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Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...
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  1. Home
  2. Stromal Lymphocytes Are Associated With Upgrade Of B3 Breast Lesions.
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  2. Stromal Lymphocytes Are Associated With Upgrade Of B3 Breast Lesions.

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Stromal lymphocytes are associated with upgrade of B3 breast lesions.

Tanjina Kader1,2,3, Elena Provenzano4, Madawa W Jayawardana1,2

  • 1Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia.

Breast Cancer Research : BCR
|July 8, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Stromal lymphocytes in breast biopsies may help predict cancer upgrades in uncertain lesions. Counting these immune cells, alongside patient age and lesion type, can identify women who might avoid unnecessary surgery.

Keywords:
Atypical ductal hyperplasiaB3 lesionsBiomarkerDuctal carcinoma in situEarly breast neoplasiaLesions of uncertain malignant potentialStromal lymphocytesTumour infiltrating lymphocytesUpgrade

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Area of Science:

  • Oncology
  • Pathology
  • Immunology

Background:

  • Women with B3 or BIRADS 3/4A breast lesions face uncertain malignant potential.
  • Surgical excision is common to rule out ductal carcinoma in situ or invasive breast cancer, occurring in up to 30% of cases.
  • Identifying non-surgical candidates could reduce overtreatment.

Purpose of the Study:

  • To investigate the stromal immune microenvironment, specifically lymphocyte counts, as a predictive biomarker for cancer upgrade in B3 lesions.
  • To develop a predictive model for upgrade using immune cell counts and clinical factors.

Main Methods:

  • Histopathological analysis of breast biopsies from 307 women with B3 lesions.
  • Quantification of lymphocytes in the stromal microenvironment surrounding the lesions.
  • Development and validation of a predictive model combining lymphocyte counts, patient age, and lesion type.
  • Main Results:

    • A significantly higher number of stromal lymphocytes was observed in upgraded B3 lesions (ductal and papillary) compared to non-upgraded lesions (p < 0.01).
    • A predictive model incorporating lymphocytes, age, and lesion type achieved an area under the curve of 0.82 (95% CI 0.77-0.87) for predicting upgrade.
    • The model demonstrated high sensitivity but limited specificity in identifying patients at risk of upgrade.

    Conclusions:

    • Stromal lymphocyte counts in biopsies show potential as a biomarker to predict cancer upgrade in B3 breast lesions.
    • A predictive model combining immune cell assessment with clinical data may help reduce unnecessary surgical interventions.
    • Further research is needed to incorporate additional predictive features for improved specificity.