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Open Access Research

Usefulness and limitations of E-cadherin and β-catenin in the classification of breast carcinomas in situ with mixed pattern

Douglas S Gomes1, Simone S Porto1, Rafael M Rocha2 and Helenice Gobbi1*

Author affiliations

1 Breast Pathology Laboratory, School of Medicine, Federal University of Minas Gerais (UFMG), Av. Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais, 30130-100, Brazil

2 Laboratory of Investigative Pathology, A.C. Camargo Hospital, São Paulo-SP, Brazil

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Citation and License

Diagnostic Pathology 2013, 8:114  doi:10.1186/1746-1596-8-114

Published: 9 July 2013

Abstract

Background

The distinction between lobular neoplasia of the breast and ductal carcinoma in situ has important therapeutic implications. In some cases, it is very difficult to determine whether the morphology of the lesion is ductal or lobular. The aim of this study was to evaluate the value of E-cadherin and β-catenin expression through the immunophenotypical characterization of carcinoma in situ with mixed pattern (CISM).

Methods

A total of 25 cases of CISM were analyzed considering cytology/mixed architecture (ductal and lobular), nuclear pleomorphism, loss of cell cohesion, and presence of comedonecrosis. The immunophenotype pattern was considered E-cadherin positive and β-catenin positive, or negative.

Results

Nineteen (76%) cases presented a mixed cytology and / or architectural pattern, two (8%) presented nuclear pleomorphism, two (8%) presented mixed cytology and nuclear pleomorphism, and two (8%) presented comedonecrosis and nuclear pleomorphism. A complete positivity for E-cadherin and β-catenin was observed in 11 cases (44%). In one case, the lesion was negative for both markers and showed nuclear pleomorphis. Thirteen lesions showed negative staining in areas of lobular cytology and positive staining in cells presenting the ductal pattern.

Conclusions

The expression of E-cadherin and β-catenin, combined with cytological and architectural analysis, may highlight different immunophenotypes and improve classification of CISM.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1693384202970681 webcite

Keywords:
E-cadherin; β-catenin; Breast cancer; Lobular neoplasia; Ductal carcinoma in situ; Immunohistochemistry

Additional non-English language abstract - Portuguese

Introdução

A distinção entre neoplasia lobular e carcinoma ductal in situ tem importantes implicações terapêuticas. No entanto, em alguns casos, é muito difícil determinar se a morfologia da lesão é ductal ou lobular. O objetivo deste estudo foi avaliar a expressão de E-caderina e β-catenina na caracterização imunofenotípica dos carcinomas in situ de padrão misto (CISM).

Métodos

Um total de vinte e cinco casos de CISM foram analisados considerando a citologia/arquitetura mista (ductal e lobular), pleomorfismo nuclear e presença de comedonecrose. A expressão imuno-histoquímica foi considerada positiva para E-caderina e β-catenina, ou negativa.

Resultados

Dezenove (76%) casos apresentavam somente citologia e/ou padrão arquitetural misto (ductal e lobular), dois casos (8%) apresentaram somente pleomorfismo nuclear, dois casos (8%) apresentavam citologia mista e pleomorfismo nuclear, e dois casos (8%) tinham comedonecrose e pleomorfismo nuclear. Uma positividade completa para E-caderina e β-catenina foi observada em 11 casos (44%). Em um caso a lesão foi negativa para ambos marcadores e apresentava pleomorfismo nuclear e comedonecrose. Em 13 lesões o imunofenótipo foi negativo em áreas lobulares e positivo em áreas ductais.

Conclusão

A caracterização imunofenotípica com E-caderina e β-catenina, combinada com a análise citológica e arquitetural, pode destacar diferentes imunofenótipos e auxiliar na classificação dos CISM.