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Breast carcinoma in sclerosing adenosis: a clinicopathological and immunophenotypical analysis on 206 lesions
  1. Bao-Hua Yu1,2,
  2. Shao-Xian Tang1,2,
  3. Xiao-Li Xu1,2,
  4. Yu-Fan Cheng1,2,
  5. Rui Bi1,2,
  6. Ruo-Hong Shui1,2,
  7. Xiao-Yu Tu1,2,
  8. Hong-Fen Lu1,2,
  9. Xiao-Yan Zhou1,2,
  10. Wen-Tao Yang1,2
  1. 1 Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
  2. 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
  1. Correspondence to Dr Wen-Tao Yang, Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; yangwt2000{at}163.com

Abstract

Aims To fully elucidate the clinicopathological features of breast carcinoma in sclerosing adenosis (SA-BC).

Methods Clinical and histological characteristics of 206 SA-BCs from 180 patients were retrospectively evaluated. Immunohistochemical phenotype was examined. The clinicopathological relevance of the topographical pattern of SA-BCs was analysed.

Results Overall, up to 46 patients (25.6%) had contralateral cancer, either SA associated or not. Of 99 cases who underwent core needle biopsy (CNB), 36 were underestimated as adenosis or atypical ductal hyperplasia at CNB, 5 invasive cases were misinterpreted as in situ carcinomas, whereas 4 ductal carcinoma in situ (DCIS) cases were overdiagnosed as invasive carcinoma. Microscopically, 163 tumours were in situ, including 136 DCIS, 19 lobular carcinomas in situ (LCIS) and 8 mixed DCIS/LCIS; of these carcinomas in situ (CIS), 37 had microinvasion. The DCIS group exhibited low, intermediate and high grades in 53.7%, 34.6% and 11.8% of cases, respectively, mostly with solid (43.4%) or cribriform (41.9%) pattern. Forty out of 43 invasive cases were invasive ductal carcinoma (IDC), mostly DCIS predominant. Immunophenotypically, luminal A phenotype was identified in 55.1%, 63.2% and 45.0% of DCIS, LCIS and IDC cases, respectively. Topographical type A group (carcinoma being entirely confined to SA, n=176) was characterised by smaller size, less invasiveness, lower grade and more frequency of luminal A immunophenotype compared with type B group (≥ 50% but not all of the carcinomatous lesion being located in SA, n=30) (all P<0.05).

Conclusions CIS, especially non-high-grade DCIS, represents the most common variant of SA-BC, and luminal A is the most predominant immunophenotype. CNB assessment might be challenging in some SA-BCs. The topographical pattern has great clinicopathological relevance. Careful evaluation of the contralateral breast and long-term follow-up for patients with SA-BC is necessary given its high prevalence of bilaterality.

  • breast pathology
  • histopathology
  • immunohistochemistry

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Footnotes

  • BHY and SXT are co-first authors and both contributed equally to the paper.

  • BHY and SXT contributed equally.

  • Handling editor Dhirendra Govender.

  • Contributors WTY: conceived the study and revised the manuscript. BHY: designed the study and wrote the manuscript. SXT: collected and analysed the data and reviewed the manuscript. XLX, YFC, RB, RHS, XYT and HFL: performed the morphological study and IHC evaluation. XYZ: performed data interpretation and reviewed the manuscript.

  • Funding This study was funded by Science and Technology Commission of Shanghai Municipality (15495810300).

  • Competing interests None declared.

  • Ethics approval the Institutional Review Board of Fudan University Shanghai Cancer Center, Shanghai, China.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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