DUCTAL CARCINOMA IN-SITU - ASSESSMENT OF NECROSIS AND NUCLEAR MORPHOLOGY AND THEIR ASSOCIATION WITH BIOLOGICAL MARKERS

One hundred and five cases of pure ductal carcinoma in situ (DCIS) see n in the Guy's Hospital breast unit between 1975 and 1991 were reviewe d. The presence and extent of necrosis and the degree of cytonuclear d ifferentiation were assessed and the expression of p53 protein, cerbB( 2) protein, progesterone receptor, and a proliferation antigen KiS1, a ll factors reported to be of prognostic significance in invasive ducta l carcinoma, was evaluated using immunohistochemical methods. A strong correlation was seen between the presence and extent of necrosis and the degree of cytonuclear differentiation and between both these morph ological criteria and the biological markers as well as between the in dividual markers. The presence of extensive necrosis was associated wi th lack of cytonuclear differentiation and both were associated with a high proliferation rate, the presence of cerbB(2) and p53 protein, an d the absence of progesterone receptors. In cases with little or no ne crosis, there was good nuclear differentiation and a strong correlatio n with the presence of progesterone receptor, absence of cerbB(2) and p53 protein, and a low rate of proliferation.