PATHOLOGIC AND MOLECULAR SUBTYPES CHARACTERISTICS OF OUR BREAST CANCER PATIENTS IN KOSOVO

Brunilda Profka Haxhiu; Goran Kondov; Luljeta Abdullahu; Fisnik Kurshumliu; Borislav Kondov

Brunilda Profka Haxhiu Clinic of Oncology, University Clinical Centre of Kosovo, Republic of Kosovo
Goran Kondov University Clinic of Thoracic and Vascular Surgery, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Luljeta Abdullahu Clinical Service of Nuclear Medicine, University Clinical Centre of Kosovo, Republic of Kosovo
Fisnik Kurshumliu Institute of Pathology, University Clinical Centre of Kosovo, Republic of Kosovo
Borislav Kondov University Clinic of Thoracic and Vascular Surgery, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia

Abstract

To classify breast cancer cases by molecular subtypes (Luminal A, Luminal B [HER2-positive], Luminal B [HER2-negative], HER2-positive, and triple-negative). The secondary objective was to analyze associations between immunohistochemical markers, molecular subtypes, and established prognostic factors (stage, grade, age, and tumor location). This prospective study included 100 patients diagnosed with breast cancer and treated at an oncology clinic. All patients underwent various treatment modalities, including surgical intervention. Radical mastectomy (RM) remained the predominant surgical approach, performed in 83% of cases, compared to 16% who underwent breast-conserving surgery (BCS). Across all molecular subtypes, RM combined with lymph node dissection was the primary surgical treatment. Even among patients with the Luminal A subtype, the ratio of BCS to RM was 1:3. Molecular subtypes were found to correlate with tumor volume and disease stage, reflecting differences in disease progression. A considerable number of cases were diagnosed at locally advanced stages, contributing to the preference for mastectomy over BCS. This tendency may reflect the need for more aggressive treatment strategies at the time of diagnosis due to the advanced nature of the disease.

Keywords: breast cancer, molecular subtypes.

References

1.Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. doi:10.3322/caac.21660
2.Liedtke C, Rody A, Gluz O, et al. The prognostic impact of age in different molecular subtypes of breast cancer. Breast Cancer Res Treat. 2015;152(3):667-673. doi:10.1007/s10549-015-3491-3
3.Prat A, Ellis MJ, Perou CM. Practical implications of gene-expression-based assays for breast oncologists. Nat Rev Clin Oncol. 2011;9(1):48-57. doi:10.1038/nrclinonc.2011.178
4.Lønning PE. Breast cancer prognostication and prediction: are we making progress? Ann Oncol. 2007;18 Suppl 8:viii3-7. doi:10.1093/annonc/mdm260
5.Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 2005;11(16):5678-5685. doi:10.1158/1078-0432.CCR-04-2421
6.Wiechmann L, Sampson M, Stempel M, et al. Presenting features of breast cancer differ by molecular subtype. Ann Surg Oncol. 2009;16(10):2705-2710. doi:10.1245/s10434-009-0606-2
7.Dawson SJ, Makretsov N, Blows FM, et al. BCL2 in breast cancer: a favourable prognostic marker across molecular subtypes and independent of adjuvant therapy received. Br J Cancer. 2010;103(5):668-675. doi:10.1038/sj.bjc.6605736
8.Easton DF. How many more breast cancer predisposition genes are there? Breast Cancer Res. 1999;1:14. doi:10.1186/bcr6
9.Hassan Ali S, SP S, N AK. Rate of breast-conserving surgery vs mastectomy in breast cancer: a tertiary care centre experience from South India. Indian J Surg Oncol. 2019;10(1):72-76. doi:10.1007/s13193-018-0818-7
10.Spitale A, Mazzola P, Soldini D, Mazzucchelli L, Bordoni A. Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol. 2009;20(4):628-635. doi:10.1093/annonc/mdn675
11.Djiwa T, Koui B, Simgban P, et al. Histo-molecular profile of breast cancer in young women in Togo. Clin Pathol. 2022;15:2632010X221112452. doi:10.1177/2632010X221112452