Breast – Malignant, Males, Children

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Breast-malignant, males, children

Luminal phenotype

Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.

Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)

Revised: 13 September 2009

Last major update: September 2009

Terminology

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● Not part of current WHO breast classification

Features

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● Classification is based on gene expression (molecular) profile studies; subtype reflects clustering of genes activated by ER signaling pathways

● Distribution by molecular typing is luminal A: 71%, luminal B: 8%, HER2+: 6%: basal-like: 15% (Ann Surg Oncol 2009 Jul 11 [Epub ahead of print])

● Some authors also include categories of luminal A-HER2 and luminal B-HER2 hybrids (Int J Clin Exp Pathol 2009;2:444)

● Luminal cytokeratins are CK7/8, 18 and 19

● Luminal subtypes include luminal A (ER+ [strong], PR+, HER2-) and luminal B (ER+ [weak/moderate], PR-, sometimes HER2+)

● Luminal A and B subtypes are associated with mutations in E-cadherin and MAP2K4, and amplifications of Cyclin D1, HER2 and HDM2 (Breast Cancer Res Treat 2009 Jul 11 [Epub ahead of print])

● Luminal A breast cancers are usually low grade, with slow growth and better prognosis than luminal B (J Natl Cancer Inst 2009;101:736)

● Luminal B breast cancers: some are HER2+, but the major biological distinction from Luminal A is the proliferation signature, in which CCNB1, MKI67 and MYBL2 genes have higher expression in luminal B than in luminal A tumors (BMC Genomics 2006 Apr 27;7:96)

Micro images

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Classic Luminal A tumor Uncommonly, Luminal A tumor

is ER+ (strong), Ki-67 low has high Ki-67 index

Positive stains

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● CK7, CK8/18, ER

End of Breast – Malignant, Males, Children > Luminal phenotype

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