Cyclin D1 Expression in Triple-Negative Breast Cancer with New Treatment Implications

Hartel PH, Donald R and Fleming

Davis Medical Center of Davis Health System, Elkins, West Virginia, USA
West Virginia School of Medicine, Morgantown, West Virginia, USA
West Virginia School of Osteopathic Medicine, Lewisburg, West Virginia, USA

^*Correspondance to: Paul H Hartel 

 PDF  Full Text Review Article | Open Access

Abstract:

While targeted therapies are available for breast cancer patients whose tumors express ER, PR, or show HER-2 overexpression, no such treatment exists for “triple-negative” cases. As immunohistiochemistry (IHC) expression of Cyclin D1 has been shown concordant with Cyclin D1 gene amplification, we evaluated Cyclin D1 IHC expression in 25 cases of triple-negative invasive ductal carcinoma to clarify its relationship with clinical and pathologic parameters. Twenty-six invasive carcinomas negative for ER, PR, and HER-2 were reviewed. One sarcomatoid carcinoma was omitted leaving 25 invasive ductal carcinomas for this pilot study. Clinical information, including treatment response, was gleaned from patient records. Only one case was known to be BRCA-positive. Tumors were morphologically reviewed and Cyclin D1 IHC applied using BCL-1. Chi square and t-test statistical analyses were performed. Patients were female and ranged in age from 32 to 88 years (m=59). Tumors were in left (n=16) and right breasts (n=9) with tumor size ranging from 0.4 cm up to 7.2 cm (m=2.7cm). Tumors were invasive dustal carcinomas of no special type, Nottingham grade 1 (n=1), 2 (n=10) and 3 (n=14). Eight cases had an in-situ component, high grade (n=7) or low grade (n=1), ranging from 5% to 70% of tumor (m= 23%). All tumors showed Cyclin D1 expression from light and focal staining (1+; n=6; Group 1) to focal intense (2+; n=9) or diffuse intense staining (3+; n=10). The latter two groups were combined for analyses (Group 2). While patients were younger in Group 2, this was not statistically significant. Patients with tumors showing intense BCL-1 staining (Group 2) had larger tumors (p<.05) with more capillary/lymphatic invasion (p<.005) and lymph node metastases (p<.007), and were less likely to respond to treatment (p=.01; see Table 1). Cyclin D1 expression may serve as a marker for more biologically aggressive triple-negative breast cancer. These tumors may respond to targeted therapy that down-regulates Cyclin D1 amplification. Further research with larger sample sizes is needed.

Keywords:

Triple negative; Breast cancer; Invasive ductal carcinoma; Cyclin D1; Immunohistochemistry; Personalized medicine

Cite the Article:

Hartel PH, Donald R, Fleming. Cyclin D1 Expression in Triple-Negative Breast Cancer with New Treatment Implications. Clin Oncol. 2016; 1: 1044.