THE CLASSIFICATION OF DUCTAL CARCINOMA IN-SITU AND ITS ASSOCIATION WITH BIOLOGICAL MARKERS

One hundred five cases of pure ductal carcinoma in situ (DCIS) seen in the Guys Hospital breast unit between 1975 and 1991 were reviewed and reclassified using a modified histologic classification based on cyto logical features as well as histological architecture. The expression of p53 protein, cerbB2 protein, progesterone receptor, and a prolifera tion antigen KiS1, all factors reported to be of prognostic significan ce in invasive ductal carcinoma, was also evaluated using immunohistoc hemical methods. The mode of presentation of these cases was noted, an d its relationship to biological markers and histologic type was also assessed. Good interobserver agreement was achieved by two independent observers using the modified histologic classification. Strong correl ation was seen between histologic pattern and biological markers as we ll as between the individual markers. Poorly differentiated DCIS was a ssociated with a high proliferation rate, the presence of cerbB2 and p 53 protein and the absence of progesterone receptors. Well-differentia ted DCIS showed the reverse, and the intermediate group showed an inte rmediate pattern. Paget's disease of the nipple was only seen in assoc iation with poorly differentiated DCIS, but no other significant assoc iation was noted between mode of presentation and DCIS type. Copyright (C) 1994 by W.B. Saunders Company