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Research ArticleClinical Studies

Epithelial-mesenchymal Transition Factor and Its Association With Mammographic Density and Breast Cancer Prognosis

EUN YOUNG KIM and SANGJEONG AHN
Anticancer Research May 2023, 43 (5) 2281-2292; DOI: https://doi.org/10.21873/anticanres.16392
EUN YOUNG KIM
1Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;
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SANGJEONG AHN
2Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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  • ORCID record for SANGJEONG AHN
  • For correspondence: vanitasahn@gmail.com
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Abstract

Background/Aim: The tumor microenvironment influences tumor progression, invasion, and metastasis. This study determined the expression levels of epithelial-mesenchymal transition (EMT) factors according to zone and their correlation with mammographic breast density and investigated the prognostic value of EMT factors. Patients and Methods: The clinical and pathological data of invasive carcinoma and ductal carcinoma in situ were reviewed. Primary breast tissue samples were evaluated using immunohistochemistry (IHC) staining of the EMT-associated markers, including α-SMA, vimentin, MMP-9, and CD34. The expression levels were analyzed in three areas: the tumor center, interface, and distal zones. EMT factors were correlated with mammographic breast density and oncologic outcomes. Results: An overall EMT phenotype conversion from positive to negative was seen in 55.7% of α-SMA- and 34.4% of MMP-9-positive cells between the tumor center and interface zones, which was significantly different (p<0.05). Most changes in EMT expression from the center to the distal zone were from positive to negative, but 23.0% of CD34-expressing cells showed negative to positive conversion. The proportion of α-SMA, vimentin, and MMP-9 expression was higher in the non-dense breast group compared to the dense breast group in the interface and distal zones (p<0.05). CD34 expression in the distal zone was an independent favorable prognostic factor for disease-free survival (p=0.039). Conclusion: The differential expression of EMT markers in each zone suggests heterogeneous cancer cell populations within each zone of breast cancer. EMT factor expression can also interplay between breast density stroma and geographical tumor zone.

Key Words:
  • Breast carcinoma
  • epithelial mesenchymal transition
  • mammographic breast density
  • prognosis
  • Received January 31, 2023.
  • Revision received February 17, 2023.
  • Accepted February 20, 2023.
  • Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 43 (5)
Anticancer Research
Vol. 43, Issue 5
May 2023
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Epithelial-mesenchymal Transition Factor and Its Association With Mammographic Density and Breast Cancer Prognosis
EUN YOUNG KIM, SANGJEONG AHN
Anticancer Research May 2023, 43 (5) 2281-2292; DOI: 10.21873/anticanres.16392

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Epithelial-mesenchymal Transition Factor and Its Association With Mammographic Density and Breast Cancer Prognosis
EUN YOUNG KIM, SANGJEONG AHN
Anticancer Research May 2023, 43 (5) 2281-2292; DOI: 10.21873/anticanres.16392
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Keywords

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