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Novel genetic aberrations in breast phyllodes tumours: comparison between prognostically distinct groups.

Wai Jin Tan1, Johnathan C Lai, Aye Aye Thike

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Genetic aberrations in phyllodes tumours of the breast correlate with clinical behaviour. Increased chromosomal abnormalities, amplifications (e.g., EGFR), and deletions (e.g., CDKN2A) were found in aggressive phyllodes tumours, aiding targeted therapy development.

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Area of Science:

  • Oncology
  • Genetics
  • Pathology

Background:

  • Phyllodes tumours of the breast are rare fibroepithelial neoplasms with unpredictable clinical behaviour.
  • Histological assessment has limitations in predicting phyllodes tumour prognosis.
  • Molecular data on phyllodes tumours are limited but crucial for understanding disease progression.

Purpose of the Study:

  • To investigate genetic aberrations in phyllodes tumours.
  • To correlate genetic changes with clinical behaviour (recurrence/metastasis).
  • To identify potential therapeutic targets for phyllodes tumours.

Main Methods:

  • Analysis of 20 phyllodes tumours stratified by clinical outcome.
  • Utilized Affymetrix OncoScan™ FFPE Express microarray for copy number and mutation analysis.
  • Cross-validation with Sanger sequencing, FISH, and immunohistochemistry.

Main Results:

  • Phyllodes tumours that recurred/metastasized showed significantly more chromosomal aberrations (median 19 events) than non-recurring ones (median 3.5 events).
  • High-level amplifications (MDM4, RAF1, EGFR, PDZD2) and homozygous deletions (CDKN2A, MACROD2) were exclusive to aggressive cases.
  • EGFR amplification correlated with increased EGFR protein expression; CDKN2A deletion correlated with protein loss.

Conclusions:

  • Genetic aberrations, particularly copy number changes, are associated with aggressive phyllodes tumour behaviour.
  • Specific amplified (EGFR) and deleted (CDKN2A) genes represent potential therapeutic targets.
  • Molecular profiling can improve understanding and guide individualized treatment strategies for phyllodes tumours.