Relation of elastosis to biochemical and immunohistochemical steroid receptor findings, Ki-67 and epidermal growth factor receptor (EGFR) immunostaining in invasive ductal breast cancer

A perspective of comparative salivary and breast pathology. Part I: microstructural aspects, adaptations and cellular events

This is the first part of a review comparing the pathology of salivary and mammary glands. Here, less obvious similarities and differences in functional histology and their influences on pathology are examined with emphasis on myoepithelial cells, stromal components, analogues of mucosa-associated lymphoid tissue, steroid receptors, and intraparenchymal cells of monocytic lineage. Particular cell phenotypes (oncocytic, apocrine, neuroendocrine and clear) are critically evaluated and responses to atrophy, infarction and fine-needle aspiration biopsy procedures are highlighted together with aspects of metaplasia, regeneration, ageing and microcalcification. Areas of controversy or uncertainty which may benefit from further investigations are also discussed.

Clinico-Pathological Characteristics of Triple Negative and Non Triple Negative High Grade Breast Carcinomas with and Without Basal Marker (CK5/6 and EGFR) Expression at a Rural Tertiary Hospital in India

Aims of the study were to evaluate the expression Cytokeratin 5/6(CK5/6) and Epidermal Growth Factor Receptor (EGFR) among triple negative breast cancers and high grade infiltrating duct carcinomas. Further to probe if triple negative phenotype can be a surrogate marker for basal phenotype and to correlate the expression of basal markers with disease free survivals among triple negative phenotype and high grade infiltrating duct carcinomas.

c-myc amplifications in primary breast carcinomas and their local recurrences

OBJECTIVE

To evaluate the role of c-myc oncogene amplifications in the progression of invasive breast carcinomas.

METHODS

c-myc gene copy number was evaluated in a series of 49 primary breast carcinomas and the corresponding local recurrences using fluorescence in situ hybridisation.

RESULTS

11 of the primary carcinomas (22%) harboured c-myc amplifications; these tumours typically were hormone receptor negative and occurred in younger patients (43 v 53 years). At the time of relapse, six additional tumours had acquired a c-myc amplification. The mean recurrence-free survival was 24 months; c-myc amplified tumours relapsed significantly earlier than carcinomas without amplification (18 v 27 months). Univariate analysis showed a worse overall survival in these patients.

CONCLUSIONS

While c-myc amplifications can be observed in early stage breast cancer, especially in younger patients, they often occur later in tumour development and appear to be associated with disease progression.

CTCF Gene Mutations in Invasive Ductal Breast Cancer

The CTCF gene encodes for a transcriptional repressor of the c-myc oncogene and has previously been mapped to one of the smallest regions of overlapping interstitial deletions on chromosome 16q22.1 in invasive breast cancer. This chromosomal region is frequently deleted in both invasive lobular and ductal breast carcinomas. However, no target genes have been identified in invasive ductal breast cancer. We examined CTCF protein expression in 18 invasive ductal breast carcinomas using immunohistochemistry. Additionally, loss of heterozygosity (LOH) at chromosome 16q22.1 was determined and the complete cDNA sequence of CTCF was screened for mutations. Immunohistochemically, 17 tumours showed a moderate to strong nuclear staining for CTCF, one case was completely negative. Sequencing analysis revealed a tumour-specific truncating 14 bp insertion with silencing of the wild type allele in this case. In one further case we found a missense mutation that was shown not to be tumour-specific. Concordant with the antiproliferative effects of the CTCF protein in vivo, CTCF may be involved in tumour initiation or proliferation in individual cases of invasive ductal breast carcinoma.

C-myc oncogene amplification in ductal carcinoma in situ of the breast

The c-myc oncogene is frequently activated in invasive breast cancer and has been associated with high nuclear grade, lymph node metastasis and poorer disease outcome. We have examined c-myc oncogene amplification using fluorescence in situ hybridization in a series of 96 pure DCIS. Additionally we assessed amplification and expression of the Her2 and bcl-2 oncogenes. The findings were compared with clinicopathological data, Ki-67 proliferative index and hormone receptor status. We observed c-myc oncogene amplification in 19 tumours (20%). These cases were significantly associated with an average of 38% higher proliferative activity (p = 0.045), a 43% larger tumour size (p = 0.029) and the otherwise rare micropapillary subtype (p = 0.0005). Concluding the c-myc oncogene appears to be involved in the development of a more aggressive phenotype of DCIS.

Tenascin expression in elastotic cuffs of invasive ductal carcinoma of the breast

We studied immunohistochemically one thousand one hundred and thirty-seven cases of primary invasive breast cancers (NST) and adjacent normal mammary glands for tenascin expression, and compared their elastic content to verify if a relationship exists between tenascin expression and elastosis. Periductal, perivascular and stromal elastosis were graded on a scale from 0 to 3 (absent to massive). All carcinomas showed tenascin expression and elastosis with various histological appearances. In the adjacent breast, teanscon was distributed around the normal ducts or with extasia and uctal hyperplasia without atypia. Digestion of the sections with elastase prior to staining resulted in a loss of the specific staining reactions in all areas where elastosis was present. Tenascin staining was observed in the mesenchyme closely surrounding the neoplastic ducts and the cancer cell nests. Stromal tenascin staining appeared stronger in those carcinomas that exhibited marked desmoplastic reactions. The highly differentiated tumours contained more elastosis in their tumour tissue than the poorly differentiated ones, whereas tenascin expression was stronger in poorly differentiated tumours than well differentiated tumours. A strong staining for tenascin was observed in the elastotic cuff. Tenascin staining did not disappear afterwards with elastase. We did not find a statistically significant correlation between tenascin expression, elastosis and prognostic factors such as size of the tumour, lymph node metastasis, tumour necrosis and age. In our study tenascin proved to be an additional element in elastotic areas even though the significance of an association between elastosis and tenascin is still unknown, as is that of elastosis itself.