retinal Dehydrogenase / Q000032:analysis; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000737:chemistry / Q000473:pathology*; D014746:Vimentin / Q000032:analysis
D014408:Biomarkers, Tumor; C000614131:CDKN2A protein, human; C081876:CKAP4 protein, human; D057167:Claudins; D019941:Cyclin-Dependent Kinase Inhibitor p16; D007527:Isoenzymes; D008565:Membrane Proteins; D011944:Receptors, Androgen; D014746:Vimentin; D007633:Keratins; D000080924:Aldehyde Dehydrogenase 1 Family; C510223:ALDH1A1 protein, human; D050697:Retinal Dehydrogenase; C512478:EGFR protein, human; D066246:ErbB Receptors
Basal-like carcinoma; Breast cancer; Immunohistochemistry; Triple-negative; Tumor-infiltrating lymphocytes