Histological grade and efferent vascular invasion in human breast carcinoma

Abstract

Summary.-Primary breast carcinomas (23) with axillary-node metastases that also showed tumour cells in the efferent nodal vessels, tended to be of higher histological grade than those (21) without efferent vascular invasion. Nuclear hyperchromatism and mitosis is the factor of importance to grading in this respect. This factor also differentiated between RE+ and RE-carcinomas in this material.PROGNOSIS IN BREAST CARCINOMA iS related to the histological grade of the primary tumour (Freedman et al., 1979). The TNM stage (International Union against Cancer, 1972) at which a tumour presents is also a reflection of its histological grade (Thoresen et al., 1981). Prognosis is further clearly related to the presence or absence of nodal metastases (Truscott, 1947) and patients who in addition to nodal tumour have tumour cells in their efferent nodal vessels (efferent vascular invasion (EVI), Hartveit, 1979b) have a poorer 5-year survival than those without (Hartveit, 1979a).The relationship between histological grade and EVI has now been investigated in a series of 44 patients, 23 with and 21 without EVI. PATIENTS, MATERIAL AND METHODSThe patients investigated formed part of a series of 222 cases that has been reported in connection w\ith histological grading and oestrogen receptor (RE) status of the primary (Thoresen et al., 1981). The relationship between RE status, EVI and early recurrence in this material has also been reported (Hartveit et al., 1980a, b).The present series consists of consecutive cases of primary infiltrating breast carcinoma in which modified radical mastectomy and axillary-node dissection had been carried out. Cases were excluded if the tumour type was not suitable for grading by the WHO method (Scarff & Torloni, 1968) or if the nodal sections available did not pass through the efferent area at the hilus (Hartveit, 1979b).A total of 44 cases were available for study, 23 with EVI and 21 without. Of the former 18 were RE+ (> 3 fmol receptor per mg cytosol protein); 15 of the EVI-were also RE+. In the material as a whole there was little difference in RE status according to TNM stage on a percentage basis (Table I), or nodal metastases (Table II). The excess of RE+ tumours in these 2 subgroups is thus probably a function of the composition of the material as a whole.The histological grade of the primary tumours in each subgroup had been recorded previously. These records were reviewed and the results broken up into their separate factors. In addition to the histological grade, the number of points scored for the 3 factors used (i.e. tubular formation, 1-3; nuclear hyperchromatism and mitosis, 1-3; and nuclear pleiomorphism, 1-3; see Scarff & Torloni, 1968) were noted and the mean values calculated. A similar procedure was followed for the nodal tumour which had not been graded before.The mean number of points scored was also related to the RE status of the primary tumour, using the dextran-coated charcoal

Prognostic significance of lymphatic invasion in lymph node-positive breast carcinoma: findings from a large case series with long-term follow-up using immunohistochemical endothelial marker

“…The same findings were reported in many previous studies [21][22][23][24] and from previous findings by our group. 2,7,8,15,25,26 The rate of LI in the current study was 47%, which lies in the same range as that reported in other studies: 28%, 20 46%, 13 and 55% 27 of patients with LN-positive BC in different patient cohorts.…”

Oestrogen and progesterone receptor content and the distribution of histological grade in breast cancer

“…The similarity in the patterns of occurrence for ER and PgR stress their probable interdependence (17), but the figures also stress the need to carry out both determinations as ER and PgR status do not always go hand in hand. The incidence of the second factor used in the grading system (mitosis and hyperchromasia) was previously shown to differ in some ER positive and ER negative tumours (19) which form part of the present series; this was confirmed here. In addition this factor is the most important discriminant for PgR, but with PgR factor 3 is also involved.…”

Activation of precursors for matrix metalloproteinases 1 (interstitial collagenase) and 3 (stromelysin) by rat mast-cell proteinases I and II

“…Several reports have noted the association of mast cells with areas of connective-tissue degradation, especially at sites of tumour invasion in breast carcinoma and melanoma (Hartveit et al, 1984;Dabbous et al, 1986) and at sites of cartilage erosion in rheumatoid arthritis . Mast-cell proteinase extracts were reported to activate proMMP-l (Birkedal-Hansen et al, 1976;Dabbous et al, 1986), and recent studies have shown that mast-cell tryptase generates collagenase activity indirectly through its ability to activate proMMP-3 (Gruber et al, 1989).…”