Faculty Collaboration Database

Diagnostic utility of snail in metaplastic breast carcinoma. Diagn Pathol 2010 Nov 26;5:76

Date

11/30/2010

Pubmed ID

21110878

Pubmed Central ID

PMC3003230

DOI

10.1186/1746-1596-5-76

Scopus ID

2-s2.0-78649327382 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

Metaplastic breast carcinoma (MBC) is a rare subtype of breast cancer characterized by coexistence of carcinomatous and sarcomatous components. Snail is a nuclear transcription factor incriminated in the transition of epithelial to mesenchymal differentiation of breast cancer. Aberrant Snail expression results in lost expression of the cell adhesion molecule E-cadherin, an event associated with changes in epithelial architecture and invasive growth. We aimed to identify the utility of Snail, and of traditional immunohistochemical markers, in accurate MBC classification and to evaluate clinicopathologic characteristics and outcome.We retrospectively reviewed 34 MBC cases from January 1997 to September 2007. The control group contained 26 spindle cell lesions. Immunohistochemistry used Snail, p63, epidermal growth factor receptor (EGFR), OSCAR, and wide spectrum cytokeratin (WS-KER). Negative was a score less than 1%. We found that Snail and EGFR are sensitive (100%) markers with low specificity (3.8% and 19.2%) for detecting MBC. p63 and WS-KER are specific (100%), with moderate sensitivity (67.6% and 76.5%); OSCAR is sensitive (85.3%) and specific (92.3%). A combination of any 2 of the p63, OSCAR, and WS-KER markers increased sensitivity and specificity. MBCs tended to be high-grade (77%), triple negative (negative for estrogen receptor, progesterone receptor, and HER2) [27/33; 81.8%], and carcinomas with low incidence of axillary lymph node involvement (15%), and decreased disease-free [71% (95%CI: 54%, 94%) at 3 yrs.) and overall survival. A combination of p63, OSCAR and WS-KER are useful in its work-up. On the other hand, Snail is neither a diagnostic nor a prognostic marker for MBC.

Author List

Nassar A, Sookhan N, Santisteban M, Bryant SC, Boughey JC, Giorgadze T, Degnim A

Author

Tamara Giorgadze MD Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
Breast Neoplasms
Carcinoma
Case-Control Studies
Disease-Free Survival
ErbB Receptors
Female
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Keratins
Male
Metaplasia
Middle Aged
Minnesota
Neoplasm Staging
Predictive Value of Tests
Receptor, ErbB-2
Receptors, Cell Surface
Receptors, Estrogen
Receptors, Progesterone
Retrospective Studies
Sensitivity and Specificity
Snail Family Transcription Factors
Time Factors
Transcription Factors
Treatment Outcome
Young Adult