The intra-tumoral stroma in patients with breast cancer increases with age

Vangangelt, Kiki M. H.; Kramer, Claire J. H.; Bastiaannet, Esther; Putter, Hein; Cohen, Danielle; van Pelt, Gabi W.; Rakha, Emad A.; Green, Andrew R.; Tollenaar, Rob A. E. M.; Mesker, Wilma E.

Abstract

Purpose
The tumor microenvironment in older patients is subject to changes. The tumor-stroma ratio (TSR) was evaluated in order to estimate the amount of intra-tumoral stroma and to evaluate the prognostic value of the TSR in older patients with breast cancer (≥70 years).

Methods
Two retrospective cohorts, the FOCUS study (N = 619) and the Nottingham Breast Cancer series (N = 1793), were used for assessment of the TSR on hematoxylin and eosin stained tissue slides.

Results
The intra-tumoral stroma increases with age in the FOCUS study and the Nottingham Breast Cancer series (B 0.031, 95% CI 0.006-0.057, P = 0.016 and B 0.034, 95% CI 0.015-0.054, P ≤ 0.001, respectively). Fifty-one percent of the patients from the Nottingham Breast Cancer series ≤40 years had a stroma-high tumor compared to 73% of the patients of ≥90 years from the FOCUS study. The TSR did not validate as an independent prognostic parameter in patients ≥70 years.

Conclusions
The intra-tumoral stroma increases with age. This might be the result of an activated tumor microenvironment. The TSR did not validate as an independent prognostic parameter in patients ≥70 years in contrast to young women with breast cancer as published previously.

Citation

Vangangelt, K. M. H., Kramer, C. J. H., Bastiaannet, E., Putter, H., Cohen, D., van Pelt, G. W., Rakha, E. A., Green, A. R., Tollenaar, R. A. E. M., & Mesker, W. E. (2020). The intra-tumoral stroma in patients with breast cancer increases with age. Breast Cancer Research and Treatment, 179(1), 37–45. https://doi.org/10.1007/s10549-019-05422-6

• Journal Article Type: Article
• Acceptance Date: Aug 24, 2019
• Online Publication Date: Sep 18, 2019
• Publication Date: 2020-01
• Deposit Date: Aug 27, 2019
• Publicly Available Date: Sep 19, 2020
• Journal: Breast Cancer Research and Treatment
• Print ISSN: 0167-6806
• Electronic ISSN: 1573-7217
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 179
• Issue: 1
• Pages: 37–45
• DOI: https://doi.org/10.1007/s10549-019-05422-6
• Keywords: Cancer Research; Oncology
• Public URL: https://nottingham-repository.worktribe.com/output/2504869
• Publisher URL: https://link.springer.com/article/10.1007/s10549-019-05422-6
• Additional Information: Received: 1 July 2019; Accepted: 24 August 2019; First Online: 18 September 2019; : ; : The authors declare no potential conflicts of interest.; : All samples from the FOCUS study were anonymized and according to national ethical guidelines (“Code for Proper Secondary Use of Human Tissue”, Dutch Federation of Medical Scientific Societies). The clinical data from the Nottingham Breast Cancer series were anonymized and the study was approved by the Nottingham Research Ethics Committee 2 under the title ‘Development of a molecular genetic classification of breast cancer’. The study was performed in accordance with the 1964 Helsinki declaration and its later amendments. The research performed comply with the current laws of the country.; : No additional informed consent was required as all data were anonymized.
• Contract Date: Aug 27, 2019