Breast cancer stromal elastosis is associated with mammography screening detection, low Ki67 expression and favourable prognosis in a population-based study

Diagnostic Pathology

Jon Lømo⁵  Lars A Akslen²  Jan Mæhlen⁵  Øystein Garred⁵  Knut Liestøl¹  Einar Vigeland⁴  Hans Aas⁶  Elisabeth Wik²  Tor A Klingen³  Ying Chen³ 

[1] Institute of Informatics, University of Oslo, Oslo, Norway;Department of Pathology, Haukeland University Hospital, Bergen, Norway;Department of Pathology, Vestfold Hospital, Tønsberg, Norway;Department of Radiology, Vestfold Hospital, Tønsberg, Norway;Department of Pathology, Oslo University Hospital, Oslo, 0424, Norway;Department of Surgery, Vestfold Hospital, Tønsberg, Norway

关键词: Ki67;    Elastosis;    Mammography screening;    Breast cancer;   

Others  :  1175191
DOI  :  10.1186/s13000-014-0230-8

 received in 2014-08-26, accepted in 2014-12-10,  发布年份 2014

【 摘 要 】

Background

Mammography screen-detected breast cancers have a better prognosis than predicted from established prognostic markers. A search for additional features that are characteristic for these tumours and their prognosis is needed to reduce overtreatment, a recognized challenge in breast cancer patient management today. Here, we have investigated the occurrence and importance of tumour elastosis.

Methods

We performed a population based retrospective study of breast cancers detected in the Norwegian Breast Cancer Screening Programme in Vestfold County during 2004–2009. In total, 197 invasive screen-detected cancers and 75 interval cancers in patients aged 50–69 years were compared with regard to standard clinico-pathological parameters and tumour shape, as well as ER, PR, HER2 and Ki67 expression. In particular, the presence of elastotic material in tumours was graded on a 4-tiered scale (score 0–3).

Results

Screen-detected cancers had a significantly higher content of stromal elastosis than interval cancers (p < 0.001). High content of elastosis (score 3) correlated strongly with stellate tumour shape, low histological grade, and ER+/HER2- status. Further, high elastosis score was significantly associated with lower Ki67 expression. In survival analyses, cases with high elastosis demonstrated increased recurrence free (p = 0.03) and disease-specific survival (p = 0.11) compared to cases with low elastosis.

Conclusion

There is a strong correlation between the presence of tumour elastosis, stellate tumour shape and mammography detection of breast cancers. To our knowledge, this is the first time elastosis has been studied in relation to breast cancer detection method. Presence of elastosis is associated with low tumour cell proliferation (Ki67) and a good prognosis.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_230 webcite

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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