Clinicopathological characteristics of atypical cystic duct (ACD) of the breast: Assessment of ACD as a precancerous lesion

Citation
R. Kusama et al., Clinicopathological characteristics of atypical cystic duct (ACD) of the breast: Assessment of ACD as a precancerous lesion, PATHOL INT, 50(10), 2000, pp. 793-800
Citations number
25
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
PATHOLOGY INTERNATIONAL
ISSN journal
1320-5463 → ACNP
Volume
50
Issue
10
Year of publication
2000
Pages
793 - 800
Database
ISI
SICI code
1320-5463(200010)50:10<793:CCOACD>2.0.ZU;2-#
Abstract
To clarify the clinicopathological features of an atypical cystic duct (ACD ) as defined by Tsuchiya's criteria as a precancerous lesion of the breast, we used 200 whole mammary gland serial sections of breast cancer. Forty-fo ur (22%) of the 200 breast cancer patients had ACD breast lesions. The freq uency of patients with ACD increased in premenopausal women (P = 0.001). Th ere was no correlation between the ACD-present group and the ACD-absent gro up for immunohistochemical status of the estrogen receptor (ER), progestero ne receptor (PgR), p53, or c-erbB2; Ki-67 labeling index of cancer tissues; size of tumor, or lymph node metastases. A number of ACD lesions displayed continuity to cancer lesions. In 500 serial sections of a paraffin-embedde d tissue of a ACD case at 3 mum intervals, an apparent transition from ACD into ductal carcinoma in situ was observed. Immunohistochemical analysis us ing alpha -smooth muscle actin showed that myoepithelial cells of ACD stain ed strongly, and their nuclei and cytoplasm were thinning. In 16 of the 44 (36%) ACD-present patients, carcinoma cells stained positive for p53. Withi n those 16 cases, 12 cases (75%) were positive for p53 in ACD lesions. Ther e was a significant correlation between the expression of p53 protein in ma lignant cells and ACD (P = 0.001). All 44 ACD lesions had no staining of c- erbB2, regardless of staining in malignant lesions. The mean Ki-67 labeling index of ACD lesions was low (0.3%), suggesting that ACD had a low prolife rative rate. We suggest that ACD is the precancerous breast lesion because of a histologic continuum between ACD and malignancy, and because of p53 pr otein expression in ACD.