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J Clin Pathol. 2013 Aug;66(8):665-70. doi: 10.1136/jclinpath-2012-201428. Epub 2013 Mar 28.

Ductal carcinoma in situ associated with triple negative invasive breast cancer: evidence for a precursor-product relationship.

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  • 1Department of Pathology, Singapore General Hospital, Singapore.

Abstract

AIMS:

We evaluated pathological features of the ductal carcinoma in situ component of 241 triple negative invasive breast cancers.

RESULTS:

We found that 151 (62.6%) in situ lesions were of high nuclear grade, and 236 (97.9%) were triple negative (oestrogen receptor, progesterone receptor, cerbB2 negative). Immunohistochemistry for cytokeratin (CK)5/6, CK14, CK17, epidermal growth factor receptor (EGFR), CD117, 34βE12, p63 and smooth muscle actin (SMA) revealed positive staining in 5 (2.1%), 60 (24.9%), 69 (28.6%), 37 (15.4%), 69 (28.6%), 137 (56.8%), 3 (1.2%) and 22 (9.1%) in situ ductal components respectively, with fair to substantial agreement of staining results (positive versus negative) between in situ and corresponding invasive elements for CK5/6, CK14, CK17, EGFR, CD117 and 34βE12; but none to fair agreement for p63 and SMA respectively. When the tri-panel of CK14, EGFR and 34βE12 was used to define the basal phenotype, 68% revealed basal-like expression of both in situ and invasive components of the same case.

CONCLUSIONS:

Our data support the notion that triple negative ductal carcinoma in situ is the precursor of the corresponding invasive counterpart, and that basal-like expression is maintained in the majority of invasive cancers associated with basal-like in situ disease. Future studies that prospectively evaluate morphological and biological characteristics of invasive cancers that develop from triple negative and basal-like ductal carcinoma in situ lesions will assist in validating these findings.

KEYWORDS:

BREAST CANCER; BREAST PATHOLOGY; IMMUNOHISTOCHEMISTRY

PMID:
23539741
[PubMed - indexed for MEDLINE]
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