Grading and Study of Biological Markers in Ductal Carcinoma in situ and Concurrent Infiltrating Ductal Carcinoma of Breast

摘要

Breast cancer is the most common cancer in women. Breast cancer has surpassed cervical cancer and is now the leading cause of cancer death; however, cervical cancer still remains common in rural areas.Aim: To assess the architectural pattern, nuclear grade, presence and absence of necrosis of Infiltrating Duct Carcinoma (IDC) and concurrent Ductal Carcinoma in situ (DCIS) and to correlate the biological markers of the two.Materials and Methods: The present study was carried out in the Department of Pathology, Father Muller Medical College, Mangaluru, Karnataka, India from January 2011 to February 2013. The mastectomy and lumpectomy specimens received in the histopathology laboratory were studied for the presence of IDC and concurrent DCIS. Haematoxylin and Eosin (H&E) staining for histological diagnosis and IHC analysis for ER, PR and Her-2eu was carried out. All the data were analysed using SSPS software version 13.0.Results: This study included total 60 cases of IDC (NOS) with concurrent DCIS. The mean age of patients was 48.6 years (SD ±11.21). Most common anatomic location was in the left breast. Majority of tumours were Grade 2 followed by Grade 3. The grades of the IDC and coexisting DCIS were concordant in 66.66% cases and 33.33% cases showed discordance. Also, 98.33% of cases showed similar expression of ER, PR and Her2eu in both the components. Statistically, a strong correlation was seen in the grades, ER, PR and Her2eu expression of IDC and DCIS (p<0.001).Conclusion: We found that to a great extent, it is possible to predict the biological behaviour of one component when that of the other is known and this may help in planning patient management when only DCIS is present.