Biological subtypes of breast cancer: Prognostic and therapeutic implications

Aims. Cardiovascular diseases are the primary cause of premature morbidity and mortality in early breast cancer patients after treatment with cardiotoxic chemotherapeutic agents. Arterial stiffness is an independent risk factor for future cardiovascular diseases and can be used as a predictive marker of subclinical cardiac damage. The aim of this study is to analyze the arterial stiffness in breast cancer patients who are in the follow-up period after receiving anthracycline-based chemotherapy regimens with trastuzumab. Methods and Material. We enrolled 45 HER2-positive breast cancer patients who are on follow-up at least for six months after completion of adjuvant chemotherapy with trastuzumab, and cardiovascular risk matched 30 control volunteers. The measurements were done with pulse wave analyzing machine. Results. Mean pulse wave velocity was higher in breast cancer patients compared to controls. The pulse wave velocity was significantly higher in patients receiving aromatase inhibitors compared to patients under tamoxifen. It was also significantly higher in postmenopausal breast cancer patients than postmenopausal controls. Conclusions. Arterial stiffness measurements may predict the breast cancer survivors with higher risk for cardiovascular events earlier in the follow-up period, and necessary preventive approaches and/or treatments can be applied.

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumour in adults. Identification of accessible and cost‑effective prognostic factors may better guide adjuvant treatment‑related decisions. The neutrophil‑to‑lymphocyte ratio (NLR) and platelet‑to‑lymphocyte ratio (PLR) are markers of host inflammatory response, and their increase has recently been shown to be a poor prognostic factor in several malignancies. The aim of the present study was to investigate the prognostic value of preoperative NLR and PLR in GBM patients. Between 2012 and 2017, 104 patients who had undergone surgery for GBM were considered for adjuvant therapy in our institution. Of those, 80 patients with evaluable pre‑corticosteroid full blood count results were identified and included in the final analysis. The Eastern Cooperative Oncology Group performance status, localization, radiochemotherapy and second‑line systemic therapy were found to be independent prognostic indicators for progression‑free and overall survival. The median overall survival was 13.2 months. Patients with NLR 4; however, this difference was not statistically significant (P>0.05). Overall survival also did not differ significantly between patients with low and those with high PLR values (10.2 vs. 15.2 months, respectively; P=0.105). In conclusion, the results of the present study suggest that pre‑treatment NLR and PLR do not have prognostic value in GBM patients; however, large‑scale trials are required to confirm these findings.

Background: Breast cancer is a heterogeneous complex of diseases comprising different subtypes that have different treatment responses and clinical outcomes. Systemic inflammation is known to be associated with poor prognosis in many types of cancer. The neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR) are factors used as indicators of inflammation. In this study, we evaluated NLR and PLR ratios in breast cancer subtypes. Methods: A total of 255 breast cancer patients were evaluated retrospectively. Patients were classified into three subtypes: estrogen receptor (ER)- or progesterone receptor (PR)-positive tumors were classified as luminal tumors; human epidermal growth factor receptor-2 (HER2)-overexpressed and ER-negative tumors were classified as HER2-positive tumors; and ER, PR, and HER2-negative tumors were classified as triple-negative tumors. The NLR and PLR were calculated. Results: The median NLR and PLR were 3 (0.37–37,1) and 137 (37.1–421.3), respectively. 66.7% of the patients were luminal type, 19.2% were HER2 positive, and 14.1% were triple negative. NLR was not associated with grade (p: 0.412), lymphovascular invasion (p: 0.326), tumor size (p: 0.232) and metastatic lymph node involvement (p: 0.406). PLR was higher in the patients with lymph node metastasis than in those without lymph node metastasis (p: 0.03). The NLR was 2 in the luminal group, 1.8 in the HER2-positive group, and 1.9 in the triple-negative group, but the differences were not significant(p: 0.051). PLR was 141 in the luminal group, 136 in the HER2-positive group, and 130 in the triple-negative group, but the differences were not significant. Conclusion: We could not find any significant differences for NLR and PLR according to breast cancer subtypes.

Oncocytic neoplasms occur in several organs and are most commonly found in the thyroid, kidneys and salivary glands. Oncocytic neoplasms of the adrenal cortex are extremely rare and are usually non-functioning.

Nodal (N) status and molecular subtypes are well-known prognostic factors for breast cancer patients. The aim of the present study was to evaluate whether there was a prognostic role of molecular subtypes for pN3a breast cancer patients in the inodern therapeutic era. The present study retrospectively evaluated a total of 521 breast cancer patients who had 10 or more metastatic lymph nodes and received adjuvant systemic therapy at the Oncology Department of four different centers in Turkey between 2000-2015. Patients were divided into four molecular subtypes by immunohistochemical staining. There were no significant differences in relapse rates according to the molecular subtypes (P=0.07). The five year disease free survival rate was 62% for the whole study population, 67% for Luminal A tumors, 53% for Luminal B tumors, 64% for human epidermal growth factor receptor 2-positive tumors and 56% for triple negative tumors. Luminal A patients had a better progression free survival when compared with Luminal B (P=0.026) and triple negative (P=0.07) patients. pT stage (P<0.001), and breast cancer subtype (P<0.001), remained significant independent factors for disease free survival. Therefore, breast cancer subtypes are still prognostic for patients with pN3 breast cancer.