Morphological and phenotypical features of ovarian metastases in breast cancer patientsReportar como inadecuado

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BMC Cancer

, 17:206

Surgical oncology, cancer imaging, and interventional therapeutics


BackgroundAutotransplantation of frozen-thawed ovarian tissue is a method to preserve ovarian function and fertility in patients undergoing gonadotoxic therapy. In oncology patients, the safety cannot yet be guaranteed, since current tumor detection methods can only exclude the presence of malignant cells in ovarian fragments that are not transplanted. We determined the need for a novel detection method by studying the distribution of tumor cells in ovaries from patients with breast cancer. Furthermore, we examined which cell-surface proteins are suitable as a target for non-invasive tumor-specific imaging of ovarian metastases from invasive breast cancer.

MethodsUsing the nationwide database of the Dutch Pathology Registry PALGA, we identified a cohort of 46 women with primary invasive breast cancer and ovarian metastases. The localization and morphology of ovarian metastases were determined on hematoxylin-and-eosin-stained sections. The following cell-surface markers were immunohistochemically analyzed: E-cadherin, epithelial membrane antigen EMA, human epidermal growth receptor type 2 Her2-neu, carcinoembryonic antigen CEA, αvβ6 integrin and epithelial cell adhesion molecule EpCAM.

ResultsThe majority of ovarian metastases 71% consisted of a solitary metastasis or multiple distinct nodules separated by uninvolved ovarian tissue, suggesting that ovarian metastases might be overlooked by the current detection approach. Combining the targets E-cadherin, EMA and Her2-neu resulted in nearly 100% detection of ductal ovarian metastases, whereas the combination of EMA, Her2-neu and EpCAM was most suitable to detect lobular ovarian metastases.

ConclusionsExamination of the actual ovarian transplants is recommended. A combination of targets is most appropriate to detect ovarian metastases by tumor-specific imaging.

Keywordsbreast cancer fertility preservation ovarian metastases ovarian tissue autotransplantation tumor markers tumor-specific imaging AbbreviationsASRMAmerican Society for Reproductive Medicine

CEACarcinoembryonic antigen

CK-7Cytokeratin 7



EMAEpithelial membrane antigen

EpCAMEpithelial cell adhesion molecule

FFPEFormalin-fixed paraffin-embedded

FMWVDutch Federation of Biomedical Scientific Societies

GCDFP15Gross cystic disease fluid protein-15


Her2-neuHuman epidermal growth receptor type 2

NIRFNear-infrared fluorescence

PALGAthe Dutch Pathology Registry

PBSPhosphate buffered saline

PCRPolymerase chain reaction

pHPotential hydrogen


SPSSStatistical package for the social sciences

WT1Wilms’ tumor antigen-1

Electronic supplementary materialThe online version of this article doi:10.1186-s12885-017-3191-y contains supplementary material, which is available to authorized users.

Autor: Inge T. A. Peters - Merle A. van der Steen - Bertine W. Huisman - Carina G. J .M. Hilders - Vincent T. H. B. M. Sm


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