Association between the degree of fibrosis in fibrotic focus and the unfavorable clinicopathological prognostic features of breast cancer

Yongfu Li; Yuhan Wei; Wenjun Tang; Jingru Luo; Minghua Wang; Haifeng Lin; Hong Guo; Yuling Ma; Jun Zhang; Qin Li

doi:10.7717/peerj.8067

Association between the degree of fibrosis in fibrotic focus and the unfavorable clinicopathological prognostic features of breast cancer

PeerJ. 2019 Nov 15:7:e8067. doi: 10.7717/peerj.8067. eCollection 2019.

Authors

Yongfu Li^{1

2}, Yuhan Wei¹, Wenjun Tang², Jingru Luo², Minghua Wang³, Haifeng Lin², Hong Guo⁴, Yuling Ma⁵, Jun Zhang⁶, Qin Li¹

Affiliations

¹ Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
² Department of Oncology, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China.
³ Department of Pathology, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China.
⁴ Department of Surgery, Beijing Changping District Hospital of Traditional Medicine, Beijing, China.
⁵ Department of Gynecology, Beijing Changping District Hospital of Traditional Medicine, Beijing, China.
⁶ Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.

Abstract

Objective: To explore the association between the degree of fibrosis in fibrotic focus (FF) and the unfavorable clinicopathological prognostic features of breast cancer.

Methods: A total of 169 cases of breast invasive ductal carcinoma (IDC) were included in the study. Hematoxylin and eosin (H&E) staining was performed in the primary lesion of breast IDC and the degree of fibrosis in tumor-stromal FF was assessed. The association between the degree of fibrosis in FF and the well-known clinicopathologic features of breast cancer was investigated and the influence of the degree of fibrosis in FF on the survival was analyzed.

Results: Tumor size >2 cm (P = 0.023), vascular invasion (P = 0.011), lymphatic vessel invasion (P < 0.001) and HER-2+ (P = 0.032) were positively correlated with the degree of fibrosis in FF in breast IDC. The result of multivariate analysis showed that lymphatic vessel invasion was the only independent correlation factor of high fibrosis in FF in breast IDC (OR = 3.82, 95% CI[1.13 ∼ 12.82], P = 0.031). The Nottingham prognostic index (NPI) of high fibrosis in FF was significantly higher than that of mild and moderate fibrosis in FF in the no vascular infiltration subgroup, the no nerve infiltration subgroup, and the Luminal A subgroup (P = 0.014, 0.039, and 0.018; respectively).

Conclusions: The high fibrosis in FF is closely associated with the strong invasiveness and the high malignancy of breast IDC. The degree of fibrosis in FF might be considered as a very practical and meaningful pathological feature of breast cancer.

Keywords: Breast cancer; Breast invasive ductal carcinoma; Fibrotic focus; Lymphatic vessel invasion; Nottingham prognostic index; Prognosis; Tumor size; Vascular invasion; Fibrosis; The unfavorable clinicopathological prognostic features.

Grants and funding

This study was funded by the National Natural Science Foundation of China (Grant NO. 81301912), the Beijing Municipal Health System High-level Health Person Foundation Project (Grant NO. 2014-3-005), and the Beijing Municipal Science and Technology Commission Foundation (Capital Features, Z161100000516083). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.