ÖSTROJEN RESEPTÖRÜ NEGATİF İNVAZİV MEME ...

SUMMARY
Breast carcinoma is a very common but extremely heterogeneus disease that exhibits a full range
of bilogical behaviour. Despite this range of behaviour most tumors (75%) are categorized within a
single histological diagnostic category of invasive ductal cancer of NST. The majority of those
have a luminal phenotype; that is they express smilar proteins to those found in the normal inner
luminal cells of breast ducts and asini and such as express ER, CK8/18. But 2-18% also coexpress
proteins normally found in the outer contractile myoepithelial or basal layer of normal breast duct
and asini. These proteins include CK5/14, Smooth muscle markers (SMA, Calponin, p63). These
tumors are usually ER(-), PR(-), HER-2(-) (Triple negative ). There are not identified in routine
practice and there is no consensus terminology about these tumors. Their own preferred name, such
as basaloid, basal-like or ductal carcinoma with myoepithelial phenotype to describe them.
In recent years; have identified several distinct breast cancer subtypes.These are: luminalA,
luminalB , Basal-like , HER-2 overexpressing and Normal breast like. These results strongly
support the notion that different tumor subtypes originate from different cell types. The worst
prognosed group is Basal like and HER-2 (+) subtypes. Basal like breast carcinomas can escape
observation in routine practice or not realised however these tumour groups are candidates for
future treatment models.
The purpose of this study was to determine the characteristics of 47 ER(-) breast cancers through
analysis of several morphological and immunophenotypical profile and research the HER-2
positive and triple negative/ basal like subsets and their frequency, common and diverse features
by routin morphologic and immunohistochemical examination.
47 ER (-), 16ER(+) cases with retrievable histological material (blocks and slides) were included
in this study. Patients' clinical history and cancer characteristics including tumor type, histological
grade, tumor size, lymph node status were obtained from the pathology database. An H&E stained
section from a representative tumor block was examined for the various morphological parameters
such as pushing margin, lymphoid stromal infiltrate, clear cell changes, basaloid change,
undifferentiated/small cell pattern, squamoid or spindle cell changes, tumor giant cells and
prominent central fibrosis/necrosis. The antibodies utilized included ER, PR, CK5/6, CK18,
CK14,CK17, SMA, BRCA1, CerbB-2, p63. Calponin, SMA, p63 were utilized to identify
myoepithelial differentiation, CK5/6, CK14, CK17 which identify basal; CK18 luminal epithelial
differentiation respectively were also included.
Finally: High grade,, lymphoid stroma, and central fibrosis/necrosis are the dominant
morphological findings. In addition, squamoid, clear cell and spindle cell differentiation may be
identified. Alterations in protein expression of basal type cytokeratins, SMA, Calponin and
BRCA1, are also more commonly seen than ER(+) invasive breast cancers.
Key words: Basal phenotype, breast cancer, estrogen receptor, new functional classification.
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