• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brjcancerBJC HomepageBJC Advance online publicationBJC Current IssueSubmitting an article to BJCWeb feeds
Br J Cancer. Sep 2001; 85(6): 869–874.
PMCID: PMC2375068

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

Abstract

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. © 2001 Cancer Research Campaign  http://www.bjcancer.com

Keywords: breast cancer, invasive, in situ, progression

Full Text

The Full Text of this article is available as a PDF (56K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Allred DC, Clark GM, Molina R, Tandon AK, Schnitt SJ, Gilchrist KW, Osborne CK, Tormey DC, McGuire WL. Overexpression of HER-2/neu and its relationship with other prognostic factors change during the progression of in situ to invasive breast cancer. Hum Pathol. 1992 Sep;23(9):974–979. [PubMed]
  • Andersen J, Nielsen M, Christensen L. New aspects of the natural history of in situ and invasive carcinoma in the female breast. Results from autopsy investigations. Verh Dtsch Ges Pathol. 1985;69:88–95. [PubMed]
  • Bradley SJ, Weaver DW, Bouwman DL. Alternatives in the surgical management of in situ breast cancer. A meta-analysis of outcome. Am Surg. 1990 Jul;56(7):428–432. [PubMed]
  • Buerger H, Otterbach F, Simon R, Poremba C, Diallo R, Decker T, Riethdorf L, Brinkschmidt C, Dockhorn-Dworniczak B, Boecker W. Comparative genomic hybridization of ductal carcinoma in situ of the breast-evidence of multiple genetic pathways. J Pathol. 1999 Mar;187(4):396–402. [PubMed]
  • Douglas-Jones AG, Gupta SK, Attanoos RL, Morgan JM, Mansel RE. A critical appraisal of six modern classifications of ductal carcinoma in situ of the breast (DCIS): correlation with grade of associated invasive carcinoma. Histopathology. 1996 Nov;29(5):397–409. [PubMed]
  • Engels K, Fox SB, Whitehouse RM, Gatter KC, Harris AL. Distinct angiogenic patterns are associated with high-grade in situ ductal carcinomas of the breast. J Pathol. 1997 Feb;181(2):207–212. [PubMed]
  • Fisher B, Costantino J, Redmond C, Fisher E, Margolese R, Dimitrov N, Wolmark N, Wickerham DL, Deutsch M, Ore L, et al. Lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer. N Engl J Med. 1993 Jun 3;328(22):1581–1586. [PubMed]
  • Fox SB, Leek RD, Weekes MP, Whitehouse RM, Gatter KC, Harris AL. Quantitation and prognostic value of breast cancer angiogenesis: comparison of microvessel density, Chalkley count, and computer image analysis. J Pathol. 1995 Nov;177(3):275–283. [PubMed]
  • Graham MD, Lakhani S, Gazet JC. Breast conserving surgery in the management of in situ breast carcinoma. Eur J Surg Oncol. 1991 Jun;17(3):258–264. [PubMed]
  • Guidi AJ, Fischer L, Harris JR, Schnitt SJ. Microvessel density and distribution in ductal carcinoma in situ of the breast. J Natl Cancer Inst. 1994 Apr 20;86(8):614–619. [PubMed]
  • Gupta SK, Douglas-Jones AG, Fenn N, Morgan JM, Mansel RE. The clinical behavior of breast carcinoma is probably determined at the preinvasive stage (ductal carcinoma in situ). Cancer. 1997 Nov 1;80(9):1740–1745. [PubMed]
  • Holland R, Peterse JL, Millis RR, Eusebi V, Faverly D, van de Vijver MJ, Zafrani B. Ductal carcinoma in situ: a proposal for a new classification. Semin Diagn Pathol. 1994 Aug;11(3):167–180. [PubMed]
  • Iglehart JD, Kerns BJ, Huper G, Marks JR. Maintenance of DNA content and erbB-2 alterations in intraductal and invasive phases of mammary cancer. Breast Cancer Res Treat. 1995 Jun;34(3):253–263. [PubMed]
  • Leal CB, Schmitt FC, Bento MJ, Maia NC, Lopes CS. Ductal carcinoma in situ of the breast. Histologic categorization and its relationship to ploidy and immunohistochemical expression of hormone receptors, p53, and c-erbB-2 protein. Cancer. 1995 Apr 15;75(8):2123–2131. [PubMed]
  • Page DL, Dupont WD, Rogers LW, Landenberger M. Intraductal carcinoma of the breast: follow-up after biopsy only. Cancer. 1982 Feb 15;49(4):751–758. [PubMed]
  • Price P, Sinnett HD, Gusterson B, Walsh G, A'Hern RP, McKinna JA. Duct carcinoma in situ: predictors of local recurrence and progression in patients treated by surgery alone. Br J Cancer. 1990 Jun;61(6):869–872. [PMC free article] [PubMed]
  • Rosen PP, Braun DW, Jr, Kinne DE. The clinical significance of pre-invasive breast carcinoma. Cancer. 1980 Aug 15;46(4 Suppl):919–925. [PubMed]
  • Solin LJ, Kurtz J, Fourquet A, Amalric R, Recht A, Bornstein BA, Kuske R, Taylor M, Barrett W, Fowble B, et al. Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast. J Clin Oncol. 1996 Mar;14(3):754–763. [PubMed]
  • Somerville JE, Clarke LA, Biggart JD. c-erbB-2 overexpression and histological type of in situ and invasive breast carcinoma. J Clin Pathol. 1992 Jan;45(1):16–20. [PMC free article] [PubMed]
  • Stomper PC, Connolly JL, Meyer JE, Harris JR. Clinically occult ductal carcinoma in situ detected with mammography: analysis of 100 cases with radiologic-pathologic correlation. Radiology. 1989 Jul;172(1):235–241. [PubMed]
  • Swain SM. Ductal carcinoma in situ. Cancer Invest. 1992;10(5):443–454. [PubMed]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

Formats: