Prognostic effect analysis of molecular subtype on young breast cancer patients

Objective： To make a prognostic effect analysis of molecular subtype on young breast cancer patients.Methods： Totally 187 cases of young breast cancer patients less than 40 years old treated in Obstetrics and Gynecology Hospital of Fudan University between June 2005 and June 2011 were included in our study. We described their clinical-pathological characteristics, disease-free survival（DFS） rate, and overall survival（OS） rate after a median follow-up period of 61 months. The factors associated with prognosis were also evaluated by univariate and multivariate analyses.Results： All patients were premenopausal, with an average age of 35.36±3.88 years old. The mean tumor size was 2.43±1.53 cm. Eighty-one cases had lymph node metastasis（43.3%）, 126 cases had lymphovascular invasion（67.4%）, and 125 cases had histological grade III（66.8%） disease. Twenty-seven cases（14.4%） were Luminal A subtype, 99 cases（52.9%） were Luminal B subtype, 29 cases（15.5%） were human epidermal growth factor receptor 2（HER-2） overexpression subtype, while 32 cases（17.1%） were triple negative breast cancer（TNBC） subtype according to 2013 St Gallen expert consensus. One hundred and thirty-five cases underwent mastectomy whereas 52 cases had breast-conserving surgery. One hundred and seventy-eight cases underwent adjuvant or neoadjuvant chemotherapy. Recurrence or metastasis occurred in 29 cases, 13 of which died. The 5-year DFS and OS rates were 84% and 92%. Multivariate analysis showed that nodal status（P=0.041） and molecular subtype（P=0.037） were both independent prognostic factors of DFS, while nodal status（P=0.037） and TNBC subtype（P=0.048） were both independent prognostic factors of OS. Conclusions： Molecular subtype is an independent prognostic factor of young breast cancer patients. TNBC has a high risk of relapse and death.

Clinicopathological Data of Breast Cancer in Diabetic Patients

Background: Diabetes mellitus and breast cancer are both chronic diseases. Breast cancer in patients with diabetes is often diagnosed at an advanced stage and has worse prognosis. Aim of work: To investigate the clinicopathological factors, hormonal receptor status and molecular subtypes of breast cancer in diabetic breast cancer patients. Patients and methods: Records of patients presenting to the radiotherapy committee of the breast cancer clinic of Ain Shams University Hospital in the period between January 2017 and January 2018 were revised regarding age, presence of diabetes, presence of comorbidities, and type of the surgery performed. Pathological data such as: Tumor size (T), LN staging (LN), ER, PR, Her2/neu and Ki67 status were also recorded. Patients were divided into 2 groups: Group (I): those with diabetes and Group (II): those without diabetes. Inclusion criteria were Breast cancer cases with proven pathological diagnosis, available IHC studies, clear record of comorbidity status, age > 18 years, cases who underwent upfront surgery. Exclusion criteria were metastatic cases, bilateral cases, cases with double primary, male breast cancer cases, and those with missing data for ER, PR and Her2/neu. Results: Retrieving data from the files of the patients that met the inclusion criteria in the allocated period revealed that 117 patients had diabetes (Group I) and 199 didn’t have the disease (Group II), There was a highly significant difference between both groups regarding the age as most of the patients with diabetes were above fifty years of age (84.6%) compared to only 44.7% of the patients without diabetes also the mean age of patients with diabetes was significantly higher (59 years) compared to 48 years of age for those without diabetes. Diabetes was associated with hypertension in most of the cases (69%). Comorbidities other than hypertension were recorded in 39 diabetic patients (33.3%) and 21 (10.6%) nondiabetic patients and the difference was statistically highly significant. In the diabetic group, the most encountered comorbidity was cardiac disease in 14.5% of patients. In the diabetic group, most of the patients underwent modified radical mastectomy (MRM) with a percentage of about 54.7% compared to 48.2% of patients for both groups respectively. Regarding pathological data apart from the finding that presence of diabetes was associated with more multiple tumors (p value: 0.013), no other statistically significant differences between both groups were found. Hormonal receptor status and molecular subtypes were also not affected by presence of diabetes in the studied breast cancer patients.

Dual-miRNA-Propelled Three-Dimensional DNA Walker for Highly Specific and Rapid Discrimination of Breast Cancer Cell Subtypes in Clinical Tissue Samples

Accurate discrimination of cell subtypes at the molecular level is especially important for cancer diagnosis,but no current method allows rapid and precise detection of breast cancer subtypes.Herein,we developed an elegant DNA walker for direct and rapid differentiation of breast cancer cell subtypes via detection of dual-miRNAs in clinical tissue samples.This DNA nanomachine can be specifically initiated by endogenous miR-21 and miR-31,and the sensitivity was dramatically improved due to the DNAzyme-mediated signal amplification.This DNA walker enabled rapid detection of double miRNA characteristics in different breast cell lines and also distinguished the fluctuations in a single cell.Applications of this DNAzyme-based nanomachine in vivo and in clinical samples were demonstrated for efficient detection of breast cancer subtypes,making the method generally applicable for precise management of cancers.