Abstract
AIM: To study the histopathological features of breast carcinoma developing in postmenopausal patients on hormone replacement therapy (HRT). METHODS: The sample comprised 60 patients with invasive breast carcinoma including 31 who had received HRT at or shortly before presentation, and 29 who had not. Details concerning their tumour size, histological type and grade, lymph node status, and oestrogen and progesterone receptor status were compared. Immunoperoxidase staining for Bcl-2, p53, and E-cadherin was carried out on paraffin sections of all 60 patients. The results were then statistically analysed. RESULTS: Tumours detected in HRT patients were significantly smaller (mean 17 mm v 25 mm; p = 0.0156) and of a lower histological grade (p = 0.0414) than those detected in non-HRT patients. The incidence of invasive lobular carcinoma was slightly higher in HRT patients (19% v 14%). Immunohistologically, 87% of HRT tumours were Bcl-2 positive (compared with 79% in the control group), 29% were p53 positive (45% in the control), and 48% were E-cadherin positive (72% in the control group). Although the differences were not statistically significant there was a trend towards higher incidence of p53 negative and E-cadherin negative tumours in HRT patients. CONCLUSIONS: Breast carcinomas detected in patients on HRT have a significantly higher incidence of two favourable prognostic features (small size and a low histological grade). They also show a trend, statistically not significant, of being p53 negative and E-cadherin negative; this may be related to the slightly higher incidence of invasive lobular tumours in these patients.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barbareschi M., Caffo O., Veronese S., Leek R. D., Fina P., Fox S., Bonzanini M., Girlando S., Morelli L., Eccher C. Bcl-2 and p53 expression in node-negative breast carcinoma: a study with long-term follow-up. Hum Pathol. 1996 Nov;27(11):1149–1155. doi: 10.1016/s0046-8177(96)90307-x. [DOI] [PubMed] [Google Scholar]
- Barth A., Craig P. H., Silverstein M. J. Predictors of axillary lymph node metastases in patients with T1 breast carcinoma. Cancer. 1997 May 15;79(10):1918–1922. [PubMed] [Google Scholar]
- Bonnier P., Romain S., Giacalone P. L., Laffargue F., Martin P. M., Piana L. Clinical and biologic prognostic factors in breast cancer diagnosed during postmenopausal hormone replacement therapy. Obstet Gynecol. 1995 Jan;85(1):11–17. doi: 10.1016/0029-7844(94)00324-7. [DOI] [PubMed] [Google Scholar]
- Domagala W., Harezga B., Szadowska A., Markiewski M., Weber K., Osborn M. Nuclear p53 protein accumulates preferentially in medullary and high-grade ductal but rarely in lobular breast carcinomas. Am J Pathol. 1993 Mar;142(3):669–674. [PMC free article] [PubMed] [Google Scholar]
- Elston C. W., Ellis I. O. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991 Nov;19(5):403–410. doi: 10.1111/j.1365-2559.1991.tb00229.x. [DOI] [PubMed] [Google Scholar]
- Gamallo C., Palacios J., Suarez A., Pizarro A., Navarro P., Quintanilla M., Cano A. Correlation of E-cadherin expression with differentiation grade and histological type in breast carcinoma. Am J Pathol. 1993 Apr;142(4):987–993. [PMC free article] [PubMed] [Google Scholar]
- Joensuu H., Pylkkänen L., Toikkanen S. Bcl-2 protein expression and long-term survival in breast cancer. Am J Pathol. 1994 Nov;145(5):1191–1198. [PMC free article] [PubMed] [Google Scholar]
- Magnusson C., Holmberg L., Nordén T., Lindgren A., Persson I. Prognostic characteristics in breast cancers after hormone replacement therapy. Breast Cancer Res Treat. 1996;38(3):325–334. doi: 10.1007/BF01806152. [DOI] [PubMed] [Google Scholar]
- Moll R., Mitze M., Frixen U. H., Birchmeier W. Differential loss of E-cadherin expression in infiltrating ductal and lobular breast carcinomas. Am J Pathol. 1993 Dec;143(6):1731–1742. [PMC free article] [PubMed] [Google Scholar]
- Pratap R., Shousha S. Breast carcinoma in women under the age of 50: Relationship between p53 immunostaining, tumour grade, and axillary lymph node status. Breast Cancer Res Treat. 1998 May;49(1):35–39. doi: 10.1023/a:1005993220824. [DOI] [PubMed] [Google Scholar]
- Siitonen S. M., Kononen J. T., Helin H. J., Rantala I. S., Holli K. A., Isola J. J. Reduced E-cadherin expression is associated with invasiveness and unfavorable prognosis in breast cancer. Am J Clin Pathol. 1996 Apr;105(4):394–402. doi: 10.1093/ajcp/105.4.394. [DOI] [PubMed] [Google Scholar]
- Taylor C. R. Paraffin section immunocytochemistry for estrogen receptor: the time has come. Cancer. 1996 Jun 15;77(12):2419–2422. doi: 10.1002/(SICI)1097-0142(19960615)77:12<2419::AID-CNCR1>3.0.CO;2-H. [DOI] [PubMed] [Google Scholar]
