Osmani Asif Husain, Tulbah Asma M, AlSayed Adher, AlShanqeeti Ali, Al-Twegieri Taher, Ajarim Dahish S, Suleman Kausar
Section Medical Oncology, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Department of Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Am J Case Rep. 2021 Feb 5;22:e928012. doi: 10.12659/AJCR.928012.
BACKGROUND Invasive lobular carcinoma is special subtype of breast cancer that has clinical behavior and morphology distinct from other breast cancer subtypes. It accounts for 5-15% of breast cancer. Overall, HER-2 gene amplification occurs at a significantly lower rate in ILC, but also has been linked to adverse outcomes. Most cases of ILCs with HER-2 overexpression and or amplification generally have the pleomorphic variant. We report the first series of cases from Saudi Arabia for this rare cancer in an Arab population. CASE REPORT Nine patients retrospectively were evaluated with HER-2/neu-positive ILC of the breast that were diagnosed and managed from 2003 to 2020. Four patients were diagnosed as early breast cancer, 3 had metastatic disease and 2 were locally advanced at their initial presentation. The mean age was 58 years; 30% were classic ILC and another 60% were of mixed non-classic variants (histologic pattern represented by nuclear pleomorphism). Management of patients with HER-2-positive ILC was performed according to standard multimodality breast cancer guidelines, consisting of surgery, chemotherapy with anti-HER-2/neu blockade, radiation, and endocrine therapy, based on stage and hormone status. CONCLUSIONS In conclusion, HER-2-positive invasive lobular carcinoma of the breast is uncommon in the Arab population, which has not been previously reported in the literature. Further studies are warranted to explore the biology, molecular characteristics, and clinical course in this group of patients.
背景 浸润性小叶癌是乳腺癌的一种特殊亚型，其临床行为和形态与其他乳腺癌亚型不同。它占乳腺癌的5%-15%。总体而言，HER-2基因扩增在浸润性小叶癌中的发生率显著较低，但也与不良预后有关。大多数HER-2过表达和/或扩增的浸润性小叶癌病例通常具有多形性变异。我们报告了沙特阿拉伯阿拉伯人群中首例这种罕见癌症的系列病例。病例报告 回顾性评估了9例2003年至2020年期间诊断和治疗的HER-2/neu阳性乳腺浸润性小叶癌患者。4例患者被诊断为早期乳腺癌，3例有转移性疾病，2例初诊时为局部晚期。平均年龄为58岁；30%为经典浸润性小叶癌，另外60%为混合非经典变异型（以核多形性为组织学模式）。HER-2阳性浸润性小叶癌患者的治疗根据标准的多模式乳腺癌指南进行，包括手术、抗HER-2/neu阻断化疗、放疗和内分泌治疗，具体取决于分期和激素状态。结论 总之，HER-2阳性乳腺浸润性小叶癌在阿拉伯人群中并不常见，此前文献中未见报道。有必要进一步研究探索该组患者的生物学特性、分子特征和临床病程。
