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Biologic Markers in Ductal Carcinoma In Situ and Concurrent Infiltrating
Carcinoma: A Comparison of Eight Contemporary Grading Systems
The relevance of 8 contemporary classification and grading systems for
ductal carcinoma in situ (DCIS) of the breast was examined in 100 tumors
by comparing DCIS grade with grade of the concurrent infiltrating ductal
carcinoma (IDC).
Besides tumor size and nodal status, the
immunohistochemical parameters in both lesions were compared, including
estrogen receptor, progesterone receptor, c-erbB-2 protein, E-cadherin,
vimentin, Ki-67 (MIB1), and p27.
Nuclear grading of DCIS alone or in
combination with architectural pattern and necrosis showed the best
correlation with grade of the invasive component. There also was a positive
correlation between every biologic marker expressed in DCIS and in the
concurrent IDC, supporting a clonal relationship. Biologic markers varied
between the different grades of DCIS.
DCIS is heterogeneous, and the
progression of DCIS to IDC may be from low-grade DCIS to low-grade IDC
and high-grade DCIS to high-grade IDC.
This concept is different from the
conventional model held for intraepithelial neoplasia in the cervix, vulva,
vagina, and skin, in which there is increasing severity of in situ atypia
(dysplasia) before the development of stromal invasion.
[05/21/2001; American Journal of Clinical Pathology]
Thanks to Breastcancer.net
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