EARLY INVASIVE BREAST CANCER. ANALYSIS OF CLINICOPATHOLOGICAL PARAMETERS CORRELATED WITH EARLY METASTASIS

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1)We have retrospectively re-evaluated 45 cases of non-invasive ductal carcinomas, which had been diagnosed on core needle biopsy (CNB) specimen (16 gouge). At subsequent resected (operative) specimen, 16 (36%) cases slowed invasive ductal carcinoma components, and in addition, 4 of them had lymph nodes metastases. Thus, that CNB may not always be a good procedure to detect early invasive cancer.2)To evaluate early phase of metastases, special staining for elastic fibers as well as immunohistochemical analysis for endothelial cell markers had been performed. Lymph vessel invasion, detected by anti-D2-40 or anti-podplanin, were seen at the periphery of invasive carcinomas. Moderate to severe lymph vessel invasion could be detected even on routine H&E staining glass slides. Venous invasion could not be detected on H&E, on the other hand, it bad been only recognized by elastic fiber stains (ie. Masson-Goldner's procedure), and venous invasion was correlated well with patient survival.3)We have collected invasive ductal carcinomas with less than 10mm of maximum invasive diameter. About 200 cases had been collected, but we have never experienced the case with node positive, if the maximum diameter is less then 3mm. In addition, all of the cases with node positive and 3-4mm invasive components, had comedonecrosis and high grade nuclei in their noninvasive carcinoma components.4)cDNA microarray evaluation had been performed for invasive micropapillaxy carcinoma (IMPCa), because IMPCa may have a focus on early phase metastasis. IMIPCa had been considered to have the abnormalities for cell adhesion genes and/or genes in relation to cell polarity. Some of the had been comfirmed by additional immunostains.5)For detecting early invasive components more objectively, the usefulness of immunohistochemistry may be limited. However, basal cell markers, especially cytokeratin 5, 6, 14, can be used to making differential diagnosis between benign and malignant papillary lesions.