Specific morphological features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of breast

Fulford, L. G., Easton, D. F., Reis-Filho, J. S., Sofronis, A., Gillett, C. E., Lakhani, S. R. and Hanby, A. (2006) Specific morphological features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of breast. Histopathology, 49 1: 22-34. doi:10.1111/j.1365-2559.2006.02453.x


Author Fulford, L. G.
Easton, D. F.
Reis-Filho, J. S.
Sofronis, A.
Gillett, C. E.
Lakhani, S. R.
Hanby, A.
Title Specific morphological features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of breast
Journal name Histopathology   Check publisher's open access policy
ISSN 0309-0167
Publication date 2006
Sub-type Article (original research)
DOI 10.1111/j.1365-2559.2006.02453.x
Volume 49
Issue 1
Start page 22
End page 34
Total pages 13
Editor M. Wells
Place of publication Oxford
Publisher Blackwell Publishing
Collection year 2006
Language eng
Subject C1
321020 Pathology
730108 Cancer and related disorders
Abstract Aims: Cytokeratin (CK) 14, a myoepithelial marker, is also expressed in a proportion of breast carcinomas. There is evidence that these tumours show a differing metastatic pattern and clinical outcome from other invasive ductal carcinomas (IDCs) and may need different management. Currently, they are not identified in routine practice and no morphological guidelines exist to aid their identification. The aim of this study was to analyse the histological features of CK14+ IDC. Methods and results: A detailed histological review of 453 grade 3 IDCs revealed 88 (19.4%) that expressed CK14. Assessment was made independently by two pathologists using a standardized 'tick-box' proforma covering grade, architectural and cytological features. The results were analysed using logistic regression to identify features that predicted for basal phenotype. Concordance between the two pathologists was fair to good for most parameters (kappa 0.4-0.6). On multiple logistic regression, the basal phenotype was highly significantly associated with the presence of a central scar (P = 0.005), tumour necrosis (P < 0.0001), presence of spindle cells (P = 0.006) or squamous metaplasia (P < 0.0001), high total mitotic count (> 40 per 10 high-power field) (P = 0.0002) and high nuclear-cytoplasmic ratio (P = 0.0002). Conclusions: Specific morphological features are strongly associated with basal-like breast carcinoma. These could be used in routine diagnostic practice to identify this important subset of tumours.
Keyword Cell Biology
Pathology
Basal Phenotype
Breast Carcinoma
Pathology
Prognosis
Central Acellular Zones
Spindle-cell-carcinoma
Metaplastic Carcinomas
Medullary Carcinoma
Epithelial Phenotype
Estrogen-receptor
Follow-up
Cancer
Brca1
Expression
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 07:56:58 EST