ABSTRACT
Estrogen receptor (ER) and human epidermal growth factor 2 (HER2) expression guide the use of neoadjuvant chemotherapy (NACT) in patients with early breast cancer. We evaluate the independent predictive value of adding a multigene profile (CIT256 and PAM50) to immunohistochemical (IHC) profile regarding pathological complete response (pCR) and conversion of positive to negative axillary lymph node status. The cohort includes 458 patients who had genomic profiling performed as standard of care. Using logistic regression, higher pCR and node conversion rates among patients with Non-luminal subtypes are shown, and importantly the predictive value is independent of IHC profile. In patients with ER-positive and HER2-negative breast cancer an odds ratio of 9.78 (95% CI 2.60;36.8), P < 0.001 is found for pCR among CIT256 Non-luminal vs. Luminal subtypes. The results suggest a role for integrated use of up-front multigene subtyping for selection of a neoadjuvant approach in ER-positive HER2-negative breast cancer.
ABSTRACT
We investigated the area of the tidemark in osteoarthritic and normal cartilage by stereology as well as the number of vessels penetrating the tidemark. The area of the tidemark was significantly increased in osteoarthritis, as was the number of vessels penetrating the tidemark. These three-dimensional findings are new compared to previous two-dimensional findings where it has been discussed whether there were any differences between osteoarthritic cartilage and normal cartilage with respect to duplications of the tidemark and vascularisation. The present findings using stereology may erase the uncertainty of previous findings, and support the hypothesis that primary osteoarthritis is partly of vascular origin.