Abstract
Background
The increasing use of mammographic screening has led to an increased detection of ductal carcinomain situ (DCIS) of the breast. The detailed biological characteristics of DCIS and a new classification of DCIS based on these characteristics are needed.
Methods
Immunohistochemical studies were performed to assess the expression of c-erbB-2 (ErbB-2), estrogen receptor (ER), p53 and proliferative activity (Ki-67) in 65 patients with pure DCIS and 60 with invasive ductal carcinoma (IDC). We classified pure DCIS tumors using three classifications, the architectural, Nottingham, and Van Nuys classifications.
Results
ErbB-2, ER and p53 staining was positive in 34%, 66% and 21% of patients with DCIS, respectively, and 58%, 42% and 33% in patients with IDC, respectively. Ki-67 stained positively in 1.5 % of patients with DCIS and 11.2 % of patients with IDC. The comedo type showed a high rate of positive ErbB-2 and p53 staining. The cribriform and papillary types showed a high rate of positive ER staining. Under the Van Nuys classification, ErbB-2, p53 and Ki-67 expression were highest in the group with high nuclear grade and lowest in the group with non-high nuclear grade without necrosis.
Conclusion
Although the biological markers of IDC tended to suggest aggressive behavior more so than those of DCIS, these differences were based on the histological sub-type, comedo or non-comedo. The Van Nuys classification best defined the subgroups of DCIS with a distinct expression pattern of biological markers, and the best candidates for breast-conserving surgery.
Similar content being viewed by others
Abbreviations
- DCIS:
-
Ductal carcinomain situ
- IDC:
-
Invasive ductal carcinoma
References
Page DL, Dupont WD, Rogers LW,et al: Intraductal carcinoma of the breast: Follow-up after biopsy only.Cancer 49:751–758, 1982.
Lagios MD, Margolin FR, Westdahl PR,et al:Mam-mographically detected duct carcinoma.in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence.Cancer 63:618–624, 1989.
Page DL, Dupont WD, Rogers LW,et al: Continued local recurrence of carcinoma 15-25 years after a diagnosis of low grade ductal carcinom.in situ of the breast treated only by biopsy.Cancer 76:1197–1200, 1995.
Poller DN, Silverstein MJ, Galea M,et al: Ideas in pathology. Ductal carcinom.in situ of the breast: A proposal for a new simplified histological classification association between cellular proliferation and c-erbB-2 protein expression.Modern Pathol 7:257–262, 1994.
Silverstein MJ, Poller DN, Waisman JR,et al: Prognostic classification of breast ductal carcinoma-in-situ.Lancet 345:1154–1157, 1995.
Iwase H, Omoto Y, Iwata H,et al: Genetic and epigenetic alterations of the estrogen receptor gene and hormone independence in human breast cancer.Oncology 55:11–16, 1998.
Caleffi M, Teague MW, Jensen RA,et al: p53 gene mutations and steroid receptor status in breast cancer. Clinicopathologic correlations and prognostic assessment.Cancer 73:2147–2156, 1994.
Kobayashi S, Iwase H, Itoh Y,et al: Estrogen receptor, c-erbB-2 and nm23/NDP kinase expression in the intraductal and invasive components of human breast cancers.Jpn J Cancer Res 83:859–865, 1992.
Shi SR, Key ME, Kalra KL: Antigen retrieval in formalin-fixed, paraffin-embedded tissues: An enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections.J Histochem Cytochem 39:741–748, 1991.
Ramachandra S, Machin L, Ashley S,et al: Immunohistochemical distribution of c-erbB-2 in in situ breast carcinoma-a detailed morphological analysis.J Pathol 161:7–14, 1990.
Barnes DM, Bartkova J, Camplejohn RS,et al: Overexpression of the c-erbB-2 oncoprotein: why does this occur more frequently in ductal carcinoma in situ than in invasive mammary carcinoma and is this of prognostic significance.Eur J Cancer 28:644–648, 1992.
Poller DN, Snead DR, Roberts EC,et al: Oestrogen receptor expression in ductal carcinoma in situ of the breast: Relationship to flow cytometric analysis of DNA and expression of the c-erbB-2 oncoprotein.Br J Cancer 68:156–161, 1993.
Wilbur DC and Barrows GH: Estrogen and progesterone receptor and c-erbB-2 oncoprotein analysis in pure in situ breast carcinoma: An immunohistochemical study.Modern Pathol 6:114–120, 1993.
Davidoff AM, Humphrey PA, Iglehart JD,et al: Genetic basis for p53 overexpression in human breast cancer.P Natl Acad Sci USA 88:5006–5010, 1991.
Walker RA, Dealing SJ, Lane DP,et al: Expression of p53 protein in infiltrating an.in-situ breast carcinomas.J Pathol 165:203–211, 1991.
Poller DN, Roberts EC, Bell JA,et al: p53 protein expression in mammary ductal carcinoma in situ: Relationship to immunohistochemical expression of estrogen receptor and c-erbB-2 protein.Hum Pathol 24:463–468, 1993.
Bobrow LG, Happerfield LC, Gregory WM,et al: Ductal carcinom.in situ: Assessment of necrosis and nuclear morphology and their association with biological markers.J Pathol 176:333–341, 1995.
Done SJ, Arneson NC, Ozcelik H,et al: p53 mutations in mammary ductal carcinoma in situ but not in epithelial hyperplasias.Cancer Res 58:785–789, 1998.
Zafrani B, Leroyer A, Fourquet A,et al: Mammo-graphically-detected ductal in situ carcinoma of the breast analyzed with a new classification. A study of 127 cases: Correlation with estrogen and progesterone receptors, p53 and c-erbB-2 proteins, and proliferative activity.Semin Diagn Pathol 11:208–214, 1994.
Author information
Authors and Affiliations
About this article
Cite this article
Iwase, H., Ando, Y., Ichihara, S. et al. Immunohistochemical analysis on biological markers in ductal carcinomain situ of the breast. Breast Cancer 8, 98–104 (2001). https://doi.org/10.1007/BF02967487
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02967487