Sonographic correlations with the new molecular ... - Springer Link

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Accepted: 3 March 2009. Published online: 14 May 2009 ... to determine the ultrasound correlates of these novel ... molecular classes of invasive breast ... developed using tissue microarray technology to enable analysis of several proteins.

Eur Radiol (2009) 19: 2342–2348 DOI 10.1007/s00330-009-1418-2

I. T. H. Au-Yong A. J. Evans S. Taneja E. A. Rakha A. R. Green C. Paish I. O. Ellis

Received: 11 November 2008 Revised: 20 January 2009 Accepted: 3 March 2009 Published online: 14 May 2009 # European Society of Radiology 2009

I. T. H. Au-Yong (*) . A. J. Evans . S. Taneja Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham, UK, NG5 1PB e-mail: [email protected] Tel.: +44-115-0373324 E. A. Rakha . A. R. Green . C. Paish . I. O. Ellis Division of Pathology, School of Molecular Medical Sciences and University of Nottingham, Nottingham University Hospitals NHS Trust, Nottingham, UK

BREAST

Sonographic correlations with the new molecular classification of invasive breast cancer

Abstract Ultrasound is a useful adjunct to mammography for the characterisation and biopsy of solid breast lesions. Protein expression profiling of breast cancer has identified specific subgroups with potential clinical, biological and therapeutic implications. The aim of this study was to determine the ultrasound correlates of these novel molecular classes of invasive breast cancer. The ultrasound findings in 358 patients with operable breast cancer were correlated with the previously described protein expression classes identified by our group using immunohistochemical (IHC) assessment of a large series of breast cancer cases in which 25 proteins of known relevance in breast cancer were assessed, including hormone receptors, HER2 status, basal and luminal markers, p53 and e-cadherin. The proportion of occult lesions was not significantly different in the two groups. Significant differences were

Introduction The prognosis of breast cancer has traditionally been determined by histological type [1], grade [2–4], size [5] and lymph node status [5]. More recently, the presence of lymphovascular invasion has also been shown to be an important histological indicator of prognosis [6]. In addition, the presence of specific molecular markers such as oestrogen receptor (ER), progesterone receptor (PR), c-erbB2 (HER2), p53, basal cytokeratins and ecadherin may provide additional prognostic information and enable targeted therapy [7].

noted between the two groups expressing luminal epithelial markers and hormone receptors (1 and 2), including a greater proportion of ill-defined, irregular and distally attenuating tumours in group 2. Tumours characterised by c-erbB2/MUC1 expression, with weak hormone receptor positivity (group 3) were also more likely to be ill defined. Tumours expressing basal markers (group 5) were less likely to have an echogenic halo. The ultrasound features of breast cancer show areas of significant correlation with molecular classes of invasive breast cancer identified by IHC analysis. The biological reasons for these findings and their implications regarding imaging protocols require further study and may enable improved detection of these lesions. Keywords Breast cancer . Breast ultrasound . Molecular classification . Tissue microarray . Protein expression

These traditional histopathological prognostic markers have been shown to be poor predictors of outcome in small (