Abstract
The vast majority of invasive breast tumors are ductal and lobular breast carcinomas. Despite the many similarities, some clinical follow-up data and the patterns of metastases suggest that these histological subtypes of breast cancer are biologically distinct. Few papers, however, describe immunohistochemical markers useful for differentiation of these carcinomas. Many investigations suggest that E cadherin protein expression is lost in lobular but not in ductal carcinoma. The absence of E-CD, as a partial loss of epithelial differentiation, may account for the extended spread of lobular carcinoma in situ and the peculiar diffuse invasion mode of invasive lobular carcinoma. Some investigations report the significance of E-CD associated proteins alpha-, beta-, gamma-catenin expression, as well as the usefulness of cytokeratins 5, 6, 8, 7 and thrombospondin in differentiating histological types of breast invasive carcinomas. Several reports have suggested the possibility that invasive ductal and lobular cancers differ with respect to expression of antigens involved in proliferation and cell cycle regulation. It has been shown that vascular endothelial growth factor expression, also the expression of maspin, a tumour suppressor gene product, is higher in ductal, than in lobular carcinoma. Expression of NKX3.1, a member of the NK-class of homeodomain, is highly restricted and is found primarily in lobular carcinoma. Some histological and immunohistochemical characteristics of pleomorphic lobular carcinoma are also discussed.
Highlights
Invasive ductal and lobular breast carcinomas are the most common malignancies of the breast, accounting for 80 % and 15 % of all invasive breast tumors, respectively
Many investigations suggest that E cadherin protein expression is lost in lobular but not in ductal carcinoma
There were no significant differences in vascular density between the two types of invasive carcinoma, suggesting that Vascular endothelial growth factor (VEGF) is important in angiogenesis in infiltrating ductal carcinoma (IDC), but that other angiogenic factors are important in ILC48
Summary
Invasive ductal and lobular breast carcinomas are the most common malignancies of the breast, accounting for 80 % and 15 % of all invasive breast tumors, respectively. Treatment for stage-matched ductal versus lobular tumors is similar[3,4], some studies suggest that metastatic patterns differ between lobular and ductal tumors[5,6], and lobular tumors may be less responsive to neoadjuvant therapy[7]. Such studies suggest that lobular tumor development and progression may follow a distinct pathway from ductal tumors. In order to study the biological differences between histological types of breast carcinoma, Ruibal et al analyzed clinical and biological parameters in breast cancer patients. Mersin et al reported that patients with ILC were older, had low grade tumor and less lymphatic vascular invasion, they had no survival advantage compared with their counterparts, and histologic type was not an independent prognostic factor for outcome[14]
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