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Archives of General Internal Medicine | Volume 2
&
April 04-05, 2018 | Miami, USA
International Conference on
Internal Medicine & Practice and Primary Care
International Meeting on
Breast Pathology & Cancer Diagnosis
Background:
Breast cancer ranks as the first malignancy
affecting females, contributing 29% of all female cancers
diagnosed each year. It is second only to lung cancer as
a cause of cancer death in females. There is increasing
evidence that this cancer is originated in and maintained by
a small population of undifferentiated cells with self-renewal
and proliferation capacities that called breast cancer stem
cells (BCSCs).
Objective
: This study is aiming to assess the prognostic value
of BCSCs (CD44+ CD24) in patients with metastatic breast
cancer as well as the overall survival.
Patients & Methods
: The present study was conducted
on 60 patients with metastatic breast cancer, presented to
outpatient clinics in Oncology Center, Mansoura University
from December 2010 till November 2014. All patients
received treatment (surgery, chemotherapy, radiotherapy,
hormonal treatment or combination of two or more lines)
according to protocols and guidelines. The presence of breast
cancer stem cells was evaluated by immunohistochemistry
expression of CD44 and CD24 to assess its possible prognostic
and predictive values via correlation with overall survival,
tumor response and different clinico-pathological features
of the patients. The expression patterns were analyzed
according to the clinico-pathologic prognostic parameters,
such as hormone receptors, Her2/neu status, grade of
tumors and stage on presentation as well as overall survival.
Results
: Median agewas 50 (31-70) years. Twenty six patients
(43.3%) were premenopausal and 34 patients (56.7%) were
postmenopausal. This study classified the breast tumor
tissues into four subgroups according to CD44 and CD24
expression patterns (CD44+ CD24- group that carry stem
cell property were 41.7% and the remaining three groups
( CD44- CD24-, CD44+ CD24+ , CD44- CD24+) were 58.3%.
64% of tumors with CD44+ CD24- BCSCs were IDC histology,
84% of cases belongs to this group were grade 3, 88% were
stage III on presentation, 56% were luminal subtype, 68%
of them developed both bone and visceral metastasis. Our
study showed that presence of BCSCs (CD44+ CD24-) carry
significantly shorter OS (19 vs. 44 months) compared to
other three groups. Also, a multivariate analysis showed
that presence of BCSCs (CD44+ CD24-) was significant
independent prognostic factor for poor overall survival.
Conclusion
: This study is a prospective trial testing the
concept of detecting breast cancer stem cells in tumor
tissue biopsies, according to CD44 & CD24 expression status.
As such, it has demonstrated both the feasibility of this
approach and its implication as a future prognostic marker,
and has paved the way for future research in this field.
Speaker Biography
Kamel Farag is a Medical Oncologist with interest in Breast and GI cancers. He is
Assistant Consultant of Oncology in King Faisal Specialist Hospital & Research Center,
Jeddah, Saudi Arabia. He is Associate Professor of Medicine and Medical Oncology at
Mansoura University, School of Medicine, Egypt, where he also earned his Medical
degree. He completed his residency and got his Master’s Degree at Mansoura
University. He rapidly moved to National Cancer Institute, Cairo University to get his
Doctorate Degree. He is a member in various oncology societies in regional area.
e:
faragkamel@yahoo.comThe prognostic significance of breast cancer stem cells in patients with metastatic breast cancer
Kamel Farag
Mansoura University, Egypt