Prognostic Value of Tertiary Lymphoid Structures in Primary Breast Cancer and Their Association With Immune...

Area of Science:

• Oncology
• Immunology
• Pathology

Background:

• Tertiary lymphoid structures (TLS) are transient immune aggregates found in various diseases.
• Their role in primary breast cancer (BC) and association with the tumor immune microenvironment remain incompletely understood.

Purpose of the Study:

• To investigate the distribution, maturity, and prognostic significance of TLS in primary breast cancer.
• To analyze the relationship between TLS features and the tumor immune microenvironment, including immune cell infiltration and patient survival.

Main Methods:

• Retrospective analysis of 60 primary breast cancer tumor samples.
• Immunohistochemical staining to evaluate TLS presence and maturity.
• Kaplan-Meier survival analysis and logistic regression to assess recurrence-free survival (RFS) and predictive factors.

Main Results:

• TLS were detected in 58.33% of patients, with secondary follicle-like TLS being the most common mature type.
• TLS presence was associated with higher estrogen and progesterone receptor expression (p<0.05).
• TLS presence significantly correlated with improved RFS (HR=0.163, p=0.035) and increased CD4+ T cell infiltration (p=0.004).

Conclusions:

• Mature TLS, particularly secondary follicle-like structures, are associated with favorable clinicopathological features and improved prognosis in primary breast cancer.
• TLS presence indicates enhanced CD4+ T cell infiltration, highlighting their role in regulating the tumor immune microenvironment.
• TLS may serve as a prognostic biomarker and a potential target for immunomodulatory therapies in breast cancer.