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Angiosarcoma and atypical vascular lesions of the breast: diagnostic and prognostic role of MYC gene amplification and protein expression
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Angiosarcoma and atypical vascular lesions of the breast: diagnostic and prognostic role of MYC gene amplification and protein expression
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Journal Article
Angiosarcoma and atypical vascular lesions of the breast: diagnostic and prognostic role of MYC gene amplification and protein expression
2015
Overview
MYC
amplification has been reported as a prominent feature of secondary angiosarcomas (SAS). The differential diagnosis between atypical vascular lesion (AVL) and low-grade angiosarcoma (AS) can be occasionally very difficult or even impossible, and
MYC
amplification status has been pointed as an important diagnostic tool to distinguish cutaneous vascular lesions of the breast. We assessed
MYC
amplification and protein expression status by fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC), respectively, in 49 patients diagnosed with breast AS, and 30 patients diagnosed with post-radiation AVL of the breast. Clinical and pathological features, and follow-up data were collected, and survival analyses were performed. Among 37 patients with SAS, twenty patients had tumors with high-level
MYC
amplification and protein overexpression (54 %). None of primary angiosarcomas (PAS) or AVL cases showed
MYC
amplification or protein expression. Concordance between
MYC
amplification (FISH) and protein expression (IHC) was 100 % in AVL, PAS, and SAS. Survival analysis of the SAS patients demonstrates that those with
MYC
amplification had a significantly worse overall survival compared to cases without MYC amplification (
P
= 0.035). There was a non-significant trend toward a poor disease-free survival between cases with and without
MYC
amplification (
P
= 0.155). Our findings show that
MYC
amplification is a highly specific but poorly sensitive marker for SAS and, therefore, a negative result does not exclude the diagnosis of angiosarcoma.
MYC
amplification was associated with adverse prognosis, suggesting a prognostic role of
MYC
amplification status on SAS of the breast.
Publisher
Springer US,Springer,Springer Nature B.V
Subject
/ Aged
/ Analysis
/ Breast Neoplasms - diagnosis
/ Breast Neoplasms - pathology
/ Breasts
/ Female
/ Gene Expression Regulation, Neoplastic
/ Genes
/ Humans
/ In Situ Hybridization, Fluorescence
/ Medicine
/ Neoplasms, Radiation-Induced - diagnosis
/ Neoplasms, Radiation-Induced - genetics
/ Neoplasms, Radiation-Induced - pathology
/ Oncology
/ Proto-Oncogene Proteins c-myc - biosynthesis
/ Proto-Oncogene Proteins c-myc - genetics
/ Tumors
/ Vascular Malformations - diagnosis
