Differential Expression of E-Cadherin in Lobular and Ductal Neoplasms of the Breast and Its Biologic and Diagnostic Implications

Abstract

We studied the pattern of E-cadherin expression in 183 invasive carcinomas (100 ductal, 42 lobular, 41 with mixed ductal and lobular features) and 198 in situ carcinomas (131 ductal, 53 lobular, 14 in situ with ductal and lobular features) by immunohistochemistry. We found a highly significant correlation of E-cadherin membrane expression with the histologic phenotype of the tumors. While moderate to strong membrane expression of E-cadherin was seen in all invasive and in situ ductal carcinomas, 41 of 42 invasive and 50 of 53 in situ lobular carcinomas showed complete loss of expression. All in situ carcinomas diagnosed histologically as showing mixed ductal and lobular features demonstrated complete loss of staining. Invasive carcinomas with ductal and lobular features showed 3 staining patterns: (1) complete or almost complete lack of membrane staining similar to that seen in lobular carcinomas, (2) uniform membrane expression throughout the tumor similar to ductal carcinomas, and (3) focal loss of E-cadherin staining, which correlated well with the histologic impression of focal lobular features. In tumors with histologically equivocal features, immunohistochemical detection of E-cadherin expression can be a useful diagnostic tool for the differentiation of ductal and lobular carcinomas of the breast.

Expression of E-Cadherin in breast carcinomas and its association with other biological markers — a prospective study

“…This direct association was found to be 51% after accounting for chance agreement. While, Lipponen et al 39 demonstrated a similar direct association of E-CD expression with ER protein expression, other workers 30,40 did not observe any significant association between the two. It has been postulated that reversible down regulation of E-CD may occur by hypermethylation of the promoter region of E-CD expression.…”

The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology

“…In addition, this study confirms and extends the findings of the previous study that has addressed the biologic features of mixed ductal and lobular tumours [1] indicating that these tumours have features between IDC and ILC. They are more likely to be steroid receptor positive and of lower grade than IDC and of younger age and higher grade than ILC patients [13,40,41]. The prognosis for mixed tumours compared to IDC or ILC is unclear and no previous studies have addressed this issue.…”

Invasive lobular carcinoma: to grade or not to grade

“…Other authors have found E-cadherin expression in 0-45% of invasive lobular carcinomas. [59][60][61][62][63][64][65][66][67][68] In these studies no correlation with grade was made. The discrepancy in the literature with regard to the percentage of invasive lobular carcinomas expressing E-cadherin may relate to differences between the populations studied, sensitivity and specificity of the antibodies used and diagnostic variation as applied to lobular carcinomas.…”