Utility of Genomic Analysis in Differentiating Synchronous and Metachronous Lung Adenocarcinomas from Primary Adenocarcinomas with Intrapulmonary Metastasis

Distinguishing synchronous and metachronous primary lung adenocarcinomas from adenocarcinomas with intrapulmonary metastasis is essential for optimal patient management. In this study, multiple lung adenocarcinomas occurring in the same patient were evaluated using comprehensive histopathologic evaluation supplemented with molecular analysis. The cohort included 18 patients with a total of 52 lung adenocarcinomas. Eleven patients had a new diagnosis of multiple adenocarcinomas in the same lobe (n = 5) or different lobe (n = 6). Seven patients had a history of lung cancer and developed multiple new tumors. The final diagnosis was made in resection specimens (n = 49), fine needle aspiration (n = 2), and biopsy (n = 1). Adenocarcinomas were non‐mucinous, and histopathologic comparison of tumors was performed. All tumors save for one were subjected to ALK gene rearrangement testing and targeted Next Generation Sequencing (NGS). Using clinical, radiologic, and morphologic features, a confident conclusion favoring synchronous/metachronous or metastatic disease was made in 65% of patients. Cases that proved challenging included ones with more than three tumors showing overlapping growth patterns and lacking a predominant lepidic component. Genomic signatures unique to each tumor were helpful in determining the relationship of multiple carcinomas in 72% of patients. Collectively, morphologic and genomic data proved to be of greater value and achieved a conclusive diagnosis in 94% of patients. Assessment of the genomic profiles of multiple lung adenocarcinomas complements the histological findings, enabling a more comprehensive assessment of synchronous, metachronous, and metastatic lesions in most patients, thereby improving staging accuracy. Targeted NGS can identify genetic alterations with therapeutic implications.     

A Long Noncoding RNA Signature That Predicts Pathological Complete Remission Rate Sensitively in Neoadjuvant Treatment of Breast Cancer

BACKGROUND: Mounting evidence suggests that long noncoding RNAs (lncRNAs) are closely related to pathological complete response (pCR) in neoadjuvant treatment of breast cancer. Here, we construct lncRNA associated models to predict pCR rate. METHODS: LncRNA expression profiles of breast cancer patients treated with neoadjuvant chemotherapy (NAC) were obtained from Gene Expression Omnibus by repurposing existing microarray data. The prediction model was firstly built by analyzing the correlation between pCR and lncRNA expression in the discovery dataset GSE 25066 (n = 488). Another three independent datasets, GSE20194 (n = 278), GSE20271 (n = 178), and GSE22093 (n = 97), were integrated as the validation cohort to assess the prediction efficiency. RESULTS: A novel lncRNA signature (LRS) consisting of 36 lncRNAs was identified. Based on this LRS, patients with NAC treatment were divided into two groups: LRS-high group and LRS-low group, with positive correlation of pCR rate in the discovery dataset. In the validation cohort, univariate and multivariate analyses both demonstrated that high LRS was associated with higher pCR rate. Subgroup analysis confirmed that this model performed well in luminal B [odds ratio (OR) = 5.4; 95% confidence interval (CI) = 2.7-10.8; P = 1.47e-06], HER2-enriched (OR = 2.5; 95% CI = 1.1-5.7; P = .029), and basal-like (OR = 5.5; 95% CI = 2.3-16.2; P = 5.32e-04) subtypes. Compared with other preexisting prediction models, LRS demonstrated better performance with higher area under the curve. Functional annotation analysis suggested that lncRNAs in this signature were mainly involved in cancer proliferation process. CONCLUSION: Our findings indicated that our lncRNA signature was sensitive to predict pCR rate in the neoadjuvant treatment of breast cancer, which deserves further evaluation.     

Genetic diversity and population structure of a protected species: Polygala tenuifolia Willd

Polygala tenuifolia Willd. is an important protected species used in traditional Chinese medicine. In the present study, amplified fragment length polymorphism (AFLP) markers were employed to characterize the genetic diversity in wild and cultivated P. tenuifolia populations. Twelve primer combinations of AFLP produced 310 unambiguous and repetitious bands. Among these bands, 261 (84.2%) were polymorphic. The genetic diversity was high at the species level: percentage of polymorphic loci (PPL) = 84.2%, Nei's gene diversity (h) = 0.3296 and Shannon's information index (I) = 0.4822. Between the two populations, the genetic differentiation of 0.1250 was low and the gene flow was relatively high, at 3.4989. The wild population (PPL = 81.9%, h = 0.3154, I = 0.4635) showed a higher genetic diversity level than the cultivated population (PPL = 63.9%, h = 0.2507, I = 0.3688). The results suggest that the major factors threatening the persistence of P. tenuifolia resources are ecological and human factors rather than genetic. These results will assist with the design of conservation and management programs, such as in natural habitat conservation, setting the excavation time interval for resource regeneration and the substitution of cultivated for wild plants.     

Comparing the genetic diversity and structure of indigenous Korean and Chinese populations of Laodelphax striatellus Fallén using mitochondrial haplotypes

The small brown planthopper, Laodelphax striatellus Fallén, is a major migratory pest from China to Korea and transmits viral diseases of rice plants. In this study, we compared the genetic structures of overwintered indigenous Korean and Chinese populations. The eight Korean populations consisted of 33 haplotypes, and 16 of these were newly identified. The genetic diversity of the Korean population revealed high haplotype diversity (Hd) and low nucleotide diversity (π) of 0.86 ± 0.017 and 0.0024 ± 0.0001 on average, respectively. These values for the Chinese population were Hd = 0.92 ± 0.016 and π = 0.0026 ± 0.0002. Overall, genetic distances by pairwise F_ST were generally low, ranging from ? 0.022 to 0.089. Moreover, the Korean population revealed its ongoing population expansion by showing negative values in the neutrality test (Tajima's D = ? 1.4, Fu's Fs = ? 15.8) and a unimodal pattern in the mismatch distribution analysis. The genetic structures and population relationships were determined using 8 indigenous Korean and 30 Chinese populations by Bayesian approaches and population tree construction, respectively. The genetic structure was inferred as five (K = 5), and all indigenous Korean populations as well as 10 Chinese populations from the Shanghai city, Anhui, Henan, Jiangsu, Liaoning, Shandong, and Zhejiang provinces were grouped into ‘G3’. These results provide partial support for unidirectional gene flow by migratory Chinese populations into Korea. Further analysis conducted using specimens from China and Korea collected in similar periods is necessary to clarify the migration population's origin and its effect on the genetic structure of the indigenous populations.     

Oral Mucosa Dose Parameters Predicting Grade ≥3 Acute Toxicity in Locally Advanced Nasopharyngeal Carcinoma Patients Treated With Concurrent Intensity-Modulated Radiation Therapy and Chemotherapy: An Independent Validation Study Comparing Oral Cavity versus Mucosal Surface Contouring Techniques

PURPOSE: To determine whether volumes based on the contours of the mucosal surface instead of the oral cavity can be used to predict grade ≥3 acute oral mucosa toxicity in patients with locally advanced nasopharyngeal carcinoma (LANPC) treated with concurrent intensity-modulated radiation therapy (IMRT) and chemotherapy. METHODS AND MATERIALS: A standardized method for the oral cavity (oral cavity contours, OCC) and a novel method for the mucosal surface (mucosal surface contours, MSC) were developed for the oral mucosa and prospectively applied to the radiation treatment plans of 92 patients treated with concurrent IMRT and chemotherapy for LANPC. Dose–volume histogram (DVH) data were extracted and then toxicity was analyzed. Receiver operating characteristic analysis and logistic regression were carried out for both contouring methods. RESULTS: Grade ≥3 acute oral mucosa toxicity occurred to 20.7% (19/92) of patients in the study. A highly significant dose–volume relationship between oral mucosa irradiation and acute oral mucosa toxicity was supported by using both oral cavity and mucosal surface contouring techniques. In logistic regression, body weight loss was an independent factor related to grade ≥3 acute toxicity for OCC and MSC (P = .017 and 0.005, respectively), and the independent factor of dosimetric parameters for OCC and MSC were V30Gy (P = .003) and V50Gy (P = .003) respectively. In the receiver operating characteristics curve, the areas under V30Gy of the OCC curves was 0.753 (P = .001), while the areas under V50Gy of MSC curves was 0.714 (P = .004); the cut-off value was 73.155% (sensitivity, 0.842; specificity, 0.671) and 14.32% (sensitivity, 0.842; specificity, 0.575), respectively. CONCLUSION: DVH analysis of mucosal surface volumes accurately predicts grade ≥3 acute oral mucosa toxicity in patients with LANPC receiving concurrent IMRT and chemotherapy, but in clinical practice the MSC method appears no better than the OCC one.     

Maxillary tooth growth in the adult male babirusa (genus Babyrousa)

The growth of the maxillary canine teeth of the babirusa (genus Babyrousa) was studied on a sample of 149 adult male babirusa skulls from twenty-two international museum and private collections. Skulls from Buru, Sulawesi and the Togian Islands were represented. The continuous growth process was summarised into five stages (‘A’–‘E’) according to the position of the tip of the tooth over the bones of the skull. The supracutaneous portion of the tooth grew in a curve-linear fashion dorso-caudally, and was orientated such that the tips grew towards the midline of the cranium. The teeth of Sulawesi and Togian babirusa grew more dorsally over the nasal and frontal bones. Measurements were made on a subset of 45 teeth from Sulawesi babirusa skulls. The subcutaneous portion of the maxillary canine tooth (n = 22) increased in size from 37.3 mm (95% CI: 29.9–44.4 mm) in growth stage ‘B’ to 54.3 mm (49.4–59.2 mm) in growth stage ‘E’ as the erupted portion of the tooth (n = 19) lengthened from 81.3 mm (43.8–118.9 mm) in growth stage ‘A’ to 215.3 mm (177.8–252.9 mm) in growth stage ‘E’. The apical end of the tooth was open and thin-walled. The lumen of the tooth was filled with a cone of well vascularised dental pulp that extended almost to the tip of the tooth. The angle of curvature of the tooth within the alveolus (n = 22) decreased from 19.8 (17.3–22.3) degrees in growth stage ‘B’ to 7.4 (5.7–9.0) degrees in growth stage ‘E’. The corresponding supracutaneous angle of curvature (n = 25) reduced from 36.8 (33.6–40.1) degrees in growth stage ‘A’ to 10.7 (8.6–12.8) degrees in growth stage ‘E’.     

Anthropometric dimensions provide reliable estimates of abdominal adiposity: A validation study

Abdominal fat accumulation is a major risk factor for cardiometabolic morbidity and mortality. The purpose of the study is to assess the possibility of developing accurate estimation equations based on body measurements to determine total abdominal (TFA), subcutaneous (SFA) and visceral fat area (VFA). Hungarian volunteers (n = 198) aged between 20 and 81 years were enrolled in the study, which was conducted between July and November 2014. All persons underwent anthropometric measurements and computer tomographic (CT) scanning. Sex-specific multiple linear regression analyses were conducted in a subgroup of 98 participants to generate estimation models, then Bland–Altman's analyses were applied in the cross-validation group to compare their predictive efficiency. The variables best predicting VFA were hip circumference, calf circumference and waist-to-hip ratio (WHR) for males (R² = 0.713; SEE = 5602.1 mm²) and sagittal abdominal diameter (SAD), WHR, thigh circumference and triceps skinfold for females (R² = 0.845; SEE = 3835.6 mm²). The SFA prediction equation included SAD, thigh circumference and abdominal skinfold for males (R² = 0.848; SEE = 4124.1 mm²), body mass index and thigh circumference for females (R² = 0.861; SEE = 5049.7 mm²). Prediction accuracy was the highest in the case of TFA: hip circumference and WHR for males (R² = 0.910; SEE = 5637.2 mm²), SAD, thigh circumference and abdominal skinfold for females (R² = 0.915; SEE = 6197.5 mm²) were used in the equations. The results suggested that deviations in the predictions were independent of the amount of adipose tissue. Estimation of abdominal fat depots based on anthropometric traits could provide a cheap, reliable method in epidemiologic research and public health screening to evaluate the risk of cardiometabolic events.     

NFATc1 Expression as a Prognosticator in Urothelial Carcinoma of the Upper Urinary Tract

We recently found that NFATc1, a member of the NFAT family and a key regulator of the immune response, could induce bladder carcinogenesis and cancer progression. In this study, we immunohistochemically stained for NFATc1 in upper urinary tract urothelial carcinoma (UUTUC) specimens and paired nonneoplastic urothelial tissues. NFATc1 was positive in 51 [52%; 40 (40%) weak (1+), 9 (9%) moderate (2+), and 2 (2%) strong (3+)] of 99 UUTUCs, which was significantly higher than in benign urothelium [30 (36%) of 83; 28 (34%) weak and 2 (2%) moderate] (0 vs 1+/2+/3+, P = .038; 0/1+ vs 2+/3+, P = .023). There were no significant associations between NFATc1 expression pattern and tumor grade or pT stage. However, the positive rates of NFATc1 expression tended to be higher in renal pelvic tumors (60%) than in ureteral tumors (42%; P = .080) as well as in pN+ tumors (75%) than in pN0 tumors (49%; P = .089). Kaplan-Meier and log-rank tests revealed that moderate (2+) to strong (3+) NFATc1 expression correlated with lower progression-free survival (P = .032) and cancer-specific survival (P = .005) rates in the 99 cases. Patients with high (2+/3+) NFATc1 muscle-invasive tumor (n = 9) also had a significantly higher risk of cancer-specific mortality (P = .021) compared to those with low (0/1+) NFATc1 muscle-invasive tumor (n = 53). Thus, compared with nonneoplastic urothelium, a significant increase in the expression of NFATc1 in UUTUC was seen, implying the involvement of NFATc1 signals in the development of UUTUC. The current results further suggest that NFATc1 overexpression serves as a predictor of poor prognosis in patients with UUTUC.     

Prognostic Value of Molecular Breast Cancer Subtypes based on Her2, ESR1, PGR and Ki67 mRNA-Expression in Muscle Invasive Bladder Cancer

INTRODUCTION: Gene expression analyses have identified similarities between bladder and breast cancer, where clinical risk stratification is based on Her2, ESR1, PGR and Ki67 expression. The aim of the study was to assess the respective marker gene expression in patients treated with radical cystectomy for muscle-invasive bladder cancer (MIBC) and to evaluate the applicability of breast cancer subtypes for MIBC risk stratification. MATERIALS & METHODS: 102 patients treated with radical cystectomy for MIBC were assessed. Using routine FFPE tissue and an IVD validated kit, mRNA expression was measured by single step RT-qPCR. Partition test were employed to define cut-off values for high or low marker gene expression. Association of expression with outcome was assessed using Kaplan-Meier analysis and multivariate cox regression analysis. Finally, we performed validation of our results in the MD-Anderson cohort (n = 57). RESULTS: Cancer specific survival (CSS) was impaired in patients with high gene expression of Her2 (P = 0.0009) and ESR1 (P = 0.04). In the multivariate regression model Her2 expression remained significant for the prediction of CSS (HR = 2.11, CI 1.11-4.21, P = 0.024). Furthermore, molecular stratification by breast cancer subgroups was significant (P = 0.023) for CSS prediction. Especially the differentiation between Her2-positive and Luminal A (HR = 4.41, CI 1.53-18.71, P = 0.004) and Luminal B (HR = 1.96, CI 0.99-4.08, P = 0.053) respectively was an independent prognostic parameter for CSS. External validation resulted in comparable risk stratification with differences in fractional subgroups distribution. CONCLUSION: Gene expression of Her2, ESR1, PGR, Ki67 and corresponding breast cancer subtypes allow a risk-stratification in MIBC, whereby Her2 overexpressing tumors reveal a particularly poor prognosis.     

Synthesis,potential anti-inflammatory and analgesic activities study of (S)-N-substituted-1-phenyl-3,4-dihydroisoquinoline-2(1H)-carboxamides

A series of (S)-N-substitued-1-phenyl-3,4-dihydroisoquinoline-2(1H)-carboxamide derivatives were designed, synthesized and evaluated for their anti-inflammatory and analgesic effects in vivo. Among the synthesized compounds 2a and 2n showed the best anti-inflammatory activity (inhibition rate: 95% and 92.7%, respectively) and analgesic effect (inhibition rate: 100% and 100%, respectively), which was greater than that or nearly equivalent to that of indomethacin. Compounds 2a and 2n were selected to test their inhibitory effects against ovine COX-1 and COX-2 using the cyclooxygenase inhibition assay in vitro. Compounds 2a and 2n are weak inhibitors of COX-1 isozyme but displayed moderate COX-2 isozyme inhibitory effects (IC₅₀ = 0.47 μM and 1.63 μM, respectively) and COX-2 selectivity indexes (SI = 11.5 and 4.8). Furthermore, compound 2a was more inhibitors of COX-2 isozyme active than the reference drug celecoxib.     

Treatment outcomes and late toxicities of intensity-modulated radiation therapy for 1091 Japanese patients with localized prostate cancer

Aim

This study aimed to evaluate the treatment result of intensity-modulated radiation therapy (IMRT) in a large number of Japanese patients with prostate cancer.

Thymic tumors and results of radiotherapy

Aim

The aim of this study was to evaluate thymic epithelial tumors (TETs) for treatment outcomes and prognostic factors on survival.

Early life conditions,reproductive and sexuality-related life history outcomes among human males: A systematic review and meta-analysis

In order to investigate the association between early life conditions and reproductive and sexuality-related life history outcomes among men, we conducted a meta-analysis that compiled the results of 198 articles. A total of 331 effect sizes drawn from 573 samples were included. The meta-analysis revealed that low family socioeconomic status was associated with early sexual debut (r = 0.07), early first birth (r = 0.14), and early marriage (r = 0.03). There was no significant association between family socioeconomic status and pubertal timing or number of sexual partners. Parental absence was associated with early sexual debut (r = ? 0.12), greater number of sexual partners (r = ? 0.19), early first birth (r = ? 0.14), and early marriage (r = ? 0.13). There was no significant association between parental absence and pubertal timing. Small body size before puberty was associated with delayed pubertal timing (r = ? 0.10). There was no significant association between adult body size and number of offspring, and between body size at birth and pubertal timing. Small adult body size, greater number of siblings, and older parents were associated with non-heterosexual orientation (rs = 0.12, 0.03, and 0.03 respectively). Factors such as sampling procedure, data collection method, and age cut-off used to measure family structure change influenced the association between some predictors (e.g., family socioeconomic status) and outcomes (e.g., first birth). The findings are discussed in relation to the utility of life history theory for understanding human male reproductive and sexuality-related outcomes.     

SSR and morphological trait based population structure analysis of 130 diverse flax (Linum usitatissimum L.) accessions

A total of 130 flax accessions of diverse morphotypes and worldwide origin were assessed for genetic diversity and population structure using 11 morphological traits and microsatellite markers (15 gSSRs and 7 EST–SSRs). Analysis performed after classifying these accessions on the basis of plant height, branching pattern, seed size, Indian/foreign origin into six categories called sub-populations viz. fibre type exotic, fibre type indigenous, intermediate type exotic, intermediate type indigenous, linseed type exotic and linseed type indigenous. The study assessed different diversity indices, AMOVA, population structure and included a principal coordinate analysis based on different marker systems. The highest diversity was exhibited by gSSR markers (SI = 0.46; He = 0.31; P = 85.11). AMOVA based on all markers explained significant difference among fibre type, intermediate type and linseed type populations of flax. In terms of variation explained by different markers, EST-SSR markers (12%) better differentiated flax populations compared to morphological (9%) and gSSR (6%) markers at P = 0.01. The maximum Nei's unbiased genetic distance (D = 0.11) was observed between fibre type and linseed type exotic sub-populations based on EST-SSR markers. The combined structure analysis by using all markers grouped Indian fibre type accessions (63.4%) in a separate cluster along with the Indian intermediate type (48.7%), whereas Indian accessions (82.16%) of linseed type constituted an independent cluster. These findings were supported by the results of the principal coordinate analysis. Morphological markers employed in the study found complementary with microsatellite based markers in deciphering genetic diversity and population structure of the flax germplasm.     

Traveling behavior of a termite in tunnels with different curvatures and base surface roughness

This study focused on understanding the termite traveling behavior. Artificial tunnels with different curvatures and base surface roughness were constructed. Each tunnel was 50 mm in length, with widths of W (W = 2, 3, or 4 mm). The distance between the two ends of the tunnel was D (D = 20, 30, 40, or 50 mm). A higher value of D means a lower curvature. The roughness, R (R = 60, 120, 240 and ∞), was generated by uniformly sanding the substrate with a sanding machine. A higher R value means a finer base surface. The symbol ∞ represents a smooth surface. Time (τ) taken by a termite to pass through the tunnel was measured. τ was longer in tunnels with a smooth surface compared with the tunnels with a rough surface. When W = 2, there was no effect of the roughness on speed. This is because the narrow tunnel width diluted the effects of the smoothness of the surface. When W = 3, τ was statistically shorter for R = 240, than for R = 60 and 120. This suggests that an appropriate surface roughness could positively contribute to the traveling speed.     

Impact of lactation stage on milk composition and blood biochemical and hematological parameters of dairy Baladi goats

The objective of this study was to elucidate the impact of lactation stage on milk composition, hematological and biochemical parameters of dairy Baladi goats under Egyptian conditions. Forty-eight Baladi goats (32.8 ± 2.9 kg of BW) were enrolled in the current study. The lactation period has been divided into three stages; early (DIM less than 80 days), Mid (DIM 80–140 days), and Late (DIM over 140 days). Baladi goats had decreased daily-MY at a rate of 18.4% and 31.9% at mid and late stages of lactation, compared with early stage, respectively (p = 0.001). Furthermore, lactose% decreased significantly with progress of lactation (p = 0.017). Total solids%, however, decreased significantly at early stage of lactation in comparison with mid and late stages (p = 0.022). On the contrary, no significant differences were found in protein, fat and SNF percentages at different stages of lactation (p = 0.836, 0.625 and 0.281, respectively). Serum glucose and total protein were significantly reduced at late stage of lactation in comparison with early and mid stages (p = 0.001 and 0.001, respectively). On the contrary, no significant differences were found for erythrocytes count, hemoglobin, serum cholesterol, catalase and triiodothyronine at different stages of lactation. There were high and positive correlations between daily-MY and serum total protein (r = 0.87, P < 0.01) and triiodothyronine (r = 0.41, P < 0.01). However, negative estimates were reported between daily-MY and triglycerides (r = ?0.55, P < 0.01) and cholesterol (r = ?0.33, P < 0.05). Our results indicate that dairy Baladi goats produce milk with relatively stable protein, fat and solid not fat (SNF) contents at the different stages of lactation, encouraging the continuous utilization of their milk in processing. Also, dairy Baladi goats seem able to maintain the most vital biochemical parameters.     

Preliminary SAR and biological evaluation of antitubercular triazolothiadiazine derivatives against drug-susceptible and drug-resistant Mtb strains

Following up the SAR study of triazolothiadiazoles for their antitubercular activities targeting Mt SD in our previous study, on the principle of scaffold hopping, the C3 and C6 positions of triazolothiadiazine were examined systematically to define a preliminary structure–activity relationship (SAR) with respect to biological activity. This study herein highlights the potential of two highly potent advanced leads 6c-3, 6g-3 and several other compounds with comparable potencies as promising new candidates for the treatment of TB (6c-3, MIC-H37Rv = 0.25 μg/mL; MIC-MDRTB = 2.0 μg/mL; MIC-RDRTB = 0.25 μg/mL; Mt SD-IC₅₀ = 86.39 μg/mL; and 6g-3, MIC-H37Rv = 1.0 μg/mL; MIC-MDRTB = 4.0 μg/mL; MIC-RDRTB = 2.0 μg/mL; Mt SD-IC₅₀ = 73.57 μg/mL). Compounds 6c-3 and 6g-3 possessed a para-nitro phenyl at the 6 position showed low Vero and HepG2 cells toxicity, turning out to be two excellent lead candidates for preclinical trials. In addition, in vitro Mt SD inhibitory assay indicates that Mt SD is at least one of the targets for their antitubercular activity. Thus, they may turn out to be promising multidrug-resistance-reversing agents.     

Contrast Enhancement on Cone-Beam Breast-CT for Discrimination of Breast Cancer Immunohistochemical Subtypes

PURPOSE: To evaluate whether contrast enhancement on cone-beam breast-CT (CBBCT) could aid in discrimination of breast cancer subtypes and receptor status. METHODS: This study included female patients age >40 years with malignant breast lesions identified on contrast-enhanced CBBCT. Contrast enhancement of malignant breast lesions was standardized to breast fat tissue contrast enhancement. All breast lesions were approved via image-guided biopsy or surgery. Immunohistochemical staining was conducted for expression of estrogen (ER), progesterone (PR), human epidermal growth factor receptor-2 (HER2) and Ki-67 index. Contrast enhancement of breast lesions was correlated with immunohistochemical breast cancer subtypes (Luminal A, Luminal B, HER2 positive, triple negative), receptor status and Ki-67 expression. RESULTS: Highest contrast enhancement was seen for Luminal A lesions (93.6 HU) compared to Luminal B lesions (47.6 HU, P = .002), HER2 positive lesions (83.5 HU, P = .359) and triple negative lesions (45.3 HU, P = .005). Contrast enhancement of HER2 positive lesions was higher than Luminal B lesions (P = .044) and triple negative lesions (P = .039). No significant difference was evident between Luminal B and triple negative lesions (P = .439). Lesions with high Ki-67 index showed lower contrast enhancement than those with low Ki-67 index (P = .0043). ER, PR and HER2 positive lesions demonstrated higher contrast enhancement than their receptor negative counterparts, although differences did not reach statistical significance (P = .1714; P = .3603; P = .2166). CONCLUSIONS: Contrast enhancement of malignant breast lesions on CBBCT correlates with immunohistochemical subtype and proliferative potential. Thereby, CBBCT might aid in selecting individualized treatment strategies for breast cancer patients based on pre-operative imaging.