GATA-3 Expression in Different Immunohistochemical Classes of Invasive Breast Carcinoma
Shimaa Abd El Raouf El Said;
Abstract
SUMMARY
W
orldwide, breast carcinoma is the most common malignancy in women. In Egypt, breast carcinoma accounts for 18.6- 31% of all female carcinomas and has a younger age distribution than in Europe and North America.
Breast carcinoma (BC) is a heterogeneous disease with different histopathological and molecular characteristics. They were categorized into at least five main molecular subgroups which have different clinical outcomes and overall survival. Patient with a history of breast cancer, when carcinoma occurs at another organ site, it is important to distinguish between metastatic breast cancer and a second primary.
Estrogen receptor (ER), Gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin are the most commonly used immunomarkers for identifying breast primary in metastatic tumors of unknown origin. The reported sensitivities for Gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin are 35% and 50% respectively.
GATA-3 is emerging as a sensitive and relatively specific marker for breast carcinomas. Several studies reported its high expression in breast and urothelial carcinomas.
The purpose of this study is to investigate the expression of GATA-3 in different molecular and histomorphologic subtypes of breast carcinoma, as well as, evaluation of GATA-3 expression in metastatic breast carcinoma.
A total of 85 cases were included in the current study were collected from the archive of Pathology Department of Al-Demerdash Hospital and Ain Shams University Specialized Hospital. The cases were categorized into 60 cases of primary invasive breast carcinoma, divided into ER positive [luminal (A and B)], HER2 positive and triple-negative molecular subtypes. In addition 25 cases of metastatic adenocarcinoma were included. All metastatic cases had previous history of breast carcinoma.
In the present study positive GATA-3 expression was detected in 54 (90%) of the primary breast carcinoma cases. Seventy-eight percent of the cases showed a strong and diffuse (4+ and 3+) nuclear staining. All of ER positive primary breast carcinoma cases were positive for GATA-3. Furthermore, GATA-3 expression was detected in (80%) and (90%) of HER2 positive and triple negative carcinomas, respectively. The difference was significant statistically.
According to the morphologic types of primary breast carcinomas in the current study 90.9% of invasive duct carcinomas (IDC-NST) showed GATA-3 expression. All invasive lobular carcinomas (ILCs) examined were positive for GATA-3 labeling. As regards GATA-3 expression in medullary carcinomas (MCs); this study revealed that positive GATA-3 expression was detected in 80% of MCs. Mucinous and micropapillary carcinoma cases examined in the present study were 100% strongly positive for GATA-3.
Data of the present study showed a statistically significant negative correlation between GATA-3 expression and the tumor grade. However, the current study didn’t find a statistically significant correlation between GATA-3 expression and tumor size or lymph node status.
However the data of the present study didn’t show a statistically significant correlation between different age groups and GATA-3 expression. The cases which showed strong and diffuse (4+) GATA-3 expression were among young age group with mean age (53.03). On the other hand, the cases which showed lost GATA-3 expression were among older age group with the mean age (61.83).
In the present study (24/25) 96% of metastatic carcinoma cases were positive for GATA-3. No statistically significant difference was detected in GATA-3 expression in primary breast carcinomas versus metastatic carcinoma cases. Statistical analysis of the data of the present study didn’t find a statistically significant distinction between GATA-3 expression in primary breast carcinoma and metastatic carcinoma cases. This support the fact that GATA-3 expression is maintained in primary as well as metastatic breast carcinomas including ER negative cases
GATA-3 is a breast-specific immunomarker, especially when encountering ER-negative breast carcinomas. GATA-3 should be included in the panel of immunomarkers in the workup of tumors of unknown primary, when metastatic breast carcinoma is a consideration. That will be useful in early diagnosis, proper management and increase overall survival.
W
orldwide, breast carcinoma is the most common malignancy in women. In Egypt, breast carcinoma accounts for 18.6- 31% of all female carcinomas and has a younger age distribution than in Europe and North America.
Breast carcinoma (BC) is a heterogeneous disease with different histopathological and molecular characteristics. They were categorized into at least five main molecular subgroups which have different clinical outcomes and overall survival. Patient with a history of breast cancer, when carcinoma occurs at another organ site, it is important to distinguish between metastatic breast cancer and a second primary.
Estrogen receptor (ER), Gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin are the most commonly used immunomarkers for identifying breast primary in metastatic tumors of unknown origin. The reported sensitivities for Gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin are 35% and 50% respectively.
GATA-3 is emerging as a sensitive and relatively specific marker for breast carcinomas. Several studies reported its high expression in breast and urothelial carcinomas.
The purpose of this study is to investigate the expression of GATA-3 in different molecular and histomorphologic subtypes of breast carcinoma, as well as, evaluation of GATA-3 expression in metastatic breast carcinoma.
A total of 85 cases were included in the current study were collected from the archive of Pathology Department of Al-Demerdash Hospital and Ain Shams University Specialized Hospital. The cases were categorized into 60 cases of primary invasive breast carcinoma, divided into ER positive [luminal (A and B)], HER2 positive and triple-negative molecular subtypes. In addition 25 cases of metastatic adenocarcinoma were included. All metastatic cases had previous history of breast carcinoma.
In the present study positive GATA-3 expression was detected in 54 (90%) of the primary breast carcinoma cases. Seventy-eight percent of the cases showed a strong and diffuse (4+ and 3+) nuclear staining. All of ER positive primary breast carcinoma cases were positive for GATA-3. Furthermore, GATA-3 expression was detected in (80%) and (90%) of HER2 positive and triple negative carcinomas, respectively. The difference was significant statistically.
According to the morphologic types of primary breast carcinomas in the current study 90.9% of invasive duct carcinomas (IDC-NST) showed GATA-3 expression. All invasive lobular carcinomas (ILCs) examined were positive for GATA-3 labeling. As regards GATA-3 expression in medullary carcinomas (MCs); this study revealed that positive GATA-3 expression was detected in 80% of MCs. Mucinous and micropapillary carcinoma cases examined in the present study were 100% strongly positive for GATA-3.
Data of the present study showed a statistically significant negative correlation between GATA-3 expression and the tumor grade. However, the current study didn’t find a statistically significant correlation between GATA-3 expression and tumor size or lymph node status.
However the data of the present study didn’t show a statistically significant correlation between different age groups and GATA-3 expression. The cases which showed strong and diffuse (4+) GATA-3 expression were among young age group with mean age (53.03). On the other hand, the cases which showed lost GATA-3 expression were among older age group with the mean age (61.83).
In the present study (24/25) 96% of metastatic carcinoma cases were positive for GATA-3. No statistically significant difference was detected in GATA-3 expression in primary breast carcinomas versus metastatic carcinoma cases. Statistical analysis of the data of the present study didn’t find a statistically significant distinction between GATA-3 expression in primary breast carcinoma and metastatic carcinoma cases. This support the fact that GATA-3 expression is maintained in primary as well as metastatic breast carcinomas including ER negative cases
GATA-3 is a breast-specific immunomarker, especially when encountering ER-negative breast carcinomas. GATA-3 should be included in the panel of immunomarkers in the workup of tumors of unknown primary, when metastatic breast carcinoma is a consideration. That will be useful in early diagnosis, proper management and increase overall survival.
Other data
| Title | GATA-3 Expression in Different Immunohistochemical Classes of Invasive Breast Carcinoma | Other Titles | إظهار جتا-3 فى الأنماط المناعيه المختلفه لسرطان الثدي المتغلغل | Authors | Shimaa Abd El Raouf El Said | Issue Date | 2016 |
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