Tumour markers in breast carcinoma correlate with grade rather than with invasiveness

Abstract

Summary Ductal breast carcinoma in situ (DCIS) is regarded as a precursor to invasive breast cancer. The progression from in situ to invasive cancer is however little understood. We compared some tumour markers in invasive and in situ breast carcinomas trying to find steps in this progression. We designed a semi-experimental setting and compared histopathological grading and tumour marker expression in pure DCIS (n = 194), small invasive lesions (n = 127) and lesions with both an invasive and in situ component (n = 305). Grading was done according to the Elston-Ellis and EORTC classification systems, respectively. Immunohistochemical staining was conducted for p53, c-erbB-2, Ki-67, ER, PR, bcl-2 and angiogenesis. All markers correlated with grade rather than with invasiveness. No marker was clearly associated with the progression from in situ to invasiveness. The expression of tumour markers was almost identical in the 2 components of mixed lesions. DCIS as a group showed a more 'malignant picture' than invasive cancer according to the markers, probably, due to a higher proportion of poorly differentiated lesions. The step between in situ and invasive cancer seems to occur independently of tumour grade. The results suggest that well-differentiated DCIS progress to well-differentiated invasive cancer and poorly differentiated DCIS progress to poorly differentiated invasive cancer.

Breast cancer as heterogeneous disease: contributing factors and carcinogenesis mechanisms

“…Our results are also in agreement with other molecular studies on cancer proliferation, biology, and genetics, which demonstrated that lobular tumors exhibited similarities to low-grade ductal tumors [22][23][24]. Several studies have revealed a striking similarity between in situ and invasive breast cancers, where all markers correlated with grade rather than with tumor invasiveness [22,[25][26][27], and there was a good concordance between grade in primary and metastatic tumors [28][29][30]. Recent molecular studies have demonstrated that qualitative and quantitative differences exist between ER(?)…”

Gene expression profiles of human breast cancer progression

“…2 and 3). This finding is consistent with a previous study indicating that expression of several prominent tumor markers (p53, ERBB2, Ki-67, ER, PR, and bcl2) correlate with tumor grade but not with the distinction between DCIS and IDC (17). Nonetheless, it is of great interest to understand the transcriptional program that drives invasive growth due to its clinical importance.…”

Ductal carcinoma in situ of the breast with different histopathological grades and corresponding new breast tumour events: Analysis of loss of heterozygosity

“…All DCIS tumours in the present study were previously analysed as part of a study assessing the status of p53, c-erbB-2, Ki-67, ER, PR, Bcl-2, and angiogenesis in DCIS and invasive carcinomas (see Table II) [28]. These markers correlated with grade as the DCIS grade 3 tumours had a more malignant pattern for all of them.…”

“…The samples were previously analysed by immunohistochemical staining of p53, c-erbB-2, Ki-67, Bcl-2, and the hormone-receptors for oestrogen and progesterone (results shown in Table I) [28]. New slides, 15 Á/17 mm thick, were cut from the paraffin blocks and stained with toluidine blue.…”