Advertisement

Medical Oncology

, 31:172 | Cite as

Co-expression of EGFR and CK5/6 in primary squamous cell carcinoma of the breast

  • Jin Wang
  • Xinke Zhang
  • Jiehua He
  • Mingtian Yang
  • Jun Tang
  • Xing Li
  • Hailin Tang
  • Xiaoming Xie
Original Paper

Abstract

Primary squamous cell carcinoma of the breast (PSCCB) is an extremely rare breast tumor lacking hormone receptors and HER2 expression. However, in comparison with triple-negative invasive ductal carcinoma (TN-IDC), little is known about the PSCCB. Twenty-nine patients with PSCCB in Sun Yat-sen University Cancer Center from 1995 to 2010 were recruited in this study, along with 681 cases of TN-IDC during the same period. The clinicopathologic features and prognosis of PSCCB compared to TN-IDC were assessed. Furthermore, biomarkers of EGFR, CK5/6, E-cadherin, VEGF, TOPII, and p53 were immunostained to investigate the prognostic determinant of PSCCB. Patients with PSCCB were older than those with TN-IDC (P = 0.009) and presented with lower lymph node involvement (P = 0.015). There was no difference in overall survival (OS) between PSCCB and TN-IDC. However, the disease-free survival (DFS) of PSCCB was poorer than that of TN-IDC (P = 0.007). Multivariate analysis revealed that combined over-expression of EGFR and CK5/6 was the only independent prognostic factor for OS of PSCCB (HR 6.08, 95 % CI 1.33–27.85, P = 0.020) and associated with lymphatic metastasis (P = 0.023) and p53 expression (P = 0.013). Other predictors for poorer OS and DFS were lymphatic metastasis and stage III, which failed to show significance after multivariate analysis. Furthermore, platinum-based chemotherapy was identified to improve the OS of PSCCB with EGFR + CK5/6+ (P = 0.027). The prognosis of PSCCB is poorer than that of TN-IDC. As the only independent prognostic factor for PSCCB, combined over-expression of EGFR and CK5/6 might be a potential indicator for the use of platinum-based chemotherapy.

Keywords

Primary squamous cell carcinoma Triple-negative breast cancer EGFR CK5/6 Platinum-based 

Notes

Acknowledgments

We would like to thank the patients that participated in this study. We would also like to thank the Guangdong Medical Association and National Natural Science Fund Committee for the funding which supported this project. This study is supported by the Medical Scientific Research Foundation of Guangdong Province (B2013143) and National Natural Science Foundation of China (31100935).

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Behranwala KA, Nasiri N, Abdullah N, Trott PA, Gui GP. Squamous cell carcinoma of the breast: clinico-pathologic implications and outcome. Eur J Surg Oncol. 2003;29:386–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Accurso A, Pettinato G, Ciancia G, Bellevicine C, Riccardi A, Rocco N. Pure primary squamous cell carcinoma of the breast presenting as an intracystic tumor. Breast J. 2012;18:608–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Stevenson JT, Graham DJ, Khiyami A, Mansour EG. Squamous cell carcinoma of the breast: a clinical approach. Ann Surg Oncol. 1996;3:367–74.PubMedCrossRefGoogle Scholar
  4. 4.
    Nayak A, Wu Y, Gilcrease MZ. Primary squamous cell carcinoma of the breast: predictors of locoregional recurrence and overall survival. Am J Surg Pathol. 2013;37:867–73.PubMedCrossRefGoogle Scholar
  5. 5.
    Tavassoli FA, Devilee P. World health organization: tumours of the breast and female genital organs. Oxfordshire: Oxford University; 2003.Google Scholar
  6. 6.
    Reis-Filho JS, Lakhani SR, Gobbi H, et al. Metaplastic carcinoma. In: Lakhani SR, Ellis IO, Schnitt SJ, et al., editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC; 2012. p. 48–52.Google Scholar
  7. 7.
    Hennessy BT, Krishnamurthy S, Giordano S, et al. Squamous cell carcinoma of the breast. J Clin Oncol. 2005;23:7827–35.PubMedCrossRefGoogle Scholar
  8. 8.
    Grabowski J, Saltzstein SL, Sadler G, Blair S. Squamous cell carcinoma of the breast: a review of 177 cases. Am Surg. 2009;75:914–7.PubMedGoogle Scholar
  9. 9.
    Siegelmann-Danieli N, Murphy TJ, Meschter SC, Stein ME, Prichard J. Primary pure squamous cell carcinoma of the breast. Clin Breast Cancer. 2005;6:270–2.PubMedCrossRefGoogle Scholar
  10. 10.
    Lee H, Jung SY, Ro JY, et al. Metaplastic breast cancer: clinicopathological features and its prognosis. J Clin Pathol. 2012;65:441–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Yerushalmi R, Hayes MM, Gelmon KA. Breast carcinoma-rare types: review of the literature. Ann Oncol. 2009;20:1763–70.PubMedCrossRefGoogle Scholar
  12. 12.
    Korbling M, Estrov Z. Adult stem cells for tissue repair: a new therapeutic concept? N Engl J Med. 2003;349:570–82.PubMedCrossRefGoogle Scholar
  13. 13.
    Wargotz ES, Norris HJ. Metaplastic carcinomas of the breast. IV. Squamous cell carcinoma of ductal origin. Cancer. 1990;65:272–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Rosen PP. Squamous carcinoma. In: Rosen PP, editor. Rosen’s breast pathology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009. p. 506–24.Google Scholar
  15. 15.
    Edge SB, Byrd DR, Compton CC, et al. American Joint Committee on cancer staging manual. 7th ed. New York: Springer; 2009.Google Scholar
  16. 16.
    Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16.PubMedCrossRefGoogle Scholar
  17. 17.
    Hayes MM, Peterse JL, Yavuz E, Vischer GH, Eusebi V. Squamous cell carcinoma in situ of the breast: a light microscopic and immunohistochemical study of a previously undescribed lesion. Am J Surg Pathol. 2007;31:1414–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Jung SY, Kim HY, Nam BH, et al. Worse prognosis of metaplastic breast cancer patients than other patients with triple-negative breast cancer. Breast Cancer Res Treat. 2010;120:627–37.PubMedCrossRefGoogle Scholar
  19. 19.
    Bae SY, Lee SK, Koo MY, et al. The prognoses of metaplastic breast cancer patients compared to those of triple-negative breast cancer patients. Breast Cancer Res Treat. 2011;126:471–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Nielsen TO, Hsu FD, Jensen K, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res. 2004;10:5367–74.PubMedCrossRefGoogle Scholar
  21. 21.
    Sorlie T, Perou CM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001;98:10869–74.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Borresen-Dale AL. TP53 and breast cancer. Hum Mutat. 2003;21:292–300.PubMedCrossRefGoogle Scholar
  23. 23.
    Yamamoto M, Hosoda M, Nakano K. p53 accumulation is a strong predictor of recurrence in estrogen receptor-positive breast cancer patients treated with aromatase inhibitors. Cancer Sci. 2014;105:81–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Bhatt L, Fernando I. Primary squamous cell carcinoma of the breast: achieving long-term control with cisplatin-based chemotherapy. Clin Breast Cancer. 2009;9:187–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Menes T, Schachter J, Morgenstern S, Fenig E, Lurie H, Gutman H. Primary squamous cell carcinoma (SqCC) of the breast. Am J Clin Oncol. 2003;26:571–3.PubMedCrossRefGoogle Scholar
  26. 26.
    Dejager D, Redlich PN, Dayer AM, Davis HL, Komorowski RA. Primary squamous cell carcinoma of the breast: sensitivity to cisplatinum-based chemotherapy. J Surg Oncol. 1995;59:199–203.PubMedCrossRefGoogle Scholar
  27. 27.
    Murialdo R, Boy D, Musizzano Y, Tixi L, Murelli F, Ballestrero A. Squamous cell carcinoma of the breast: a case report. Cases J. 2009;2:7336.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Jin Wang
    • 1
    • 3
  • Xinke Zhang
    • 2
  • Jiehua He
    • 2
  • Mingtian Yang
    • 1
  • Jun Tang
    • 1
  • Xing Li
    • 1
  • Hailin Tang
    • 3
  • Xiaoming Xie
    • 1
    • 3
  1. 1.Department of Breast OncologySun Yat-sen University Cancer CenterGuangzhouChina
  2. 2.Department of PathologySun Yat-sen University Cancer CenterGuangzhouChina
  3. 3.State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouChina

Personalised recommendations