The role of CD44+/CD24-/low biomarker for screening, diagnosis and monitoring of breast cancer.

Cancer stem cells (CSCs) have been defined as 'a cell within a tumor that possesses the capacity to self-renew and to cause the heterogeneous lineages of cancer cells that comprise the tumor'. The CSC hypothesis postulates that a small subpopulation of cancer cells drives tumor initiation, growth and metastasis. CSCs have been isolated from breast cancer using CD44+/CD24-/low phenotype. The purpose of the present study was to evaluate the expression of CD44+/CD24-/low in two diverse breast carcinomas (ductal and lobular), and to determine the correlation between expression of CD44+/CD24-/low, and clinicopathological characteristics starting from human fresh breast cancer specimens. We analyzed specimens from 57 patients using CD44 and CD24 markers by flow cytometry and immunohistochemistry and correlated the CD44+/CD24-/low phenotype with clinicopathological characteristics. Moreover, mammosphere formation was tested. In all specimens tested, CD44+/CD24-/low phenotype was detectable with mean percentage of 4.73% as confirmed also by immunohistochemical analyses. A significant statistical association was found among these phenotypic groups and age, grade G3, estrogen and progesterone receptor, Ki-67 as well as lymph node metastasis. No correlation was found for histological type. In conclusion, our data showed that CD44+/CD24-/low phenotype was found at a high frequency in tumors pT2, G3, pN3, positive for Ki-67, and negative for estrogen and progesterone receptors highlighting the hypothesis that CD44+/CD24-/low profile correlates with the more aggressive clinical-pathological features of the disease.