Carcinoma in situ of the breast: correlation of histopathology to immunohistochemical markers and DNA ploidy

In a consecutive and unselected series of 178 cases of carcinoma in situ of the breast (CIS), comprising both ductal (DCIS) and lobular type (LCIS), a nd a series of 48 cases of invasive carcinoma (IC) with predominance of DCI S, the association between histopathology, immunohistochemical markers (ER, PgR, MIB-1, c-erbB-2, and p53), and DNA ploidy was investigated, in order to discriminate biologically different groups. In DCIS, significant correla tion was shown between large nuclear size and comedonecrosis, both of which showed also strong association to DNA aneuploidy, high proliferation activ ity, low steroid receptor content, and overexpression of c-erbB-2 and p53 - factors that may indicate an aggressive behavior. Small nuclear CIS, wheth er LCIS or DCIS, on the contrary, were DNA diploid with low proliferation, and no cases showed overexpression of c-erbB-2 and p53. Heterogeneity with respect to the investigated parameters was also a frequent finding that may reflect a development complexity. In IC, comparison of the DCIS and the in vasive component showed similar patterns. No significant differences were s hown between DCIS without and with invasion. This may indicate that none of the investigated parameters on its own are essential for the event of inva sion.