PhD Scientific Days 2025

Poster Session II. - E: Pathological and Oncological Sciences

Application of the SARIFA Method in Breast Cancer: A Novel Approach to Tumor Assessment

Name of the presenter

Gregus Barbara

Institute/workplace of the presenter

Department of Pathology, Forensic and Insurance Medicine, Semmelweis University

Authors

Barbara Gregus¹, Éva Kocsmár¹, Gábor Lotz¹, Gábor Cserni², Tibor Krenács³, Zsófia Karancsi¹, Anna Mária Tőkés¹

1: Department of Pathology, Forensic and Insurance Medicine, Semmelweis University
2: Department of Pathology, Bács-Kiskun County Teaching Hospital
3: Department of Pathology and Experimental Cancer Research, Semmelweis University

Text of the abstract

Introduction: Emerging evidence highlights the role of adipocytes and tumor metabolism in cancer progression. Recently, a novel pathomorphological method, known as SARIFA (Stroma AReactive Invasion Front Areas), has been introduced in several cancer types, such as colorectal and gastric cancers, offering a new perspective on the evaluation of tumor behavior. However, its applicability in breast cancer has not yet been explored.
Aims: This study aimed to evaluate the utility of the SARIFA method in breast cancer and examine its association with clinicopathological features.
Method: 634 hematoxylin and eosin-stained digitalized slides of 410 surgical breast cancer specimens were collected and analyzed. The SARIFA method was applied to assess the direct contact between adipocytes and groups of tumor cells (comprising at least five cells) at the invasive front, as well as within the tumor parenchyma (intratumoral SARIFA). In 117 patients, more than one slide was evaluated, and SARIFA positivity was defined as SARIFA detection in at least 50% of the available slides. Data on histopathological features and clinical parameters were retrieved from Semmelweis University's and Bács-Kiskun County Teaching Hospital’s electronic database. Statistical analyses were performed with IBM SPSS Statistics.
Results: In total, 279 cases (68%) were classified as SARIFA-positive and 131 cases (32%) as SARIFA-negative. When the cases were divided according to their surrogate molecular subtypes, SARIFA positivity was observed in 81% (74/91) of Luminal A tumors, 82% (81/99) of Luminal B1, 74% (23/31) of Luminal B2, 32% (10/31) of HER2-enriched, and 56% (91/158) of triple-negative breast cancers (TNBC). SARIFA positivity significantly correlated with the pN category (p=.021). However, no significant association was found between SARIFA positivity and distant metastasis-free survival (DMFS) in the entire cohort (p=.127). In the TNBC subgroup, SARIFA positivity was associated with worse DMFS (p=.032).
Conclusion: The SARIFA method is applicable in breast cancer and shows varying distribution across molecular subtypes. SARIFA positivity was associated with worse outcomes in the TNBC subgroup. These findings suggest that SARIFA may have potential relevance in specific breast cancer subtypes, particularly triple-negative cases, but further studies are needed to clarify its prognostic value.