• CatBoost algorithm
• Metaplastic breast cancer
• Radiotherapy
• SEER
• SHAP

• Female
• Machine Learning
• Humans
• Breast Neoplasms/mortality
• Breast Neoplasms/pathology
• Breast Neoplasms/therapy
• Prognosis
• Middle Aged
• SEER Program
• Aged
• Adult
• Metaplasia
• Survival Rate
• Mastectomy, Segmental
• Radiotherapy, Adjuvant
• Neoplasm Staging

• Breast cancer-specific survival
• Hormone receptor status
• Metaplastic breast carcinoma
• Overall survival
• Race disparities
• Survival trends

• Humans
• Female
• Breast Neoplasms/mortality
• Breast Neoplasms/pathology
• Breast Neoplasms/therapy
• SEER Program
• Middle Aged
• Retrospective Studies
• Receptors, Progesterone/metabolism
• Receptors, Estrogen/metabolism
• Aged
• Adult
• Receptor, ErbB-2/metabolism
• Prognosis
• Cohort Studies
• Metaplasia
• Kaplan-Meier Estimate
• United States/epidemiology

• 21S11900400 Shanghai Municipal Science and Technology Project

• metaplastic breast cancer
• systemic treatment
• chemotherapy
• disease-free survival
• overall survival

• Humans
• Female
• Retrospective Studies
• Middle Aged
• Adult
• Aged
• Prognosis
• Breast Neoplasms/therapy
• Breast Neoplasms/pathology
• Breast Neoplasms/mortality
• Aged, 80 and over
• Treatment Outcome
• Disease-Free Survival
• Metaplasia/pathology
• Metaplasia/therapy
• Mastectomy
• Triple Negative Breast Neoplasms/pathology
• Triple Negative Breast Neoplasms/therapy
• Triple Negative Breast Neoplasms/mortality

• chemotherapy
• metaplastic breast cancer
• metastasis
• overall survival
• systemic treatment

• clinical trials
• epithelial–mesenchymal transition
• metaplastic breast carcinoma
• triple-negative breast carcinoma
• tumor immune microenvironment

• EphA2/PIK3R1/CTNNB1 pathway
• breast cancer
• targeted prediction and prevention
• vasculogenic mimicry

• funding

• Breast cancer
• Egypt
• Metaplastic
• National Cancer Institute
• Triple negative

• Metaplastic breast cancer
• Mixed histological subtype
• Propensity score matching
• Spindle
• Squamous

• 18ZXXYSY00070 Natural Science Foundation of Tianjin-Science and Technology Correspondent Project

• High-grade metaplastic breast carcinoma
• clinicopathological characteristics
• histological subtypes
• immunophenotype
• theranostic markers

• Clinical management
• Clinical outcomes
• Epithelial-to-mesenchymal transition
• Immunotherapy
• Metaplastic breast cancer
• Pathology
• Targeted therapy

• SEER
• metaplastic breast cancer
• nomogram
• overall survival (OS)
• prognosis

Objectives

Metaplastic breast cancer (MBC) is a rare neoplasm accounting for <1% of all breast cancer. We evaluated the clinical characteristics and survival outcomes of MBC.

Methods

Patients diagnosed with pathologically proven MBC were reviewed from the institutional breast cancer database from 2000 to 2017.

Results

A total of 136 patients diagnosed with MBC were included in the study. The median age of the diagnosis was 60 years, and 60% of patients were stage II at diagnosis, and 22% were stage III. About two-thirds of the patients were triple-negative; 93% had nuclear grade III, and 25% had a lymphovascular invasion. Squamous differentiation (29%) was the most common histologic subtype, followed by the spindle subtype (21%). The most common distant metastases were lung (22%), followed by bone (13%). Moreover, 60% had a mastectomy, 19% had endocrine therapy, 58% had radiation, 51% received anthracycline-based chemotherapy, 26% had non-anthracycline chemotherapy, and 22% received no chemotherapy. In the entire cohort, the two-year overall survival (OS) and five-year OS were 79% and 69%, respectively, and the two-year progression-free survival (PFS) and five-year PFS were 72% and 61%, respectively. On multivariable analysis, the stage of MBC (stage III: hazard ratio (HR), 5.065 (95% confidence interval (CI), 1.02-25.27) (p=0.048)), poor functional status (Eastern Cooperative Oncology Group (ECOG) score, 2; HR, 24.736 (95% CI, 1.92-318.73) (p=0.014)), and distant metastasis to the brain (HR, 8.453 (95% CI, 1.88-38.04) (p=0.005)) and lung (HR, 42.102 (95% CI, 7.20-246.36) (p<0.001)) were significant predictors of decreased OS.

Conclusions

MBC demonstrated early disease progression and poor overall survival. The stage of MBC, decreased performance status, and metastasis to the lung and brain were independent poor prognostic factors.

Breast cancer (BC) is the most common malignant tumor in women.

To investigate BC-associated hub genes to obtain a better understanding of BC tumorigenesis.

In total, 1203 BC samples were downloaded from The Cancer Genome Atlas database, which included 113 normal samples and 1090 tumor samples. The limma package of R software was used to analyze the differentially expressed genes (DEGs) in tumor tissues compared with normal tissues. The cluster Profiler package was used to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of upregulated and downregulated genes. Univariate Cox regression was conducted to explore the DEGs with statistical significance. Protein-protein interaction (PPI) network analysis was employed to investigate the hub genes using the CytoHubba plug-in of Cytoscape software. Survival analyses of the hub genes were carried out using the Kaplan-Meier method. The expression level of these hub genes was validated in the Gene Expression Profiling Interactive Analysis database and Human Protein Atlas database.

A total of 1317 DEGs (fold change > 2; P < 0.01) were confirmed through bioinformatics analysis, which included 744 upregulated and 573 downregulated genes in BC samples. KEGG enrichment analysis indicated that the upregulated genes were mainly enriched in the cytokine-cytokine receptor interaction, cell cycle, and the p53 signaling pathway (P < 0.01); and the downregulated genes were mainly enriched in the cytokine-cytokine receptor interaction, peroxisome proliferator-activated receptor signaling pathway, and AMP-activated protein kinase signaling pathway (P < 0.01).

In view of the results of PPI analysis, which were verified by survival and expression analyses, we conclude that MAD2L1, PLK1, SAA1, CCNB1, SHCBP1, KIF4A, ANLN, and ERCC6L may act as biomarkers for the diagnosis and prognosis in BC patients.

• Breast cancer
• Bioinformatics
• Hub gene
• The Cancer Genome Atlas
• Protein-protein interaction

The study aimed to analyze the prognostic factors of patients with triple-negative (TN) metaplastic breast carcinoma (MpBC) after surgery and to construct a nomogram for forecasting the 3-, 5-, and 8-year overall survival (OS).

A total of 998 patients extracted from the Surveillance, Epidemiology, and End Results (SEER) database were assigned to either the training or validation group at random in a ratio of 7:3. The clinical characteristics of patients in the training and validation sets were compared, and multivariate Cox regression analysis was used to identify the independent risk variables for the OS of patients with TN MpBC after surgery. These selected parameters were estimated through the Kaplan–Meier (KM) curves using the log-rank test. The nomogram for predicting the OS was constructed and validated by performing the concordance index (C-index), receiver operating characteristics (ROC) curves with area under the receiver operating characteristic curves (AUC), calibration curves, and decision curve analyses (DCAs). Patients were then stratified as high-risk and low-risk, and KM curves were performed.

Multivariate Cox regression analysis indicated that factors including age, marital status, clinical stage at diagnosis, chemotherapy, and regional node status were independent predictors of prognosis in patients with MpBC after surgery. Separate KM curves for the screened variables revealed the same statistical results as with Cox regression analysis. A prediction model was created and virtualized via nomogram based on these findings. For the training and validation cohorts, the C-index of the nomogram was 0.730 and 0.719, respectively. The AUC values of the 3-, 5-, and 8-year OS were 0.758, 0.757, and 0.785 in the training group, and 0.736, 0.735, and 0.736 for 3, 5, and 8 years in the validation group, respectively. The difference in the OS between the real observation and the forecast was quite constant according to the calibration curves. The generated clinical applicability of the nomogram was further demonstrated by the DCA analysis. In all the training and validation sets, the KM curves for the different risk subgroups revealed substantial differences in survival probabilities (P <0.001).

The study showed a nomogram that was built from a parametric survival model based on the SEER database, which can be used to make an accurate prediction of the prognosis of patients with TN MpBC after surgery.

• National Natural Science Foundation of China
• Applied Basic Research Foundation of Yunnan Province

Metaplastic Breast Cancer (MBC) of the breast is a rare entity of breast cancer, with a very poor prognosis, and whose pathophysiology is still unwell established. Therapeutic management is very heterogeneous due to its incomplete understanding. The aim of this study is to describe the demographic, clinical, and therapeutic characteristics of our MBC patient.

A cross-sectional study was conducted to evaluate the demographic and clinicopathological features of these patients. Data of patients diagnosed with metaplastic breast cancer were retrieved from our breast cancer database in Queen Elizabeth Hospital II from January 2015 to May 2021.

14 patients were diagnosed with metaplastic breast cancer during this period of study. All of them were female, with the average age of 52 years old. The patients were predominantly Bajau and Kadazan Dusun, each comprising of 35%(n = 5). 57% (n = 8) of patients were postmenopausal. 85% (n = 12) of patients were presented with breast lump of an average largest diameter of 69.23 mm. BIRADS staging of the affected breast revealed that most of the patients were BIRADS 5.57% (n = 8) patients underwent mastectomy, 4 went for either breast conserving surgery of the breast. The most common histopathological type is squamous cell carcinoma, which accounts for 42% (n = 6) of the patients. 71% (n = 10) were pathologically triple negative. 7 patients were pathologically node positive. 35% (n = 5) had lung metastasis, and one of the patients had concurrent lung and liver metastasis.

The prognosis of patients with Metaplastic carcinoma of breast remains poor because most of it detected late and histologically triple negative type. Till date, there is no specific management guideline which warrant a multi institutional studies evaluating role of new therapies such as Anti-PD-1 Therapy in combination with chemotherapy to improve patient outcome.

•

This article highlight the unique clinicopathological characteristic of special type of breast cancer, metaplastic breast cancer from cross sectional study from 2015 until 2021.

• Breast
• High-grade spindle cells
• MED12
• Malignant phyllodes tumor
• Metaplastic breast carcinoma
• Primary breast sarcomas

• Breast/pathology
• Breast Neoplasms/diagnosis
• Breast Neoplasms/genetics
• Carcinoma/diagnosis
• Carcinoma/genetics
• Female
• Humans
• Immunohistochemistry
• Phyllodes Tumor/diagnosis
• Phyllodes Tumor/genetics

• cancer
• diseases
• medical research
• oncology

• Humans
• Female
• Breast Neoplasms/drug therapy
• Breast Neoplasms/mortality
• Breast Neoplasms/pathology
• Middle Aged
• SEER Program
• Neoplasm Staging
• Aged
• Prognosis
• Adult
• Kaplan-Meier Estimate
• Propensity Score

• 81800414 National Natural Science Foundation of China
• 2021SK2026 Science and technology innovation Program of Hunan Province

Metaplastic breast cancer (MBC) are rare. The survival outcomes of MBC patients after breast conserving surgery plus radiotherapy (BCS+RT) or mastectomy have not been established. The study aimed to compare survival outcomes of MBC patients subjected to BCS+RT or mastectomy therapeutic options.

Patients who were subjected to BCS+RT or mastectomy between 2004 and 2014 were enrolled in this study through the Surveillance, Epidemiology and End Results (SEER) database. Breast cancer-specific survival (BCSS) and the overall survival (OS) of the participants were determined. Cox proportional hazard model and the Kaplan Meier method were used to determine the correlation between the two surgical methods and survival outcomes.

A total of 1197 patients were enrolled in this study. Among them, 439 patients were subjected to BCS+RT, while 758 patients were subjected to mastectomy. After propensity score matching (PSM), the BCS+RT and mastectomy groups consisted of 321 patients, respectively. The univariate and multivariate analysis with a 6-month landmark all indicate that patients receiving BCS+RT has higher OS than patients receiving mastectomy (HR = 0.701,95% CI = 0.496–0.990, P = 0.044; HR = 0.684,95% CI = 0.479–0.977, P = 0.037) while the BCSS was no difference between the two groups (HR = 0.739,95% CI = 0.474–1.153, P = 0.183; HR = 0.741,95% CI = 0.468–1.173, P = 0.200).

The BCS+RT therapeutic option exhibits a higher OS in MBC patients compared to the mastectomy approach.

• Adult
• Aged
• Aged, 80 and over
• Breast Neoplasms/mortality
• Breast Neoplasms/radiotherapy
• Breast Neoplasms/surgery
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Mastectomy, Segmental/methods
• Middle Aged
• Multivariate Analysis
• Prognosis
• Propensity Score
• Proportional Hazards Models
• Radiotherapy, Adjuvant/methods
• Retrospective Studies
• SEER Program
• Treatment Outcome
• Young Adult

Metaplastic breast carcinoma (MBC) is a heterogeneous group of infrequent triple negative (TN) invasive carcinomas with poor prognosis. MBCs have a different clinical behavior from other types of triple negative breast cancer (TNBC), being more resistant to standard chemotherapy. MBCs are an example of tumors with activation of epithelial–mesenchymal transition (EMT). The mechanisms involved in EMT could be responsible for the increase in the infiltrative and metastatic capacity of MBCs and resistance to treatments. In addition, a relationship between EMT and the immune response has been seen in these tumors. In this sense, MBC differ from other TN tumors showing a lower number of tumor-infiltrating lymphocytes (TILS) and a higher percentage of tumor cells expressing programmed death-ligand 1 (PD-L1). A better understanding of the relationship between the immune system and EMT could provide new therapeutic approaches in MBC.

• EMT
• MBC
• epithelial-mesenchymal transition immune system
• metaplastic breast carcinoma

• B7-H1 Antigen/immunology
• B7-H1 Antigen/metabolism
• Biomarkers, Tumor/genetics
• Biomarkers, Tumor/immunology
• Biomarkers, Tumor/metabolism
• Breast Neoplasms/drug therapy
• Breast Neoplasms/genetics
• Breast Neoplasms/immunology
• Breast Neoplasms/metabolism
• Cadherins/metabolism
• Carcinoma/drug therapy
• Carcinoma/genetics
• Carcinoma/immunology
• Carcinoma/metabolism
• Epithelial-Mesenchymal Transition/drug effects
• Epithelial-Mesenchymal Transition/genetics
• Epithelial-Mesenchymal Transition/immunology
• Female
• Humans
• Lymphocytes, Tumor-Infiltrating/immunology
• MicroRNAs/genetics
• MicroRNAs/metabolism
• Triple Negative Breast Neoplasms/genetics
• Triple Negative Breast Neoplasms/immunology
• Triple Negative Breast Neoplasms/metabolism
• Triple Negative Breast Neoplasms/pathology

• breast cancer
• metaplastic
• radiation
• triple negative

Purpose: Chemotherapy is the clinically recommended treatment for patients with operable metaplastic breast carcinoma (MBC); however, its impact remains controversial. This study investigated the possible role of chemotherapy in the treatment of MBC.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify the operable MBC patients. The competing risk analysis along with the propensity score matching (PSM) method was performed to evaluate the effect of chemotherapy. Moreover, a competing risk nomogram was built to identify prognosis in patients with MBC.

Results: Of the 1137 patients with MBC, 775 received chemotherapy and 362 did not receive chemotherapy. The 5-year cumulative incidence of breast cancer-specific death (BCSD) showed similar outcomes in both the Chemo and No-Chemo groups (21.1 vs. 24.3%, p = 0.57). Chemotherapy showed no apparent association with BCSD (HR, 1.07; 95% CI, 0.72–1.60; p = 0.72), even after subgroup analysis or PSM. Race, tumor size, lymph node status, and radiation were identified as the significant factors for MBC after a penalized variable selection process. In addition, a competing risk nomogram showed relatively good accuracy of prediction with a C-index of 0.766 (95% CI, 0.700–0.824).

Conclusion: Our findings demonstrated that chemotherapy did not improve BCSD for operable MBC patients. Thus, it may indicate the need to reduce exposure to the current chemotherapy strategies for patients with resectable MBC. Additionally, some novel treatment strategies are required urgently to identify and target the potential biomarkers.

• SEER
• chemotherapy
• metaplastic breast carcinoma
• nomogram
• survival analysis

Metaplastic breast cancer (MetBC) represents a therapeutic challenge. We evaluated the impact of clinicopathological characteristics and treatment modalities on outcomes among MetBC patients treated at our center.

Women with stage I-III MetBC were reviewed from our database from 2005-2018. Kaplan-Meier method was used to calculate locoregional-failure-free survival (LRFFS), overall-survival (OS) and distant-metastases-free survival (DMFS). We assessed associations with survival outcomes by log-rank tests. Multivariate Cox proportional-hazards models were used to identify independent predictors of LRFFS, OS and DMFS.

81 patients were eligible for the study. Median age at diagnosis was 48 years. 90.1% had G-III tumors, 64.2% were pathologically node negative and lympho-vascular invasion (LVI) was absent in 72.8%. 67.8% were triple negative, and 7.4% were HER2-neu positive. Most (66.7%) patients underwent mastectomy. Free margins were achieved in the entire cohort, however, 17.3% had close margin (<2 mm). Almost all patients received chemotherapy. 75.3% received radiotherapy, 23.5% received hormonal therapy and 6.2% received Trastuzumab. With a median follow-up of 54 months, 18.5% developed loco-regional recurrence and 34.6% relapsed distally. Five-year OS was 66.0%. On multivariate analysis: adjuvant radiotherapy correlated with better OS (P < .0001), and tumor size >5 cm, nodal involvement and LVI correlated with worse OS, (P = .019, P = .021, P = .028, respectively). There were no survival differences with respect to age, triple negativity, and morphologic subtype.

We report the largest single institutional series on MetBC in the Middle East region. MetBC confers worse survival outcomes, and more aggressive local and systemic treatment strategies should be investigated.

• metaplastic breast cancer
• neoadjuvant chemotherapy
• radiotherapy
• survival
• triple-negative breast cancer

Numerous risk factors for breast cancer (BC) have been identified. High-risk human papilloma virus (HR-HPV) is the etiological agent of cervical cancer and in some cases of head and neck cancer, specifically oropharyngeal cancer, but the role of HR-HPV in evoking neoplasia in BC is still unclear. In this study, all women above the age of 18 visiting the oncology clinic at Al-Azhar university hospital and Ain Shams specialized hospital between the period of February 2017 and March 2018 were invited to participate. We determined the prevalence of HR-HPV genotypes 16, 18, and 31 in breast tissue samples from 72 women with treatment-naïve BC and 15 women with benign breast lesions (BBL) by quantitative real-time PCR (qRT-PCR) and primer sets targeting the E6 and E7 regions. High-risk human papilloma virus DNA was detected in 16 of 72 (22.2%) BC cases (viral load range = 0.3-237.8 copies/uL) and 0 of 15 women with BBL. High-risk human papilloma virus was detected in 14 of 16 (87.5%), 2 of 16 (12.5%), and 0 of 16 (0%) for genotypes 16, 18, and 31, respectively. Forty-three age-matched healthy Egyptian women were enrolled as controls for assessment of local risk factors that can be used to initiate a strategy of BC prevention in Egypt. Assessment of the risk factors demonstrated that low education level, passive smoking, lack of physical activity, family history of cancer, and use of oral contraception were significant risk factors for BC. In conclusion, our results lead us to postulate that HR-HPV infection may be implicated in the development of some types of BC in Egyptian women. In addition, identification of local risk factors can support practical prevention strategies for BC in Egypt.

• Breast cancer (BC)
• high-risk human papillomavirus (HR-HPV)
• risk factors

Hereditary breast and ovarian cancer (HBOC) syndrome is most commonly characterized by deleterious germline mutations in BRCA1 and BRCA2. HBOC patients are prone to the development of malignant neoplasms in multiple organs including the breast, ovary, and fallopian tube. From a pathological perspective, a number of morphological features have been described in BRCA-associated breast and tubo-ovarian cancers. For example, breast cancers diagnosed in BRCA1-mutation carriers are frequently of a high Nottingham grade and display medullary morphology and a triple-negative and/or a basal-like immunophenotype. In contrast, breast cancers in BRCA2-mutation carriers are similar to sporadic luminal-type tumors that are positive for hormone receptors and lack expression of human epidermal growth factor receptor 2. Cancers arising in the fallopian tube and ovary are almost exclusively of a high-grade serous histotype with frequent Solid, pseudo-Endometrioid, and Transitional cell carcinoma-like morphology (“SET features”), marked nuclear atypia, high mitotic index, abundant tumor infiltrating lymphocytes, and necrosis. In addition, pushing or infiltrative micropapillary patterns of invasion have been described in BRCA-associated metastases of tubo-ovarian high-grade serous carcinomas. Besides BRCA1 and BRCA2 mutations, alterations in a number of other homologous recombination genes with moderate penetrance, including PALB2, RAD51C, RAD51D, BRIP1, and others, have also been described in HBOC patients with varying frequency; however, distinct morphological characteristics of these tumors have not been well characterized to date. In this review, the above pathological features are discussed in detail and a focus is placed on how accurate pathologic interpretation plays an important role in allowing HBOC patients to receive the best possible management.

• BRCA
• hereditary breast cancer
• hereditary tubo-ovarian cancer
• high-grade serous carcinoma
• triple-negative breast cancer

• MBC
• metaplastic breast carcinoma
• molecular alterations
• prognosis
• treatment

• HPV
• Treg
• breast cancer

• Adult
• Aged
• Breast Neoplasms/diagnosis
• Breast Neoplasms/immunology
• Breast Neoplasms/virology
• CD8-Positive T-Lymphocytes/immunology
• Case-Control Studies
• Egypt
• Female
• Flow Cytometry
• Humans
• Immunophenotyping
• Middle Aged
• Papillomavirus Infections/diagnosis
• Papillomavirus Infections/immunology
• Papillomavirus Infections/virology
• Phenotype
• Prognosis
• T-Lymphocytes, Regulatory/immunology

• science and technology development fund

• Cancer-specific survival
• Carcinosarcoma
• Invasive ductal carcinoma
• Prognosis
• SEER

Breast cancer is a heterogenous disease, exhibiting a wide range of morphological phenotypes shaping its prognosis and clinical course. However, optimal management of rarer breast cancer subtypes is often undefined and controversial in literature due to the lack of large studies and randomised trials. This review aims to discuss the treatment of 13 rare epithelial subtypes, focussing on surgery and adjuvant therapies.

• Epithelial breast cancer
• adjuvant therapy
• optimal management
• surgery

• Breast neoplasms
• Metaplastic breast cancer
• Prognosis
• Radiotherapy
• Survival

• Breast Neoplasms/epidemiology
• Breast Neoplasms/pathology
• Breast Neoplasms/radiotherapy
• Databases, Factual
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Middle Aged
• Multivariate Analysis
• Neoplasm Metastasis
• Propensity Score
• SEER Program

• R01 GM122775 NIGMS NIH HHS
• UH3 TR000943 NCATS NIH HHS
• R01 CA222007 NCI NIH HHS
• R01 CA182905 NCI NIH HHS
• Foundation for the National Institutes of Health
• National Cancer Institute
• POC
• Natural Science Foundation of Zhejiang Province

• Early breast cancer
• Local therapy
• Systemic therapy
• Treatment recommendations

• chemotherapy
• metaplastic breast cancer
• metastatic breast cancer
• prognostic factors
• systemic treatment

• Estrogen receptor
• Metaplastic breast carcinoma
• Progesterone receptor
• Triple-negative breast cancer

Breast cancer is one of the most common malignancies. The molecular mechanisms of its pathogenesis are still to be investigated. The aim of this study was to identify the potential genes associated with the progression of breast cancer. Weighted gene co-expression network analysis (WGCNA) was used to construct free-scale gene co-expression networks to explore the associations between gene sets and clinical features, and to identify candidate biomarkers. The gene expression profiles of GSE1561 were selected from the Gene Expression Omnibus (GEO) database. RNA-seq data and clinical information of breast cancer from TCGA were used for validation. A total of 18 modules were identified via the average linkage hierarchical clustering. In the significant module (R² = 0.48), 42 network hub genes were identified. Based on the Cancer Genome Atlas (TCGA) data, 5 hub genes (CCNB2, FBXO5, KIF4A, MCM10, and TPX2) were correlated with poor prognosis. Receiver operating characteristic (ROC) curve validated that the mRNA levels of these 5 genes exhibited excellent diagnostic efficiency for normal and tumor tissues. In addition, the protein levels of these 5 genes were also significantly higher in tumor tissues compared with normal tissues. Among them, CCNB2, KIF4A, and TPX2 were further upregulated in advanced tumor stage. In conclusion, 5 candidate biomarkers were identified for further basic and clinical research on breast cancer with co-expression network analysis.

• GEO
• TCGA
• breast cancer
• prognosis
• weighted gene co-expression network analysis (WGCNA)

• Axillary ultrasound (AUS)
• metaplastic breast cancer (MBC)
• outcomes
• sentinel lymph node biopsy (SLNB)
• surgery

Metaplastic carcinoma encompasses a group of neoplasms characterized by differentiation of the neoplastic epithelium into squamous cells and/or mesenchymal-looking elements. Spindle cell carcinoma is a rare variant of this special histological type. Its prognosis remains poor, with a high rate of local recurrence and distant metastasis. To date, only a small number of cases have been described. There is no clear agreement on this histological subtype.

We report a case of a 53-year-old Moroccan woman who consulted our institution following palpation of a nodule of the left breast. Mammography in combination with breast ultrasonography revealed a lesion classified as Breast Imaging Reporting and Data System 4 with microcalcification. The patient was diagnosed with spindle cell carcinoma of the breast. The diagnosis was based primarily on histological and immunohistochemical studies of the breast biopsy and secondarily on the surgical specimen. No local or distant metastasis was found. The treatment used was total surgical excision followed by radiotherapy.

We describe the features (epidemiological, clinical, histological, immunohistochemical, and therapeutic outcomes) of our patient’s case and compare them with literature data.

• Breast
• Metaplastic variant carcinoma
• Spindle cell carcinoma
• Treatment

Y-box binding protein 1 (YBX1) is involved in the multi-tumor occurrence and development. However, the regulation of YBX1 in lung tumorigenesis and the underlying mechanisms, especially its relationship with CDC25a, was remains unclear. In this study, we analyzed the expression and clinical significance of YBX1 and CDC25a in lung adenocarcinoma and identified their roles in the regulation of lung cancer growth. The retrospective analysis of 116 patients with lung adenocarcinoma indicated that YBX1 was positively correlated with CDC25a expression. The Cox-regression analysis showed only high-ranking TNM stage and low CDC25a expression were an independent risk factor of prognosis in enrolled patients. High expression of YBX1 or CDC25a protein was also observed in lung adenocarcinoma cells compared with HLF cells. ChIP assay demonstrated the binding of endogenous YBX1 to the CDC25a promoter region. Overexpression of exogenous YBX1 up-regulated the expression of the CDC25a promoter-driven luciferase. By contrast, inhibition of YBX1 by siRNA markedly decreased the capability of YBX1 binding to CDC25a promoter in A549 and H322 cells. Inhibition of YBX1 expression also blocked cell cycle progression, suppressed cell proliferation and induced apoptosis via the CDC25a pathway in vitro. Moreover, inhibition of YBX1 by siRNA suppressed tumorigenesis in a xenograft mouse model and down-regulated the expression of YBX1, CDC25a, Ki67 and cleaved caspase 3 in the tumor tissues of mice. Collectively, these results demonstrate inhibition of YBX1 suppressed lung cancer growth partly via the CDC25a pathway and high expression of YBX1/CDC25a predicts poor prognosis in human lung adenocarcinoma.

• CDC25a
• YBX1
• cell cycle regulation
• lung adenocarcinoma
• prognosis

Breast cancer (BC) is one of the most common malignancies that could threaten female health. As the molecular mechanism of BC has not yet been completely discovered, identification of related genes of this disease is an important area of research that could provide new insights into gene function as well as potential treatment targets. Here we used subnetwork extraction algorithms to identify novel BC related genes based on the known BC genes (seed genes), gene co-expression profiles and protein-protein interaction network. We computationally predicted seven key genes (EPHX2, GHRH, PPYR1, ALPP, KNG1, GSK3A and TRIT1) as putative genes of BC. Further analysis shows that six of these have been reported as breast cancer associated genes, and one (PPYR1) as cancer associated gene. Lastly, we developed an expression signature using these seven key genes which significantly stratified 1660 BC patients according to relapse free survival (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.46–0.65; Logrank p = 5.5e−13). The 7-genes signature could be established as a useful predictor of disease prognosis in BC patients. Overall, the identified seven genes might be useful prognostic and predictive molecular markers to predict the clinical outcome of BC patients.

• breast cancer
• candidate gene
• gene co-expression
• protein-protein interaction
• subnetwork extraction algorithm

• Apoptosis
• Bioactive components
• Breast cancer
• Nanoparticles
• Rats
• Tamoxifen

• 8-Hydroxy-2'-Deoxyguanosine
• Animals
• Antioxidants/metabolism
• Apoptosis/drug effects
• Deoxyguanosine/analogs & derivatives
• Deoxyguanosine/metabolism
• Estrogens/blood
• Female
• Lipid Peroxides/metabolism
• Mammary Glands, Animal/drug effects
• Mammary Glands, Animal/pathology
• Mammary Neoplasms, Experimental/blood
• Mammary Neoplasms, Experimental/drug therapy
• Mammary Neoplasms, Experimental/pathology
• Nanoparticles/chemistry
• Rats, Sprague-Dawley
• Receptor, ErbB-2/metabolism
• Tamoxifen/pharmacology
• Tamoxifen/therapeutic use

• Breast cancer
• case report
• fine-needle aspiration cytology
• metaplastic carcinoma

• Biopsy, Fine-Needle/methods
• Breast Neoplasms/diagnosis
• Breast Neoplasms/diagnostic imaging
• Breast Neoplasms/pathology
• Cytodiagnosis/methods
• Female
• Humans
• Mammography
• Metaplasia/diagnosis
• Metaplasia/diagnostic imaging
• Metaplasia/pathology
• Middle Aged
• Prognosis