SPECTRUM OF CARCINOEMBRYONIC ANTIGEN IMMUNOREACTIVITY FROM ISOLATED DUCTAL HYPERPLASIAS TO ATYPICAL HYPERPLASIAS ASSOCIATED WITH INFILTRATING DUCTAL BREAST-CANCER

Aims - To study the immunohistochemical expression of carcinoembryonic antigen (CEA) in ductal hyperplasia of the breast and to investigate its putative relation with atypia and co-existing infiltrating ductal carcinoma. Methods - Paraffin wax embedded tissue from 37 cases of iso lated ductal hyperplasia (five with atypia and 32 without atypia) and 25 cases of ductal hyperplasia associated infiltrating ductal carcinom a (IDC) (seven with atypia and 18 without atypia) was stained with a m onoclonal anti-CEA antibody using a standard avidin biotin immunoperox idase method. Results - CEA immunoreactivity was observed in eight (12 .8%) ductal hyperplasia cases. The percentage of CEA positivity in duc tal hyperplasia cases with atypia (33.3%) was substantially higher tha n that observed in cases of ductal hyperplasia without atypia (8.0%). Six cases of ductal hyperplasia associated IDC reacted with CEA; in th ese six cases the neoplastic cells of the co-existing carcinoma were a lso CEA positive. The percentage of CEA immunoreactivity in ductal hyp erplasia associated IDC was higher than that observed in isolated duct al hyperplasia (24.0 v 5.4%). The percentage of CEA immunoreactivity i n atypical ductal hyperplasia associated IDC was similar to that obser ved in IDC alone (42.9 v 40.0%). Conclusions-The presence of CEA immun oreactivity has been confirmed in benign proliferative breast lesions. The prevalence of such immunoreactivity increases from 3.1% in isolat ed, nonatypical ductal hyperplasia to 42.9% in atypical ductal hyperpl asia associated IDC. This finding and the similarity of the frequency of CEA positivity in atypical ductal hyperplasia associated IDC and in IDC alone suggests that there is a pathogenetic link between ductal h yperplasia and some types of breast cancer.