Does apoptosis contribute to a relatively better prognosis in medullary carcinoma of breast?

Abstract

Background and Aims: Apoptosis (programmed cell death) is considered to play a critical role in tumor genesis, where a down regulation of the process contributes to development and progress of neoplasia. Medullary carcinoma (MC) of breast has generally been considered to have a better prognosis than invasive ductal carcinoma not otherwise specified (IDCC-NOS), which would seem to be discrepant when one considers its anaplastic histology and high mitotic rate. We, hence, attempted to elucidate the importance and implications of apoptosis in the prognosis of medullary carcinoma of breast. Materials and Methods: Formalin-fixed, paraffin-embedded sections of 30 cases of medullary carcinoma of breast and 30 cases of IDCC-NOS (controls) were investigated by light microscopy. Results: Mean values of apoptotic count was significantly higher in MC than in IDCC-NOS (P Conclusion: It appears that a high frequency of apoptosis may be related to a favorable prognosis in medullary carcinoma even though it demonstrates a high mitotic count with a rapid cell turnover. Since apoptotic cells can be counted with a good reproducibility in H and E stained tumor sections, the apoptotic index could possibly be used as an additional prognostic indicator in invasive breast cancer.