Currently, there is no robust evidence demonstrating a clear association between Lynch syndrome and non-malignant breast pathology such as adenomyoepithelioma. We report a case of benign breast adenomyoepithelioma, which after recurrence was associated with ductal carcinoma in-situ (DCIS) in a 41-year-old woman with Lynch syndrome, who lacked significant family history of breast or ovarian cancer. Both, the adenomyoepithelioma and DCIS were found to have nuclear loss of MSH2/MSH6 by immunohistochemistry, while germline testing confirmed MSH2 gene mutation. Concordant loss of MSH2 in both lesions in the context of a MSH2 pathogenic variant in this patient with Lynch syndrome illustrates that the benign adenomyoepithelioma behaved as a likely precursor of DCIS. Our report provides a novel perspective that in some patients with Lynch syndrome adenomyoepithelioma may represent a pre-malignant precursor lesion of DCIS.
Long noncoding RNAs (lncRNAs) are increasingly recognized to play major regulatory roles in development and disease. To identify novel regulators in breast biology, we identified differentially regulated lncRNAs during mouse mammary development. Among the highest and most differentially expressed was a transcript ( Zfas1 ) antisense to the 5′ end of the protein-coding gene Znfx1 . In vivo, Zfas1 RNA is localized within the ducts and alveoli of the mammary gland. Zfas1 intronically hosts three previously undescribed C/D box snoRNAs (SNORDs): Snord12 , Snord12b , and Snord12c . In contrast to the general assumption that noncoding SNORD-host transcripts function only as vehicles to generate snoRNAs, knockdown of Zfas1 in a mammary epithelial cell line resulted in increased cellular proliferation and differentiation, while not substantially altering the levels of the SNORDs. In support of an independent function, we also found that Zfas1 is extremely stable, with a half-life >16 h. Expression analysis of the SNORDs revealed these were expressed at different levels, likely a result of distinct structures conferring differential stability. While there is relatively low primary sequence conservation between Zfas1 and its syntenic human ortholog ZFAS1 , their predicted secondary structures have similar features. Like Zfas1 , ZFAS1 is highly expressed in the mammary gland and is down-regulated in breast tumors compared to normal tissue. We propose a functional role for Zfas1/ ZFAS1 in the regulation of alveolar development and epithelial cell differentiation in the mammary gland, which, together with its dysregulation in human breast cancer, suggests ZFAS1 as a putative tumor suppressor gene.
// Fares Al-Ejeh 1* , Mariska Miranda 1,2 , Wei Shi 1 , Peter T. Simpson 3 , Sarah Song 4 , Ana Cristina Vargas 3 , Jodi M. Saunus 3 , Chanel E. Smart 3 , Mythily Mariasegaram 3 , Adrian P. Wiegmans 1 , Georgia Chenevix-Trench 5 , Sunil R. Lakhani 3,6,7 , and Kum Kum Khanna 1,2* 1 Signal Transduction Laboratory, QIMR Berghofer Medical Research Institute, Herston QLD 4006, Australia 2 The University of Queensland, St Lucia QLD 4072, Australia 3 The University of Queensland, UQ Centre for Clinical Research, Herston QLD 4029, Australia 4 The University of Queensland, QLD Centre for Medical Genomics, St Lucia QLD 4072, Australia 5 Cancer Genetics Laboratory, QIMR Berghofer Medical Research Institute, Herston QLD 4006, Australia 6 The University of Queensland, School of Medicine, Herston QLD 4006, Australia 7 Pathology Queensland: The Royal Brisbane & Women's Hospital, Herston QLD 4029, Australia Correspondence: Kum Kum Khanna, email: // Fares Al-Ejeh, email: // Keywords : Breast cancer, TNBC, kinome, cancer heterogeneity, targeted therapy Received : February 11, 2014 Accepted : March 24, 2014 Published : March 26, 2014 Abstract Our understanding of breast cancer heterogeneity at the protein level is limited despite proteins being the ultimate effectors of cellular functions. We investigated the heterogeneity of breast cancer (41 primary tumors and 15 breast cancer cell lines) at the protein and phosphoprotein levels to identify activated oncogenic pathways and developing targeted therapeutic strategies. Heterogeneity was observed not only across histological subtypes, but also within subtypes. Tumors of the Triple negative breast cancer (TNBC) subtype distributed across four different clusters where one cluster (cluster ii) showed high deregulation of many proteins and phosphoproteins. The majority of TNBC cell lines, particularly mesenchymal lines, resembled the cluster ii TNBC tumors. Indeed, TNBC cell lines were more sensitive than non-TNBC cell lines when treated with targeted inhibitors selected based on upregulated pathways in cluster ii. In line with the enrichment of the upregulated pathways with onco-clients of Hsp90, we found synergy in combining Hsp90 inhibitors with several kinase inhibitors, particularly Erk5 inhibitors. The combination of Erk5 and Hsp90 inhibitors was effective in vitro and in vivo against TNBC leading to upregulation of pro-apoptotic effectors. Our studies contribute to proteomic profiling and improve our understanding of TNBC heterogeneity to provide therapeutic opportunities for this disease.
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