Ns. Goldstein et al., Clinicopathologic implications of E-cadherin reactivity in patients with lobular carcinoma in situ of the breast, CANCER, 92(4), 2001, pp. 738-747
BACKGROUND. The current study addressed two questions pertaining to lobular
carcinoma in situ (LCIS) of the breast. First, does the risk of a subseque
nt carcinoma decrease over time after an LCIS biopsy and second, what is th
e clinical significance of E-cadherin-reactive LCIS?
METHODS. Eighty-two consecutive patients with a biopsy containing LCIS only
, no prior history of breast carcinoma, and follow-up information available
for the period 1955-1976 were reviewed. No patients underwent a mastectomy
for LCIS. Four hundred eighty-six sections were stained with E-cadherin. E
-cadherin reactivity was correlated with clinicopathologic features of the
LCIS and subsequent tumors. The mean number of blocks stained per case was
5.9. The mean follow-up period was 21.6 years.
RESULTS. Sixteen patients (19.5%) developed 21 subsequent invasive carcinom
as (9 ipsilateral, 2 contralateral, and 5 bilateral carcinomas). The 10-yea
r and 20-year actuarial rates of developing subsequent carcinoma were 7.8%
and 15.4%, respectively. Six of the 21 carcinomas (29%) developed after 20
years. Nine LCIS cases (10.9%) had focal E-cadherin reactivity. When compar
ed with patients with nonreactive LCIS, patients with E-cadherin-reactive L
CIS more frequently developed a subsequent ipsilateral carcinoma that had a
ductal component (55.5% vs. 12.3%; P < 0.01). The subsequent carcinomas al
so developed after significantly shorter time periods (mean of 7.6 years vs
. 19.6 years; P < 0.01).
CONCLUSIONS. LCIS appears to confer a persistent, increased risk of subsequ
ent breast carcinoma that does not appear to decrease over time. E-cadherin
reactivity appears to identify a subset of LCIS patients with risk factors
for subsequent carcinoma similar to those of patients with low-grade intra
ductal carcinoma. <(c)> 2001 American Cancer Society.