Intraductal spread of invasive breast carcinoma has a positive correlationwith c-erb B-2 overexpression and vascular invasion

BACKGROUND Studies of the histologic characteristics and biologic behavior of the intraductal spread of breast carcinoma are critically important in t hat they may lead to the identification of a unique spread pattern rather t han a noninvasive lesion. METHODS, Paraffin embedded specimens of 187 primary invasive breast carcino mas and 4 noninvasive ductal carcinomas, obtained by wide excision, quadran tectomy, total glandectomy, or mastectomy, were studied immunohistochemical ly. The overexpression of c-erb B-2, p53, bcl-2, and MIB-1, as well as the histologic characteristics of intraductal spread (such as histologic featur es and histologic grade), were assessed. Chi-square and Fisher exact tests were conducted to evaluate significant differences; the Macintosh for Exper t StatView 4.0 system was used to conduct these tests. RESULTS, The histologic characteristics of intraductal spread were similar to those of noninvasive ductal carcinoma. However, the expressions of c-erb B-2, p53, and other biologic markers of intraductal spread were similar to those of the main invasive tumor. The overexpression of c-erb, B-2 protein was found more often in the group that was positive for intraductal spread than in the group that was negative (P < 0.01). Intraductal spread was fou nd more often in the group that was positive for lymphatic and venous invas ion than in the group that was negative (P < 0.005). Subnipple margin posit ive status was related closely to intraductal spread (P < 0.0001). CONCLUSIONS, The positive correlation between intraductal spread and c-erb B-2 overexpression as well as lymphatic, venous invasion was recognized, an d it was determined that intraductal spread of invasive breast carcinoma po ssesses an invasive and metastatic potential that is distinct from noninvas ive ductal carcinoma. (C) 1999 American Cancer Society.