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Aldehyde dehydrogenase 1‐positive cells in axillary lymph node metastases after chemotherapy as a prognostic factor in patients with lymph node‐positive breast cancer
Author(s) -
Sakakibara Masahiro,
Fujimori Toshihiko,
Miyoshi Tetsutaro,
Nagashima Takeshi,
Fujimoto Hiroshi,
Suzuki Hiroshi Tiberu,
Ohki Yohsuke,
Fushimi Koya,
Yokomizo Jissei,
Nakatani Yukio,
Miyazaki Masaru
Publication year - 2011
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.26725
Subject(s) - medicine , breast cancer , chemotherapy , lymph node , cancer , lymph , oncology , axillary lymph nodes , ca15 3 , metastatic breast cancer , pathology , primary tumor , metastasis
BACKGROUND: Aldehyde dehydrogenase 1 (ALDH1)‐positive cells exhibit stem‐like or progenitor ability and have been considered a clinically important diagnostic and therapeutic target in patients with breast cancer. In this study, the authors evaluated responsiveness to chemotherapy of ALDH1‐positive cells in primary and metastatic lesions and its relation to prognosis for patients with lymph node‐positive breast cancer. METHODS: In total, 115 patients who had breast cancer with cytologically confirmed lymph node metastases and who underwent surgery after neoadjuvant chemotherapy (NAC) were evaluated. By using ALDH1 immunohistochemistry in core‐needle biopsy specimens of the primary tumor, cytology samples of axillary lymph nodes before NAC, and pathologic samples of each after NAC, the clinical significance of ALDH1‐positive cell status was evaluated in primary and metastatic lesions before and after NAC. RESULTS: The presence of ALDH1‐positive cancer cells, but not ALDH1‐negative cancer cells, in primary and metastatic lesions after NAC was associated with a worse prognosis. In multivariate analysis, only ALDH1‐positive cells in metastatic lesions after NAC correlated with overall survival. The responsiveness of ALDH1‐positive cells to chemotherapy differed between primary and metastatic lesions, and the findings indicated that ALDH1‐positive cells in metastatic lesions after NAC may clinically precede those in the primary lesion. CONCLUSIONS: The responsiveness of ALDH1‐positive cells to chemotherapy in primary and metastatic lesions and its prognostic significance were clarified in patients with breast cancer. The authors concluded that ALDH1‐positive status may represent a surrogate marker as a new concept in patients with lymph node‐positive breast cancer. Cancer 2012. © 2011 American Cancer Society.