Nuclear morphometry in male breast carcinoma: Association with cell proliferative activity, oncogene expression, DNA content and prognosis

Chiusa, Luigi; Margaria, E; Pich, Achille

doi:10.1002/1097-0215(20001120)89:6<494::aid-ijc5>3.0.co;2-l

Cited by 13 publications

(15 citation statements)

References 37 publications

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“…The differences also include nuclear features, like greater variations in nuclear sizes and shapes of Nigerian tumours. Nuclear morphometric parameters can identify an aggressive tumour phenotype and provide additional prognostic information for patients with invasive breast cancer (Chiusa et al, 2000;Tahlan et al, 2000;Jalava et al, 2001). …”

Section: Introductionmentioning

confidence: 99%

Nuclear Morphometry in African Breast Cancer

Ikpatt¹,

Kuopio

Collan³

2011

Image Anal Stereol

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Three hundred cases of invasive breast cancer diagnosed between 1983 and 1999 in Calabar, Nigeria were analysed to determine the nuclear morphometric variables, and evaluate the prognostic potential of nuclear morphometry in Nigerian breast cancers. The necessary follow-up was available for 129 patients. The nuclear area was the most valuable variable. In the Nigerian material, the mean nuclear area (MNA) (SD) was 89.2 (34.0) µm 2 . MNA was significantly higher in tumours of the postmenopausal than premenopausal (p = 0.0405), in LN+ than LN-(p = 0.0202) patients, and in tumours over 3 cm than smaller ones (p < 0.0001). There were also significant differences between different clinical stages, histological grades, and histological types of tumours. Significant correlations were observed between MNA and histological grade (r = 0.64), standard mitotic index (r = 0.45) and tumour size (r = 0.20). MNA as a continuous variable was a statistically significant prognosticator in the whole material (p = 0.0281), and among the postmenopausal patients (p = 0.0238). Univariate cox´s regression demonstrated one significant grading cutpoint at MNA = 111 µm 2 , which divided the material into two groups of different survival. The development of a morphometric grading system optimal for the Nigerian material could use the latter cut-point between nuclear scores 2 and 3 in the grading system. The earlier proven cut-point of 47 µm 2 could be used between nuclear scores 1 and 2.

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Section: Introductionmentioning

confidence: 99%

Nuclear Morphometry in African Breast Cancer

Ikpatt¹,

Kuopio

Collan³

2011

Image Anal Stereol

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“…These features are quite common among MBC, 25 but in striking contrast with the papillary pattern and the bland nuclear features of the present case. In fact, DNA ploidy, 5cER and 2cDI values are generally in line with cytological grading, 14,[25][26][27] and besides aneuploidy, c-erbB-2 overexpression and high Ki-67 values are also considered unfavorable prognostic parameters. [25][26][27] This is an important point because, although classic PC is generally treated with surgery and tamoxifen, in this case the described features warranted adjuvant chemotherapy and radiotherapy.…”

Section: Discussionmentioning

confidence: 93%

Aggressive papillary male breast carcinoma on fine‐needle cytology sample

Zeppa

Mascolo

Zabatta

et al. 2003

Diagnostic Cytopathology

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Papillary carcinoma (PC) is a histological variant of breast carcinoma that is more frequently observed in males than in females, showing the same cytological features in both sexes. PC is characterized by a low grade of malignancy and a generally favorable course. We describe a case of male breast PC (MPC) diagnosed by fine-needle cytology (FNC) in which some aggressive morphologically detectable features were associated with bland cytologic features of the tumor. FNC was performed on a 3 cm palpable mass of the left breast of a 55-yr-old male. FNC yielded abundant bloody material. Two smears were Diff-Quik and Papanicolaou stained, others were used for immunocytochemical assessment of estrogen, progesterone, c-erbB-2, and Ki-67; another was Feulgen stained for DNA ploidy. Smears were highly cellular, showing isolated cells and papillary structures. Cells showed tall and well-defined cytoplasm with a columnar aspect, light anisonucleosis, coarse chromatin, and small nucleoli. Immunoperoxidase staining demonstrated positivity for estrogen (50%), negativity for progesterone, intense positivity for c-erbB-2, with specific membrane staining and positivity for Ki-67 in more than 20% of the cells. DNA-ploidy showed an aneuploid histogram with 5c exceeding rate (5cER) of 59% and 2c deviation index (2cDI) of 29%. Subsequent surgical pathology examination confirmed the cytological diagnosis of papillary carcinoma; moreover, it revealed neoplastic endolymphatic thrombi and infiltrative border of the tumor that reached the thoracic wall. Cytological features can suggest diagnosis of MPC on FNC samples. Immunocytochemical evaluation of c-erbB-2 and Ki-67 and DNA ploidy evaluation on cytological smears might reveal a biological aggressiveness of PC despite the bland microscopic features of the tumor and this should influence the therapeutic procedure.

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“…These results are in agreement with multiple studies that have shown the prognostic significance of nuclear morphometry in female and male breast cancer patients. [2][3][4][5][6][7][8] Altogether, this suggest that prognostication in male breast cancer could benefit from replacing classical nuclear atypia scoring according to the Bloom and Richardson grading system by automated nuclear morphometry of whole slide images.…”

Section: Discussionmentioning

confidence: 98%

“…The usefulness of nuclear morphometry by image analysis in providing more objective and reproducible prognosis for breast cancer patients has been recognized for a long time. [2][3][4][5][6][7][8] Prognostically important features express the nuclear size and shape (and in some cases the nuclear texture and the architecture of the tissue 9 ) in a quantitative manner. Incorporating nuclear morphometry features into grading would therefore make sense, but wider acceptance of such an approach to histological grading has been hampered by the tedious and time consuming nature of the manual segmentation of nuclei.…”

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confidence: 99%

“…One previous study on 50 male breast cancer patients revealed that nuclear morphometry features from manually produced segmentations are predictive for the survival of the patients. 7 In the work presented here, we extract two morphometric features, the mean nuclear area and standard deviation of the nuclear area, using a fully automatic segmentation method on whole slide images, and we analyze their prognostic value.…”

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confidence: 99%

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Prognostic value of automatically extracted nuclear morphometric features in whole slide images of male breast cancer

Veta¹,

Kornegoor

Huisman

et al. 2012

Modern Pathology

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Numerous studies have shown the prognostic significance of nuclear morphometry in breast cancer patients. Wide acceptance of morphometric methods has, however, been hampered by the tedious and time consuming nature of the manual segmentation of nuclei and the lack of equipment for high throughput digitization of slides. Recently, whole slide imaging became more affordable and widely available, making fully digital pathology archives feasible. In this study, we employ an automatic nuclei segmentation algorithm to extract nuclear morphometry features related to size and we analyze their prognostic value in male breast cancer. The study population comprised 101 male breast cancer patients for whom survival data was available (median follow-up of 5.7 years). Automatic segmentation was performed on digitized tissue microarray slides, and for each patient, the mean nuclear area and the standard deviation of the nuclear area were calculated. In univariate survival analysis, a significant difference was found between patients with low and high mean nuclear area (P ¼ 0.022), while nuclear atypia score did not provide prognostic value. In Cox regression, mean nuclear area had independent additional prognostic value (P ¼ 0.032) to tumor size and tubule formation. In conclusion, we present an automatic method for nuclear morphometry and its application in male breast cancer prognosis. The automatically extracted mean nuclear area proved to be a significant prognostic indicator. With the increasing availability of slide scanning equipment in pathology labs, these kinds of quantitative approaches can be easily integrated in the workflow of routine pathology practice.

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Nuclear morphometry in male breast carcinoma: Association with cell proliferative activity, oncogene expression, DNA content and prognosis

Cited by 13 publications

References 37 publications

Nuclear Morphometry in African Breast Cancer

Nuclear Morphometry in African Breast Cancer

Aggressive papillary male breast carcinoma on fine‐needle cytology sample

Prognostic value of automatically extracted nuclear morphometric features in whole slide images of male breast cancer

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