Diagnostic utility of snail in metaplastic breast carcinoma

Aziza Nassar, Nicole Sookhan, Marta Santisteban, Sandra C. Bryant, Judy C Boughey, Tamar Giorgadze, Amy C Degnim

Research output: Contribution to journalArticle

13 Citations (Scopus)

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.

Original languageEnglish (US)
Article number76
JournalDiagnostic Pathology
Volume5
Issue number1
DOIs
StatePublished - Nov 26 2010

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Snails
Breast Neoplasms
Keratins
Epidermal Growth Factor Receptor
Epithelial-Mesenchymal Transition
Cell Adhesion Molecules
Progesterone Receptors
Cadherins
Estrogen Receptors
Transcription Factors
Lymph Nodes
Immunohistochemistry
Carcinoma
Sensitivity and Specificity
Control Groups
Incidence
Growth
Neoplasms

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Cite this

Diagnostic utility of snail in metaplastic breast carcinoma. / Nassar, Aziza; Sookhan, Nicole; Santisteban, Marta; Bryant, Sandra C.; Boughey, Judy C; Giorgadze, Tamar; Degnim, Amy C.

In: Diagnostic Pathology, Vol. 5, No. 1, 76, 26.11.2010.

Research output: Contribution to journalArticle

Nassar A, Sookhan N, Santisteban M, Bryant SC, Boughey JC, Giorgadze T et al. Diagnostic utility of snail in metaplastic breast carcinoma. Diagnostic Pathology. 2010 Nov 26;5(1). 76. https://doi.org/10.1186/1746-1596-5-76
Nassar, Aziza ; Sookhan, Nicole ; Santisteban, Marta ; Bryant, Sandra C. ; Boughey, Judy C ; Giorgadze, Tamar ; Degnim, Amy C. / Diagnostic utility of snail in metaplastic breast carcinoma. In: Diagnostic Pathology. 2010 ; Vol. 5, No. 1.
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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.",
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