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In stage II/III lymph node-positive breast cancer patients less than 55 years of age, keratin 8 expression in lymph node metastases but not in the primary tumour is an indicator of better survival

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Abstract

Axillary lymph node status is one of the most important prognostic variables for breast cancer (BC). To investigate and understand the clinical, histopathological and biological factors that affect prognosis in node-positive young breast cancer patients, we compared the phenotype of 100 primary tumours with their corresponding loco-regional lymph node (LN) metastases using conventional immunohistochemistry (IHC) markers currently in use for molecular classification of breast cancer. By comparing the expression of ER, PR, HER-2, Ki67, K8, K5/6 and vimentin, we found that expression of HER-2, Ki67, K8 and vimentin is frequently lost in lymph node metastases. Between the primary tumour and corresponding lymph node metastases, expression of keratins K8 and K5/6 significantly changed. Expression of K8 in lymph node metastases, but not in primary tumours, segregates patients in two sub-groups with different outcomes. Survival of patients with K8-positive LN metastases at 5 years in comparison with patients with K8-negative LN metastases was 75 vs 48 %, at 10 years 62 vs 22 % and at 20 years 53 vs 14 % (p < 0.001). K8 immunostaining of tissue from the lymph node metastasis allows defining a sub-group of lymph node-positive BC patients with a highly unfavourable outcome, for whom therapeutic options might have to be reconsidered.

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Acknowledgments

The authors would like to thank Dr. Valentina Melita for the language revision of the paper. This study was partially supported by the MIUR PRIN 2008, Protocol no. 2008YFRLC8 002.

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    Authors and Affiliations

    1. Department of Medical Sciences, University of Trieste, Cattinara Hospital, Strada di Fiume 447, Trieste, Italy

      Serena Bonin, Danae Pracella, Renzo Barbazza & Giorgio Stanta

    2. Department of Laboratory Medicine, S.C. Pathology, Santa Maria degli Angeli Hospital, 33170, Pordenone, Italy

      Sandro Sulfaro

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    1. Serena Bonin
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    Correspondence to Giorgio Stanta.

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    Danae Pracella contributed equally to this work.

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    Bonin, S., Pracella, D., Barbazza, R. et al. In stage II/III lymph node-positive breast cancer patients less than 55 years of age, keratin 8 expression in lymph node metastases but not in the primary tumour is an indicator of better survival. Virchows Arch 466, 571–580 (2015). https://doi.org/10.1007/s00428-015-1748-1

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