Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
A biomarker study in Peruvian males with breast cancer
Carlos A Castaneda, Miluska Castillo, Luis A Bernabe, Joselyn Sanchez, Ebert Torres, Nancy Suarez, Katherine Tello, Hugo Fuentes, Jorge Dunstan, Miguel De La Cruz, Jose Manuel Cotrina, Julio Abugattas, Henry Guerra, Henry L Gomez
Carlos A Castaneda, Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15067, Peru
Carlos A Castaneda, Hugo Fuentes, Henry L Gomez, Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
Miluska Castillo, Luis A Bernabe, Joselyn Sanchez, Nancy Suarez, Katherine Tello, Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
Ebert Torres, Henry Guerra, Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
Jorge Dunstan, Miguel De La Cruz, Jose Manuel Cotrina, Julio Abugattas, Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
Author contributions: Castaneda CA, Gomez H and Castillo M contributed to the conception, design of the study, performed data analysis and interpretation; Bernabe LA, Sanchez J, Torres E, Suarez N, Tello K and Guerra H performed data acquisition, as well as providing technical support; Fuentes H, Dunstan J, De La Cruz M, Cotrina JM and Abugattas J provided administrative and material support; all authors drafted the article, made critical revisions related to the intellectual content of the manuscript and approved the final version of the article to be published.
Supported by the Consejo Nacional de Ciencia, Tecnologia e Innovacion Tecnologica, No. 198-2015-FONDECYT.
Institutional review board statement: This study was reviewed and approved by the Instituto Nacional de Enfermedades Neoplasicas Institutional Review Board. Personal and filiation data including identity of every patient was protected with an added code in the excel table. It is a retrospective case series that does not have any not activity or contact with the patients.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Carlos A Castaneda, MD, MSc, Associate Research Scientist, Faculty of Health Sciences, Universidad Cientifica del Sur, Carr. Panamericana Sur 19, Villa El Salvador, Lima 15067, Peru.
carloscastanedaaltamirano@yahoo.com
Received: March 13, 2021
Peer-review started: March 13, 2021
First decision: June 7, 2021
Revised: June 25, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: October 24, 2021
Processing time: 222 Days and 17.7 Hours
BACKGROUND
Breast cancer (BC) frequency in males is extremely low and tumor features vary from its female counterpart. Breast cancer clinical and pathological features differ by race in women. Tumor infiltrating lymphocyte (TIL) levels, mismatch repair (MMR) protein loss, androgen receptor (AR) expression, and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC. There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.
AIM
To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.
METHODS
This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018. Standard pathological features, TIL levels, MMR proteins, AR immunohistochemistry staining, and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material. Percentage of AR and estrogen receptor (ER) positive cells was additionally calculated by software after slide scanning. Statistical analyses included association tests, intraclass correlation test and Kaplan Meier overall survival curves.
RESULTS
The median age was 63 years and most cases were ER-positive (85.7%), HER2 negative (87.2%), Luminal-A phenotype (60%) and clinical stage II (41.5%) among our male breast tumors. Median TIL was 10% and higher levels tended to be associated with Luminal-B phenotype and higher grade. AR-positive was found in 85.3% and was correlated with ER (intraclass index of 0.835, P < 0.001). Loss of MMR proteins was found in 15.4% and PIK3CA mutation (H1047R) in 14.3% (belonged to the Luminal-A phenotype). Loss of MMR proteins was associated with AR-negative (P = 0.018) but not with ER (P = 0.43) or TIL (P = 0.84). Early stages (P < 0.001) and lower grade (P = 0.006) were associated with longer overall survival. ER status, phenotype, AR status, TIL level, MMR protein loss nor PIK3CA mutation was not associated with survival (P > 0.05).
CONCLUSION
Male BC is usually ER and AR positive, and Luminal-A. MMR loss and PIK3CA mutations are infrequent. Stage and grade predicted overall survival in our South American country population.
Core Tip: Most male breast cancers were estrogen receptor-positive, HER2-negative, androgen receptor (AR)-positive, and Luminal A phenotype. Loss of mismatch repair (MMR) and PIK3CA mutations was found in around 15% of the cases. AR was correlated with ER expression and without loss of MMR proteins. Stage and grade are prognostic features in Peruvian male breast cancer.
