Presentation is loading. Please wait.

Presentation is loading. Please wait.

Is mammacarcinoom onder de veertig jaar morfologisch en genetisch een andere ziekte? Marc van de Vijver, Netherlands Cancer Institute, Amsterdam, NL.

Similar presentations


Presentation on theme: "Is mammacarcinoom onder de veertig jaar morfologisch en genetisch een andere ziekte? Marc van de Vijver, Netherlands Cancer Institute, Amsterdam, NL."— Presentation transcript:

1 Is mammacarcinoom onder de veertig jaar morfologisch en genetisch een andere ziekte? Marc van de Vijver, Netherlands Cancer Institute, Amsterdam, NL

2 Age & local control Local recurrence risk for 1393 breast carcinomas treated with BCT according to different age groups Elkhuizen et al. Int J Radiat Oncol Biol Phys 40: , 1998 Age <  75 LOCAL RECURRENCE RISK

3 RR 1.37, P < Overall survival adjusted for tumor size, nodal status, chemotherapy and trial patients with primary operable breast cancer from 4 randomized EORTC trials

4 Histologische classificatie type en graad

5 Differences between breast carcinoma in young patients compared to older patients <40 years 50% grade 3 50% ER negative > 60 years 20% grade 3 20% ER negative There are also small differences in size and % of lymph node positive patients Histopathological factors

6 Clinical detection Time (years) Grade 3 (faster growth) Grade 1 (slower growth)

7 common precursor? LCIS well diff DCIS moder diff DCIS poorly diff DCIS ? E-cadherin inactivation LOH 16q invasive lobular carcinoma invasive ductal carc. grade 1 invasive ductal carc. grade 2 invasive ductal carc. grade 3 invasive ductal carc. grade 3 p53 mut., HER2 gene amplif. BRCA1/2 germline mutation inactivation of BRCA1/2 wildtype allele

8 Differences between breast carcinoma in young patients compared to older patients <40 years 10% is BRCA1/2 associated > 60 years 2% is BRCA1/2 associated No major differences in the type of genetic alterations in sporadic tumors Genetic factors

9 Histologic grade Lakhani et al., J Clin Oncol 2003

10 Estrogen receptor in BRCA1 and 2 associated breast carcinomas Lakhani et al., J Clin Oncol 2003

11 HER2 in BRCA1 and 2 associated breast carcinomas Lakhani et al.JCO2003

12 P53 in BRCA1 and 2 associated breast carcinomas Lakhani et al. JCO2003

13 Basal keratins in BRCA1 and 2 associated breast carcinomas Lakhani et al. (Breast Cancer Linkage Consortium) submitted

14 Scanned image of a flexjet 25,000 gene human microarray Hybridized with mixture of ‘red’- labeled cRNA of a tumor sample and ‘green’-labeled reference cRNA Analysis of gene expression in breast cancer

15 Perou et al., Nature 406 (2000)

16

17 Subgroup analysis of the N4+ study Juliane Hannemann, Marc van de Vijver Harm van Tinteren, Sjoerd Rodenhuis

18 Definition of subgroups

19 Sample Frequency

20 Recurrence-free survival associated with molecular subtypes

21 Overall survival associated with molecular subtypes

22 Conclusions: Breast carcinomas in young patients are more frequently of high histologic grade and ER negative; However, this only partly explains poor outcome in these patients, especially the high local recurrence rate after BCT BRCA1/2 associated tumors have distinct histological and genetic features, but only represent a small proportion of all tumors, even in young patients No specific genetic alterations have been found to be associated with tumors in young patients


Download ppt "Is mammacarcinoom onder de veertig jaar morfologisch en genetisch een andere ziekte? Marc van de Vijver, Netherlands Cancer Institute, Amsterdam, NL."

Similar presentations


Ads by Google