Abstract
We analyzed the subgross distribution of the invasive component in 875 consecutive cases of breast carcinomas using large-format histology sections and compared the immunophenotype (estrogen and progesterone receptor expression, HER2 overexpression and expression of basal-like markers, CK5/6, CK14, and epidermal growth factor receptor) in unifocal, multifocal, and diffuse tumors. Histology grade and lymph node status were also analyzed. Unifocal invasive carcinomas comprised 58.6% (513/875), multifocal invasive carcinomas 36.5% (319/875), and diffuse invasive carcinomas 4.9% (43/875) of the cases. The proportion of lymph node-positive cases was significantly higher in multifocal and diffuse carcinomas compared to unifocal cancers, but no other statistically significant differences could be verified between these tumor categories. Histological multifocality and diffuse distribution of the invasive tumor component seem to be negative morphologic prognostic parameters in breast carcinomas, independent of the molecular phenotype.
Highlights
We analyzed the subgross distribution of the invasive component in 875 consecutive cases of breast carcinomas using large-format histology sections and compared the immunophenotype in unifocal, multifocal, and diffuse tumors
The proportion of lymph node-positive cases was significantly higher in multifocal and diffuse carcinomas compared to unifocal cancers, but no other statistically significant differences could be verified between these tumor categories
Breast carcinoma is a heterogeneous group of diseases; individual cases deviate from each other in morphology, phenotype, and prognosis
Summary
Breast carcinoma is a heterogeneous group of diseases; individual cases deviate from each other in morphology, phenotype, and prognosis. Using DNA microarray technique and cluster analysis, five distinct genetic types of the disease were delineated: luminal A, luminal B, HER2 positive, basal-like, and normal breast like tumors [1, 2]. These tumor subtypes can be identified with sufficient accuracy during routine diagnosis, using a simple panel of immunohistochemical markers, including antibodies tracing estrogen receptors (ER), progesterone receptors (PR), c-erbB-2 oncoprotein overexpression (HER2), and some myoepithelial markers [3, 4]. We focused on the invasive component of the tumor and did not analyze the distribution of the in situ ductal or lobular
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