Biological Profile of in Situ Breast Cancer Investigated by Immunohistochemical Technique

Abstract

In 74 in situ breast cancers an immunohistochemical study for estrogen (ER) and progesterone (PR) receptors, proliferation index (PI), and c-erbB-2, p53, and bcl-2 overexpression was performed. Cases were categorized as ductal carcinoma in situ (DCIS) comedo: 24.3% of cases; DCIS non comedo: 27% of cases; DCIS cribriform: 5.4% of cases; lobular carcinoma in situ (LCIS): 16.3% of cases; mixed carcinoma in situ: 27% of cases. Quantitation of immunohistochemical results was obtained with an image analysis computerized system (CAS 200). The cutoff values used were: 10% of positive area for ER, PR, NEU, and bcl-2; 5% of positive area for p53; 13% of PI for proliferative activity. DCIS cribriform and LCIS displayed a higher positivity for ER (92.6 and 93.8% of cases); DCIS cribriform and DCIS non comedo a higher for PR (89 and 75.3%); DCIS comedo presented the highest values for PI (65.4%), NEU (72.8%), and p53 expression (37.3%). All DCIS cribriform and DCIS non comedo and 99.6% of LCIS expressed bcl-2. The results underscore the importance of biological characterization of breast carcinoma in situ with the aim to define lesions natural history.

Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status

“…Both high nuclear grade and comedonecrosis are associated with higher likelihood of local recurrence and development of invasive cancer [25–28]. Our findings agree with prior studies showing higher ER expression in well-differentiated lesions than in poorly differentiated lesions [17,18–24,45]. …”

The natural history of ductal carcinoma in situ of the breast: a review

“…There is also marked variation in the expression of various proteins important in breast cancer biology, particularly the estrogen and progesterone receptors (ER and PR), and the oncogene product c-erbB2 [13,[14][15][16][17]. Genotypic differences evident at the protein expression level have been confirmed using molecular techniques such as comparative genomic hybridisation (CGH) [9,10,12,18,19].…”

HER2 protein overexpression in estrogen receptor-positive ductal carcinoma in situ of the breast: frequency and implications for tamoxifen therapy

“…1, HER2 protein overexpression has been reported in approximately 40% of DCIS, and in most studies is significantly more common in lesions of high-grade than in low-grade lesions. 1,10,[12][13][14][15][16][17][18][19][20][21] Until fairly recently, information regarding biomarker expression in DCIS was largely of academic interest, since the presence or absence of expression of any of these markers did not impact upon patient management decisions. However, in December 2002, Allred et al 45 presented the results of a study assessing the relationship between ER expression in DCIS and local recurrence in patients who had been treated by lumpectomy and radiation therapy, with or without tamoxifen.…”