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Correlation between Biological Classification and Stromal Reaction in Breast Cancer

Abdol Ali Ebrahimi, Mohammad Hashemi Bahramani, Sara Aghabaklou, Maryam Zamiranvar




Background: Breast cancer is the most common cancer and a major cause of death from cancer in women. Understanding the factors, which can predict directly and indirectly the final fate of patients, can be useful in clinical decision-making and treatment choices.

Materials and Methods: In a retrospective descriptive-analytic study, 108 pathological samples of patients with primary breast cancer collected during 2011-2017 from the department of pathology in Imam Hossein Hospital (Tehran Iran). Classified regarding the association of stromal reactions in tumor tissue including necrosis rate, lymphocyte infiltrating rate, and tumor desmoplasia with different types of breast tumors including four groups of Basal like, HER2/neu, Luminal B, and Luminal A based on biological biomarkers.

Results: Mean age of the patients was 50.84±13.25 years. No significant relationship was found between age and type of groups. Majority of patients (60%) were in the pathological grade 2. A significant relationship was observed between three groups of Luminal B, and Basal-like with Grade 2 (p<0.05). Most patients suffered from intermediate desmoplasia which was significant only between three groups of Luminal B, HER2/neu and Basal-like (p<0.05). In terms of tumor necrosis, the majority of patients in the HER2/neu and Basal-like groups indicated non-extensive necrosis, which was significant (p>0.05). In both groups of Luminal A and Luminal B, most patients had no necrosis while the relationship between necrosis and pathological type of tumor was significant only in the Luminal B group (p>0.05). No significant relationship was found between the number of lymphocytes and the type of tumor.

Conclusion: This study indicated the relationship between pathological types of breast cancers based on biomarkers with pathological grade, necrosis ratio and tumor desmoplasia. Determination of the pathological type of tumor based on the status of biological markers (HER-2/neu PR, ER, Ki67) in patients with breast cancer is recommended for making decision about therapeutic plan.


Stromal factors, Biologic classification, Breast cancer


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DOI: https://doi.org/10.22037/nbm.v7i2.23316