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Pathologic changes in breast cancer after anti‐estrogen therapy
Author(s) -
Samarnthai Norasate,
Elledge Richard,
Huang Jian,
Massarweh Suleiman,
Yeh ITien
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.566.11
Subject(s) - medicine , fulvestrant , estrogen , gefitinib , breast cancer , estrogen receptor , pathology , cancer , oncology , epidermal growth factor receptor
Estrogen receptor positive breast cancers are commonly treated with anti‐estrogen therapy. However, little is known about the pathologic changes in breast cancers after anti‐estrogen therapy. This study details the histologic alterations of estrogen receptor positive breast cancers treated by anti‐estrogens in combination with gefitinib, an anti‐EGFR agent given to overcome endocrine resistance. Estrogen receptor positive tumors from 9 post‐menopausal women were studied. Patients received anastrazole, fulvestrant, and gefitinib for 4 months. Core needle biopsies were performed at day 1 and day 21, and tumors were completely excised if tumors were operable at day 112. The histologic findings were correlated with clinical responses defined by RECIST criteria. Median age was 67 years and median tumor size was 7 cm. Following treatment, all tumors had evidence of degenerative changes including smudged nuclei, decreased nuclear size, intranuclear vacuoles, vacuolated cytoplasm, and increased cellular discohesion. Increased tubule formation and intracytoplasmic lumina were seen in 6/9 cases (66.7%), and decreased mitotic rate was demonstrated 5/9 cases (55.6%). In the partial response group, there was tumor shrinkage and increased stromal fibrosis. These findings indicate increased differentiation of the cells with anti‐estrogen therapy and correlate with clinical response.