Nour Sneige's research while affiliated with University of Texas MD Anderson Cancer Center and other places
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Publications (431)
Objective:Risk-reducing therapy with selective estrogen receptor (ER) modulators and aromatase inhibitors reduce breast cancer risk. However, the effects are limited to ER-positive breast cancer. Therefore, new agents with improved toxicity profiles that reduce the risk in ER-negative breast cancers are urgently needed. The aim of this prospective,...
With the advent of mammographic screening, non-palpable lesions are increasingly detected. As the central dogma of triple assessment is frequently regarded as the gold standard in breast lesion assessment, some form of pathological evaluation is often performed. Both fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are routinely...
Purpose
Oncotype DX, a 21-gene expression profiling test, has become standard of care in the management of estrogen receptor (ER)-positive breast cancer. In multifocal tumors, it is unclear whether testing of the different foci is necessary. We evaluated the concordance of Oncotype DX recurrence scores (RS) between 2 tumor foci in synchronous bilat...
Fine needle aspiration is a minimally invasive, low-morbidity, and cost-efficient technique for the sampling of mediastinal lesions. Additionally, ancillary testing on FNA samples can be used for the refinement of diagnoses and for treatment-related purposes (flow cytometry, cytogenetics, immunohistochemistry, and molecular diagnostics). Mediastina...
Background
Claudin‐4 is a sensitive and specific marker for carcinoma in effusion cytology. The authors examined the diagnostic use of claudin‐4 versus MOC‐31 and Ber‐EP4 by comparing their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in differentiating carcinoma from mesothelioma and benign/mesothe...
PURPOSE
To our knowledge, NRG/RTOG 9804 is the only randomized trial to assess the impact of whole breast irradiation (radiation therapy [RT]) versus observation (OBS) in women with good-risk ductal carcinoma in situ (DCIS), following lumpectomy. Long-term results focusing on ipsilateral breast recurrence (IBR), the primary outcome, are presented h...
PurposeHER2 overexpression and gene amplification are routinely tested by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), respectively. In addition, HER2 mRNA expression is also tested by the Oncotype DX assay. Discordance between laboratories among the different assays remains a problem. To improve the routine HER2 report...
In preclinical studies, celecoxib has been associated with reduced risk of breast cancer. In this study, the aim was to assess the biomodulatory effect of celecoxib on blood and benign breast tissue biomarkers in women at increased risk for breast cancer. Women at increased risk for breast cancer (5-year Gail risk score of >1.67%, history of atypic...
Purpose
Mucocele-like lesions of the breast identified on core biopsy are rare high-risk lesions associated with variable upgrade rates to carcinoma on excision. We aimed to identify the clinicoradiopathological features that can help optimize management of this lesion.
Methods
We evaluated 50 mucocele-like lesions identified on core biopsies from...
Intraluminal crystalloids have rarely been described in the breast, particularly in cases with ductal carcinoma in situ (DCIS). We recently encountered a case of DCIS of the breast associated with numerous intraluminal crystalloids. The patient presented with a mass in the right breast, and microcalcifications were detected on screening and diagnos...
The aim of this study was to analyze the clinicopathological features of patients with flat epithelial atypia, diagnosed in directional vacuum-assisted biopsy targeting microcalcifications, to identify upgrade rate to in situ ductal or invasive breast carcinoma, and determine factors predicting carcinoma in the subsequent excision. We retrospective...
Implications of assessing the proximal and far para-tracheal or sub-carinal nodes (para-tracheal [PTN] or sub-carinal [SCN]) associated with lower primary esophageal carcinomas (ECs) are unclear. To evaluate the value of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) for PTN and SCN, we analyzed results by positron emission tomograph...
Background:
Papanicolaou (Pap) cytology and high-risk human papillomavirus (HPV) DNA cotesting for women aged ≥30 years are recommended for the prevention of cervical cancer. The objective of the current study was to evaluate the efficacy of this cotesting for predicting the risk of high-grade cervical intraepithelial neoplasia 3 (CIN3) during a 3...
Objective
To compare the diagnostic accuracy of ultrasound (US)-guided core needle biopsy (CNB) of breast masses performed with 14-gauge, 16-gauge and 18-gauge needles. Methods
We retrospectively reviewed the charts of 1,112 patients who underwent US-guided breast CNB with 14-gauge, 16-gauge and 18-gauge needles. Cases with surgical excision or a m...
BACKGROUND
The 2013 testing guidelines for determining the human epidermal growth factor receptor 2 (HER2) status include new cutoff points for the HER2/chromosome enumeration probe 17 (CEP17) ratio and the average HER2 copy number per cell, and they recommend using a reflex test with alternative chromosome 17 probes (Ch17Ps) to resolve equivocal H...
Selective estrogen receptor modulators (SERMs), tamoxifen, and raloxifene that reduce the risk of breast cancer are limited to only estrogen receptor-positive (ER+) breast cancer. In addition, patient acceptance of SERMs is low due to toxicity and intolerability. New agents with improved toxicity profile that reduce risk of ER-negative breast cance...
Introduction:
EasyChip HPV blot is a human papillomavirus (HPV) genotyping assay that can be potentially used for HPV assay validation or clinical HPV research. To evaluate its genotyping accuracy, we compared EasyChip HPV blot with quantitative real-time polymerase chain reaction (qRT-PCR)/type-specific PCR assays in the detection of 8 high-risk...
Background:
Peritoneal metastases (PM) in patients with gastric adenocarcinoma (GAC) may be identified by diagnostic laparoscopy (DL) or imaging (I). Although prognosis is poor, some patients have excellent outcome. We compared the overall survival (OS) of patients in 3 groups: those with positive cytology (CY+) by DL (DL-CY+), those with gross PM...
Purpose:
The Radiation Therapy Oncology Group 9804 study identified good-risk patients with ductal carcinoma in situ (DCIS), a breast cancer diagnosis found frequently in mammographically detected cancers, to test the benefit of radiotherapy (RT) after breast-conserving surgery compared with observation.
Patients and methods:
This prospective ra...
41
Background: Laparoscopic staging of patients with GC can disclose peritoneal metastases. Although this finding is associated with a poor prognosis, some patients achieve a long-term survival. In an attempt to provide explanation we compared the overall survival (OS) of patients with GC peritoneal metastases from two settings: cytology positive o...
Determining whether a pancreatic mass is a primary or secondary neoplasm is necessary for appropriate treatment. We reviewed our experience using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis of pancreatic tumors to identify clinical and cytopathologic characteristics of metastatic disease. We reviewed all cases of tum...
Objective:
The objective of our study was to describe our technique and preliminary results of ultrasound-guided fine-needle aspiration (FNA) of indeterminate internal mammary (IM) lymph nodes in patients with a history of breast cancer.
Conclusion:
Ultrasound-guided FNA of IM nodes is feasible and is particularly useful in the staging of breast...
Background:
Enhancer of zeste homolog 2 (EZH2), a member of the polycomb group proteins, has been shown to promote cancer progression and breast cancer stem cell (CSC) expansion. Breast CSCs are associated with resistance to radiation in inflammatory breast cancer (IBC), a rare but aggressive variant of breast cancer. In this retrospective study,...
Aims
Radiation Therapy Oncology Group 98-04 sought to identify women with ‘good risk’ ductal carcinoma in situ (DCIS) who receive no significant benefit from radiation. Enrolment criteria excluded close or positive margins and grade 3 disease. To ensure reproducibility in identifying good risk pathology, an optional web based teaching tool was deve...
Introduction
Microbiology culture is the gold standard for diagnosis of fungal infections; however, culture has a lengthy turnaround time. A more timely assessment is possible with cytology and Gomori-methamine silver (GMS) staining.
Objectives
To examine the diagnostic role of GMS-stained cytology smears in the detection of fungal organisms and c...
We evaluated the efficacy of using standard radiologic and histologic criteria to guide the follow-up of patients with lobular carcinoma in situ (LCIS), lobular neoplasia (LN), or atypical lobular hyperplasia (ALH). Patients with high-risk benign lesions diagnosed on biopsy were presented and reviewed in a multidisciplinary clinical management conf...
Background
Observational and experimental data support a potential breast cancer chemopreventive effect of green tea.Methods
We conducted an ancillary study using archived blood/urine from a phase IB randomised, placebo-controlled dose escalation trial of an oral green tea extract, Polyphenon E (Poly E), in breast cancer patients. Using an adaptive...
With the advent of mammographic screening, non-palpable lesions are increasingly detected. As the central dogma of triple assessment is frequently regarded as the gold standard in breast lesion assessment, some form of pathological evaluation is often performed. Both fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are routinely...
National Surgical Adjuvant Breast and Bowel Project (NSABP) trial B-31 suggested the efficacy of adjuvant trastuzumab, even in HER2-negative breast cancer. This finding prompted us to develop a predictive model for degree of benefit from trastuzumab using archived tumor blocks from B-31.
Case subjects with tumor blocks were randomly divided into di...
The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. In this study, we determined the upgrade rate to malignancy for BPs without atypia diagnosed on CNB and whether there are factors associated with upgrade.
Through our pathology database search, we studied 80 BPs without atypia iden...
Background:
The authors compared the predictive value of type 16 and/or 18 human papillomavirus (HPV) versus non-16/18 HPV types for high-grade (grade ≥2) cervical neoplasm/vaginal intraepithelial neoplasm and carcinoma (CIN/VAIN2+) in women with mildly abnormal Papanicolaou (Pap) results (ie, atypical squamous cells of undetermined significance [...
Background: Currently FDA approved chemopreventive agents for breast cancer risk reduction include the selective estrogen receptor modulators (SERMs) tamoxifen and raloxifen. However, acceptance amongst high risk women is low due to side effects that include thromboembolic events, uterine cancer and menopausal symptoms. Furthermore, SERMs only redu...
Background:
To better define the cytomorphologic spectrum of endosalpingiosis in peritoneal washings (PWs) and thereby facilitate their distinction from well differentiated serous carcinoma, the authors examined PWs from women who underwent surgery and pathologic staging of lesions other than Mullerian malignancies and correlated the findings with...
Mammary Paget disease (MPD) is considered an intraepidermal manifestation of an underlying mammary carcinoma. In contrast to extramammary Paget disease, invasion of mammary Paget cells into the dermis (invMPD) has not been reported, except for 2 cases described in Rosen's textbook. Our study was designed to identify the presence of dermal invasion...
Patients with ovarian serous tumors of low malignant potential (OSLMP) who have peritoneal implants, especially invasive implants, are at an increased risk of developing tumor recurrence. To the best of the authors' knowledge, the ability of peritoneal washing (PW) cytology to detect the presence and type of peritoneal implants has not been adequat...
We retrospectively reviewed 25 fine-needle aspiration cases of sclerosing adenosis of the breast in conjunction with histologic features of the paired core-needle biopsy and radiologic findings. The original cytologic diagnoses were benign (n = 19), focally atypical (n = 3), and suspicious for carcinoma (n = 3). The frequent features, although not...
Microglandular adenosis (MGA) is a proliferative breast lesion, which has been proposed to be a potential precursor of triple-negative breast cancers. The aims of this study were to determine whether MGAs harbour genetic alterations and if any such genetic aberrations found in MGAs are similar to those found in matched invasive carcinomas.
Twel...
Invasive ductal and lobular breast carcinomas often have different preferred metastasis sites and distinct histomorphologic characteristics. Their metastatic cytomorphologic cell features in body cavity fluids are generally readily recognized, but the single-cell/mesothelial-like pattern and its relationship to the primary tumor type have not been...
To evaluate the utility of peritoneal washing cytology (PWC) for detecting occult primary peritoneal carcinoma in patients with BRCA1 or BRCA2 mutations, we reviewed PWCs obtained during risk-reducing salpingo-oophorectomy (RRSO) from 117 patients at our institution and correlated the results with surgical pathology findings.
Records of 128 PWCs fr...
We evaluated the detection rates of PAX8 and WT1 immunostaining in 68 (45 as cell blocks, 23 as smears) serous effusion specimens that had a cytologic diagnosis of metastatic carcinoma of ovarian origin. Of the cases, 58 (85%) were positive for PAX8, 56 (82%) were positive for WT1, and 64 (94%) were immunoreactive with either or both markers. Detec...
Enhancer of zeste homolog 2 (EZH2), a member of polycomb group proteins, is involved in the regulation of cell cycle progression and has been implicated in various human malignancies, including breast cancer, and also has been associated with aggressive tumor behavior. However, the clinical significance of EZH2 expression in inflammatory breast can...
To compare the pathologic complete response (pCR) rate of patients treated with 5-fluorouracil (5-FU), doxorubicin, and cyclophosphamide (FAC) versus dose-intense FAC plus G-CSF in the neoadjuvant setting and to compare the delivered dose intensity, disease-free survival (DFS) and overall survival (OS) times, and toxicity between treatment arms in...
The selective estrogen receptor modulators (SERM), Tamoxifen and raloxifen reduce risk breast cancer. Patient acceptance of SERMs for breast cancer prevention is low due to toxicities. New agents with a better toxicity profile are needed. Aromatase inhibitors (AI) reduce the risk of contralateral breast cancer and risk of new breast cancer in high...
To date, the stability of human epidermal growth factor receptor 2 (HER2)-positive primary breast carcinomas during disease progression and the role of intervening trastuzumab treatment in the loss of HER2-positive status in paired metastases remain under-investigated.
Sixty-six patients with HER2-positive primary carcinoma and paired metastasis we...
Context.—The appropriate treatment for patients with pleomorphic lobular carcinoma in situ (PLCIS) is unknown. When diagnosed on core biopsy, excision is recommended; however, management of PLCIS when it involves margins has not been addressed.
Objective.—To evaluate the significance of PLCIS that is located close to, or at, a resection margin.
Des...
The appropriate treatment for patients with pleomorphic lobular carcinoma in situ (PLCIS) is unknown. When diagnosed on core biopsy, excision is recommended; however, management of PLCIS when it involves margins has not been addressed.
To evaluate the significance of PLCIS that is located close to, or at, a resection margin.
We identified 26 patien...
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy is used to stage mediastinal lymph nodes in cancer patients to optimize treatment strategies. In this retrospective study, the authors determined the utility of EBUS-TBNA biopsy in the evaluation of mediastinal lymphadenopathy at a high-volume cancer center.
The pat...
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy is routinely used to stage lung cancer; however, its usefulness in diagnosing lymphoproliferative disorders has not been well established. In this retrospective study, we determined the utility of EBUS-TBNA in evaluating mediastinal lymphadenopathy in patients with...
We compared the efficacy of p16 and ProExC immunostaining in detecting cervical intraepithelial neoplasia (CIN) 2+ in 136 formalin-fixed, paraffin-embedded cervical tissue specimens with consensus diagnoses of normal cervix, CIN 1, CIN 2, CIN 3, and carcinoma. Diffuse staining patterns of more than half the thickness of CINs and more than 10% of ca...
Prominent coarse eosinophilic cytoplasmic granules reminiscent of those in intestinal Paneth cells are rarely identified in breast carcinomas. In the literature, this phenomenon seems to be associated with acinic cell carcinoma of the breast or microglandular adenosis-related lesions. In this study, we report 3 breast carcinoma cases with such gran...
Our goal was to analyze clinicopathologic features of patients with atypical ductal hyperplasia (ADH) diagnosed on directional vacuum-assisted biopsy (DVAB) targeting microcalcifications to identify factors predicting the presence of carcinoma.
We retrospectively evaluated the clinical, mammographic, and histologic features of 140 patients with DVA...
The purposes of this study were to address a persistent controversy as to whether the ER status of a primary tumor remains stable during progression to metastasis and to evaluate the influence of disease course and prior systemic therapy on ER status.
Breast carcinomas from 227 women with known ER status in both primary tumor and paired metastasis...
BI-RADS Category classification is the most powerful predictor of breast cancer (BC). However, BI-RADS Category 4 lesions are associated with a highly variable rate of BC. The purpose of this study was to develop and validate a nomogram for the prediction of individual probability of BC in patients with BI-RADS Category 4 lesions.
The study include...
One-fifth of breast cancers have the triple-negative phenotype; a good prognostic marker has yet not been described for these tumours. Tumour microarrays from 58 triple-negative patients treated with surgery followed by chemotherapy were analysed for expression of cytokeratin 5/6 (CK5/6), epidermal growth factor receptor (EGFR), vimentin, p63 and c...
Background: ER and HER2 status are important to determine a patient's eligibility to receive endocrine therapy and anti-HER2 (trastuzumab) therapy, respectively. However, whether the status of ER and HER2 is stable after administration of trastuzumab and chemotherapy remains controversial. To date, there have been rare studies describing a change o...
This study specifically addressed the performance of chromogenic in situ hybridization (CISH) on HER2 testing in 66 breast carcinomas with chromosome 17 polysomy and 49 carcinomas with an equivocal HercepTest (DakoCytomation, Carpinteria, CA) score by comparing CISH with corresponding FISH results at 2 test sites and evaluating intersite agreement...
Male breast cancer accounts for around 1% of all breast cancer cases but the incidence has risen in recent years. This study aimed to classify the molecular subtypes of male breast cancers based on the expression profile of immunomarkers and to evaluate their association with clinicopathological features and expression patterns of epidermal growth...
The American Society of Clinical Oncology/ College of American Pathologists (ASCO/CAP) guideline recommendations from January 2007 identified many sources of immunohistochemistry (IHC) testing variation.
In this current study, we implemented the guidelines and addressed our institution's preanalytic, analytic, and postanalytic variables relating to...
1514
Background: Selective estrogen receptor modulators (SERMs) reduce the risk of breast cancer. Acceptance of SERMs is low due to toxicities. Agents with a better toxicity profile and surrogate endpoint biomarkers to evaluate the effect of preventive agents are needed. In addition to reducing the risk of recurrence of breast cancer, the aromatase...
Chromogenic in situ hybridization (CISH) has shown the potential to replace fluorescence in situ hybridization (FISH) to determine HER2 gene status. To validate the reliability of CISH, we used 226 consecutive breast carcinomas from 2 institutions and tested CISH and FISH on the same tumor set simultaneously at different test sites. Besides manufac...
Context.—The American Society of Clinical Oncology/ College of American Pathologists (ASCO/CAP) guideline recommendations from January 2007 identified many sources of immunohistochemistry (IHC) testing variation.
Objective.—In this current study, we implemented the guidelines and addressed our institution's preanalytic, analytic, and postanalytic v...
#3004
Background: Columnar cell lesions (CCL) are frequently identified in biopsies performed for calcifications. The primary objective of this study is to identify histologic features of CCL in directional vacuum-assisted needle biopsies (DVAB) that could predict a higher risk lesion requiring excision.
Design: From June 2002 to January 2008, we r...
Citations
... However, it was not difficult to evaluate their benignity. Presence of mucinous material in cytological diagnosis of cystic salivary gland lesion is very important as it indicates the possibility of mucoepidermoid carcinoma (5,14,17,18). Therefore, presence of mucinous material without epithelial cells is categorised as MSRSGC III (AUS) (5,14). ...
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... EBUS can be used for diagnosis and aspiration when the lesion is in the mediastinum or bronchi, and the " uid-thrill " sign on EBUS helps to diagnose bronchogenic cysts. EUBS-TBNA has become a standard procedure for obtaining biopsies for mediastinal disorders [17] . Regrettably, EBUS is ineffective in diagnosing RBCs. ...
... and 13% to 26% with Ber-Ep4 reducing their specificity for carcinomatous effusions. 21 In a large study of 229 cytology specimens, F I G U R E 6 Representative images from cohort B-negative for malignancy. (A-C) Images of cell block from case 12 of Table 2 but with superior specificity of 100%. ...
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... Patients were also evaluated according to clinicopathologic criteria for 'low risk', including RTOG 9804-like criteria (low or intermediate grade, size ≤2.5 cm, no positive margins [ink on tumor], non-palpable, screen-detected) and ECOG E5194-like criteria (low or intermediate grade, size ≤2.5 cm, no positive margins). 23,24 Summary data for treatment recommendations were also grouped by physician specialty: surgeons (independently), versus radiation oncologists (independently), versus radiation oncologists (independently) or tumor boards. ...
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... Figure 1). 9,[17][18][19] In the past, patients with low and zero expression of HER2 have been pathologically classified as "HER2-negative" BC and missing the opportunity to receive HER2-targeted therapy. However, new ADCs' action does not depend on the protein expression level of HER2. ...
... A razão HER-2/CEP-17 maior do que 2 foi interpretada como positiva para amplificação do gene. A polissomia do cromossomo 17 foi definida como presença de três ou mais sinais CEP-17 em mais de 6% das células tumorais avaliadas 16 . 12 . ...
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... Overall, at a mean follow-up time of 4.5 years, the 23 patients who were not upgraded had no evidence of malignancy. These findings support an early study on margin status for P-LCIS by Downs-Kelly et al. in 2011 with a reported local recurrence rate of 3.8% (1/26) at 18 months after surgery on one patient with positive margins [79]. In contrast to these studies, a 2017 study by Fasola et al. found no evidence of local recurrence in 12 patients with a diagnosis of P-LCIS at a median follow-up of 4.2 years, including two cases of positive margins [80]. ...
... We previously reported a significant increase in IGFBP-1 levels in women who received anastrozolebased therapy for six months (37). Likewise, in another study, we observed a significant increase in IGFBP-1 levels in women who received celecoxib-based therapy for six months (38). In this study, we did not see any significant differences in serum IGFBP-1 levels before and after treatment with dasatinib. ...
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... Interestingly, the literature suggests that only a minor subset of MLLs without atypia on core biopsy show in-situ or invasive carcinoma (1.3% and 1.8% of cases) on excision, whereas core needle biopsies showing MLL with atypia on biopsy show in-situ and invasive carcinoma in 14% and 4.7% of the cases on excision, respectively. [34][35][36][37][38][39][40] Biopsies showing MLLs should be subjected to serial sectioning and deeper levels of examination to exclude the presence of a more significant lesion. Given the small rate of upgrade of MLLs without atypia on core needle biopsy, some authors suggest that in cases where clinical, radiologic, and pathology findings are concordant, no atypical epithelium is identified despite serial sections, and no mass lesion is evident on imaging, conservative management may be considered. ...
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... Modest or no improvements in PFS and OS highlight the high-risk nature of TNBC, as well as the difficulty in identifying relevant targets and effective therapies. 4, [32][33][34][35] Data from this phase II study in a group of patients with AR-positive TNBC support and build upon the findings from others that there seems to exist a subset of patients with androgen-driven TNBC who may benefit from an AR-targeted agent. jco.org ...
