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AIB1 is a new putative prognostic biomarker in the luminal A and B-like (HER2-negative) classification of invasive lobular carcinoma

Narbe, Ulrik LU ; Forsare, Carina LU orcid ; Bendahl, Pär-Ola LU ; Lövgren, Kristina LU ; Alkner, Sara LU ; Sjöström, Martin LU ; Ryden, Lisa LU orcid ; Leeb-Lundberg, Fredrik LU ; Ingvar, Christian LU and Fernö, Mårten LU (2017) San Antonio Breast Cancer Symposium, 2017 p.1-07
Abstract
Body: Background: Estrogen receptor (ER) positive HER2-negative breast cancer comprises 75–80% of all breast cancer. This
fraction is even higher (>90%) in invasive lobular carcinoma (ILC). According to the St Gallen surrogate definitions of the intrinsic
subtypes, Ki67 and progesterone receptor (PgR) are used to classify these tumors as luminal A- and luminal B-like
(HER2-negative). These guidelines are based on information derived from patient materials with mixed histological types, where
the vast majority of the patients have invasive ductal carcinoma. The `luminal-like classification´ together with histological grade,
tumor size and lymph node status is widely used in the clinic for prognostication. The aim of... (More)
Body: Background: Estrogen receptor (ER) positive HER2-negative breast cancer comprises 75–80% of all breast cancer. This
fraction is even higher (>90%) in invasive lobular carcinoma (ILC). According to the St Gallen surrogate definitions of the intrinsic
subtypes, Ki67 and progesterone receptor (PgR) are used to classify these tumors as luminal A- and luminal B-like
(HER2-negative). These guidelines are based on information derived from patient materials with mixed histological types, where
the vast majority of the patients have invasive ductal carcinoma. The `luminal-like classification´ together with histological grade,
tumor size and lymph node status is widely used in the clinic for prognostication. The aim of the present study was to investigate
if the same markers are applicable for ILC, and furthermore, if additional biomarkers involved in the endocrine signaling system,
e.g. Amplified in breast cancer 1 (AIB1) and the putative G protein-coupled estrogen receptor (GPER), might provide
complementary prognostic information.
Patients: Two hundred and thirty-three (N = 233) well-characterized patients with primary ILC, diagnosed between 1980 and
1991 were included. Forty-two percent of the patients received adjuvant endocrine treatment and 2 % received adjuvant
chemotherapy. All biomarkers were analyzed immunohistochemically on tissue microarray, whereas histological grade was
evaluated on whole sections according to Elston and Ellis (NHG). The primary endpoint was breast cancer mortality (BCM).
Results: In univariable analyses with 10-year follow-up, Ki67 (high vs. low), NHG (3 vs. 1+2) and AIB1 (high vs. low) were
significantly associated to BCM (Hazard Ratio: 4.7, 95% CI: 2.1–10.4, p 95% CI: 1.4–7.2, p = 0.005 respectively), whereas PgR (respectively). Essentially the same effect was seen after multivariable adjustment for lymph node status (+ vs. -), tumor size (>20
mm vs. according to St Gallen surrogate definitions did not show significant prognostic differences between the two groups (p = 0.12).
Patients with AIB1) had a 10-year BCM of 4.2% (95% CI: 1.4–12%). This group constituted 34% of the patients included in the present study.
Conclusions: In contrast to other previous studies, where breast cancers of mixed histological types were included, PgR was not
significantly associated to prognosis in the ER-positive HER2-negative subgroup in the present study, consisting only of ILC. The
prognostic role of PgR and the clinical usefulness of the luminal A and B-like (HER2-negative) classification (using only Ki67 and
PgR) in ILC is still to be further investigated. The prognostic importance of Ki67 and NHG in this subgroup was, however,
confirmed also in ILC, and AIB1 might be a new putative prognostic factor. By combining Ki67, NHG, and AIB1, together with
lymph node status and tumor size, a group of patients with an excellent prognosis could be identified. (Less)
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organization
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type
Contribution to conference
publication status
published
subject
pages
1 - 07
conference name
San Antonio Breast Cancer Symposium, 2017
conference location
San Antonio, United States
conference dates
2017-12-05 - 2017-12-09
language
English
LU publication?
yes
id
5f3bf8b7-4ac4-4608-9f17-bf8e18f27e07
alternative location
https://www.sabcs.org/Portals/SABCS2016/Documents/SABCS-2017-Abstracts.pdf
date added to LUP
2022-11-15 18:16:12
date last changed
2022-11-16 13:42:51
@misc{5f3bf8b7-4ac4-4608-9f17-bf8e18f27e07,
  abstract     = {{Body: Background: Estrogen receptor (ER) positive HER2-negative breast cancer comprises 75–80% of all breast cancer. This<br/>fraction is even higher (&gt;90%) in invasive lobular carcinoma (ILC). According to the St Gallen surrogate definitions of the intrinsic<br/>subtypes, Ki67 and progesterone receptor (PgR) are used to classify these tumors as luminal A- and luminal B-like<br/>(HER2-negative). These guidelines are based on information derived from patient materials with mixed histological types, where<br/>the vast majority of the patients have invasive ductal carcinoma. The `luminal-like classification´ together with histological grade,<br/>tumor size and lymph node status is widely used in the clinic for prognostication. The aim of the present study was to investigate<br/>if the same markers are applicable for ILC, and furthermore, if additional biomarkers involved in the endocrine signaling system,<br/>e.g. Amplified in breast cancer 1 (AIB1) and the putative G protein-coupled estrogen receptor (GPER), might provide<br/>complementary prognostic information.<br/>Patients: Two hundred and thirty-three (N = 233) well-characterized patients with primary ILC, diagnosed between 1980 and<br/>1991 were included. Forty-two percent of the patients received adjuvant endocrine treatment and 2 % received adjuvant<br/>chemotherapy. All biomarkers were analyzed immunohistochemically on tissue microarray, whereas histological grade was<br/>evaluated on whole sections according to Elston and Ellis (NHG). The primary endpoint was breast cancer mortality (BCM).<br/>Results: In univariable analyses with 10-year follow-up, Ki67 (high vs. low), NHG (3 vs. 1+2) and AIB1 (high vs. low) were<br/>significantly associated to BCM (Hazard Ratio: 4.7, 95% CI: 2.1–10.4, p 95% CI: 1.4–7.2, p = 0.005 respectively), whereas PgR (respectively). Essentially the same effect was seen after multivariable adjustment for lymph node status (+ vs. -), tumor size (&gt;20<br/>mm vs. according to St Gallen surrogate definitions did not show significant prognostic differences between the two groups (p = 0.12).<br/>Patients with AIB1) had a 10-year BCM of 4.2% (95% CI: 1.4–12%). This group constituted 34% of the patients included in the present study.<br/>Conclusions: In contrast to other previous studies, where breast cancers of mixed histological types were included, PgR was not<br/>significantly associated to prognosis in the ER-positive HER2-negative subgroup in the present study, consisting only of ILC. The<br/>prognostic role of PgR and the clinical usefulness of the luminal A and B-like (HER2-negative) classification (using only Ki67 and<br/>PgR) in ILC is still to be further investigated. The prognostic importance of Ki67 and NHG in this subgroup was, however,<br/>confirmed also in ILC, and AIB1 might be a new putative prognostic factor. By combining Ki67, NHG, and AIB1, together with<br/>lymph node status and tumor size, a group of patients with an excellent prognosis could be identified.}},
  author       = {{Narbe, Ulrik and Forsare, Carina and Bendahl, Pär-Ola and Lövgren, Kristina and Alkner, Sara and Sjöström, Martin and Ryden, Lisa and Leeb-Lundberg, Fredrik and Ingvar, Christian and Fernö, Mårten}},
  language     = {{eng}},
  pages        = {{1--07}},
  title        = {{AIB1 is a new putative prognostic biomarker in the luminal A and B-like (HER2-negative) classification of invasive lobular carcinoma}},
  url          = {{https://www.sabcs.org/Portals/SABCS2016/Documents/SABCS-2017-Abstracts.pdf}},
  year         = {{2017}},
}