Aggressive cancer phenotypes
Although based on extensive research, current guidelines are not explicit in the case of surgical specimens showing various degrees of mismatch aggressive cancer phenotypes different parts of the same tumor and even more so between multicentric lesions. Synchronous breast cancer is the ideal prototype for studying inter- and intra-tumoral heterogeneity, therefore we envisaged that a study on patients with aggressive cancer phenotypes aggressive cancer phenotypes multifocal lesions could contribute to the reshaping of the staging, prognosis, and treatment of breast malignancies.
Material and Methods: A prospective observational study was conducted between January and May on patients diagnosed with breast cancer BC and surgically treated at Emergency University Hospital, Bucharest.
Thirty-seven patients had multiple breast tumors and were eligible for assessment of the heterogeneity of their lesions. Aggressive cancer phenotypes 6 were multicentric and 31 multifocal. The number of foci varied from 2 to We encountered numerous mismatches between the index and the secondary aggressive cancer phenotypes, as follows: 3 cases 8.
After careful analysis of index and secondary tumors, apart from the mismatches reported above, we discovered that the secondary tumors were actually dominant in 5 cases Conclusions: For synchronous breast tumors, the current Tumor-Node-Metastasis TNM staging system ignores not only the histopathological and immunohistochemical characteristics of the secondary foci, aggressive cancer phenotypes also their size.
When secondary lesions are more aggressive or their cumulative mass is significantly bigger than that of the index tumor, the treatment plan should be adapted accordingly. We believe that information obtained from examining secondary foci in synchronous breast cancer and assessment of the cumulative tumoral mass should be reflected in the final staging and definitive treatment.