Quantitative immunoprofiles of breast cancer performed by image analysis

OBJECTIVE: To determine the biopathologic profiles of breast cancer for gre ater knowledge of tumor natural history and clinical outcome. STUDY DESIGN: In 99 in situ (ISC) and 2718 infiltrating breast carcinomas ( IC), biologic markers (estrogen receptor [ER], progesterone receptor [PR] p roIiferation index, cerbB-2/NEU, p53, bcl-2 and DNA ploidy) were evaluated with an image analysis system (CAS 200/486). In 105 mixed invasive cancers with size less than or equal to 1 cm, a separate analysis of in situ (ISCm) and invasive component (ICm) was obtained. A clinical study of 836 invasiv e breast cancers Teas performed. RESULTS: Different biophenotypes were obtained: among ISCs, cribriform type exhibited biologic behavior similar to that of normal breast tissue (ER+, PR+, proliferation index [PI] low, NEU-, p53-, bcl-2+) the opposite profile was displayed by comedo type, and intermediate phenotypes were observed in noncomedo and lobular types. Comparing ISC and ISCm, PI and p53 expression had the highest levels in ISCm with respect to other groups. NEU overexpre ssion exhibited a decreasing value from ICm to IC. Younger women (less than or equal to 40 years) with IC demonstrated a worse biologic profile (high PI, p53+, ER- and size >2 cm). In multivariate analysis, PI and NEU in node -negative patients, and NEU, PR and size in node-positive ones emerged as p rognostic parameters. CONCLUSION: The results underline the importance of the quantitative biolog ic profile for defining tumor behavior and patient management.