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      Retrospective evaluation of histopathological examinations in invasive ductal breast cancer of no special type: an analysis of 691 patients

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          Abstract

          Introduction

          Invasive ductal carcinoma (IDC) is the most common type of breast cancer in women and accounts for about 80% of all breast cancers.

          Material and methods

          The material consisted of histological preparations derived from 691 patients treated for IDC-NST.

          Results

          In our own study material, invasive ductal breast cancer of no special type accounted for more than 60% of cases, with the largest percentage of tumors being classified as G2 (53.96%) and G3 (28.98%). In terms of tumor size, the most common IDC-NST tumors were those of stage T1c (34.59%) and T2 (35.31%). The incidence of lymph node involvement was also assessed to reveal that no lymph node metastases were present in 45.44% of IDC-NST tumors. In the histopathological analysis of IDC-NST, significant statistical correlation was demonstrated between the presence of lymph node metastases and the histological malignancy grade (N0/G1-G3 p = 0.0103; N1A/G1-G3 p = 0.0498; N1B/G1-G3 p< 0.001; N3/G1-G3 p = 0.0027; N4/G1-G3 p < 0.001), between the presence of lymph node metastases and the tumor size (N0/T1-T4 p = 0.00295; N1B/T1-T4 p < 0.001; N2/T1-T4 p < 0.001; N2A/T1-T2 p < 0.001; N4/T1-T4 p < 0.001; Nx/T1-T4 p = 0.0447), as well as between the histological malignancy grade and the tumor size (G1/T1-T4 p < 0.001; G1/2/T1-T4 p < 0.001; G2/3/T1-T4 p < 0.0267).

          Conclusions

          Own research demonstrated that the most common histological type of breast cancer is invasive ductal carcinoma of no special type (IDC-NST); statistically significant correlations were demonstrated in IDC-NST patients between the lymph node involvement status and the histological malignancy grade or tumor size as well as between the histological malignancy grade and the tumor size.

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          Prognostic significance of Nottingham histologic grade in invasive breast carcinoma.

          R W Blamey, Thomas Elston, Mohammed E Sayed … (2008)
          The three strongest prognostic determinants in operable breast cancer used in routine clinical practice are lymph node (LN) stage, primary tumor size, and histologic grade. However, grade is not included in the recent revision of the TNM staging system of breast cancer as its value is questioned in certain settings. This study is based on a large and well-characterized consecutive series of operable breast cancer (2,219 cases), treated according to standard protocols in a single institution, with a long-term follow-up (median, 111 months) to assess the prognostic value of routine assessment of histologic grade using Nottingham histologic grading system. Histologic grade is strongly associated with both breast cancer-specific survival (BCSS) and disease-free survival (DFS) in the whole series as well as in different subgroups based on tumor size (pT1a, pT1b, pT1c, and pT2) and LN stages (pN0 and pN1 and pN2). Differences in survival were also noted between different individual grades (1, 2, and 3). Multivariate analyses showed that histologic grade is an independent predictor of both BCSS and DFS in operable breast cancer as a whole as well as in all studied subgroups. Histologic grade, as assessed by the Nottingham grading system, provides a strong predictor of outcome in patients with invasive breast cancer and should be incorporated in breast cancer staging systems.
          Article 0 comments Cited 179 times – based on 0 reviews     Review now
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            Molecular evolution of breast cancer.

            Peter T Simpson, Jorge S. Reis-Filho, Theodora Gale … (2005)
            Molecular analysis of invasive breast cancer and its precursors has furthered our understanding of breast cancer progression. In the past few years, new multi-step pathways of breast cancer progression have been delineated through genotypic-phenotypic correlations. Nuclear grade, more than any other pathological feature, is strongly associated with the number and pattern of molecular genetic abnormalities in breast cancer cells. Thus, there are two distinct major pathways to the evolution of low- and high-grade invasive carcinomas: whilst the former consistently show oestrogen receptor (ER) and progesterone receptor (PgR) positivity and 16q loss, the latter are usually ER/PgR-negative and show Her-2 overexpression/amplification and complex karyotypes. The boundaries between the evolutionary pathways of well-differentiated/low-grade ductal and lobular carcinomas have been blurred, with changes in E-cadherin expression being one of the few distinguishing features between the two. In addition, lesions long thought to be precursors of breast carcinomas, such as hyperplasia of usual type, are currently considered mere risk indicators, whilst columnar cell lesions are now implicated as non-obligate precursors of atypical ductal hyperplasia (ADH) and well-differentiated ductal carcinoma in situ (DCIS). However, only through the combination of comprehensive morphological analysis and cutting-edge molecular tools can this knowledge be translated into clinical practice and patient management.
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              Infiltrating lobular carcinoma of the breast. Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns.

              X Sastre-Garau, M Jouve, B Asselain … (1996)
              The clinicopathologic features of infiltrating lobular carcinoma (ILC), which represents 5% to 15% of all breast cancers, are still controversial. In particular, the high frequency of multicentric lesions has led to questioning of the effectiveness of conservative treatment for this type of cancer. By studying a large number of cases, we aimed to compare the clinicopathological features of ILC with those of nonlobular infiltrating carcinoma (NLIC) and to assess the advisability of conservative therapy in the management of ILC. The population analyzed included 726 cases of ILC, 249 cases of mixed ILC/invasive ductal carcinoma (ILC/IDC), and 10,061 cases of NLIC. The age of patients, TNM status, estrogen- and progesterone-receptor status (ER, PR), and histologic grades of the 3 groups were compared. The follow-up was carried out on a subgroup of 5846 cases. At diagnosis, ILC tumors were found to be larger on average and were detected in patients older than those with NLIC, but the degree of lymph node involvement was lower in patients with ILC than in NLIC. In ILC, tumors are more frequently grade I and ER-positive than in NLIC. Multicentric lesions were not significantly more frequent in ILC than in NLIC. The overall survival, locoregional control, disease free interval, and metastatic spread rates were not different among the three groups neither by univariate nor multivariate analysis, but the pattern of metastatic dissemination was different. In 480 cases of ILC considered for conservation therapy, the local recurrence and overall survival rates were similar to those observed for IDC. Our analysis specifies the clinicopathological features of ILC and confirms that conservation therapy may be an appropriate treatment for this type of cancer.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Arch Med Sci
                Journal ID (iso-abbrev): Arch Med Sci
                Journal ID (publisher-id): AMS
                Title: Archives of Medical Science : AMS
                Publisher: Termedia Publishing House
                ISSN (Print): 1734-1922
                ISSN (Electronic): 1896-9151
                Publication date (Electronic): 04 March 2016
                Publication date (Print): October 2017
                Volume: 13
                Issue: 6
                Pages: 1408-1415
                Affiliations
                [1 ]Department of Human Biophysics and Physiology, Medical University of Warsaw, Warsaw, Poland
                [2 ]Student Scientific Group of Cancer Cell Biology, Department of Human Biophysics and Physiology, Medical University of Warsaw, Warsaw, Poland
                [3 ]Department of Pathomorphology, Military Institute of Medicine, Warsaw, Poland
                Author notes
                Corresponding author: Anna M. Badowska-Kozakiewicz, Department of Human Biophysics and Physiology, Medical University of Warsaw, 61 Zwirki i Wigury St, 02-091 Warsaw, Poland. Phone/fax: +48 22 628 78 46. E-mail: abadowska@ 123456wum.edu.pl
                Article
                Publisher ID: 25682
                DOI: 10.5114/aoms.2015.53964
                PMC ID: 5701672
                PubMed ID: 29181072
                SO-VID: 0c331bda-b43a-4ccf-a5b9-35f493aa82e1
                Copyright © Copyright: © 2017 Termedia & Banach
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                Date received : 24 April 2015
                Date accepted : 08 July 2015
                Categories
                Subject: Clinical Research

                ScienceOpen disciplines: Medicine
                Keywords: invasive ductal carcinoma of no special type,histological grade,tumor size,lymph node status
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: invasive ductal carcinoma of no special type, histological grade, tumor size, lymph node status

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