Early invasive cancer of the breast. Clinico-pathological analysis for establishment a new disease entity

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Most of the cases of invasive ductal carcinoma (IDC) of the breast may be developed through the stage of in situ carcinoma (DCIS). Thus we have analyzed the "early" invasive carcinomas to clarify the pathogenesis and clinical significances of these lesions. (1) Clinicopathological review of the minimally invasive (less than 1 mm) carcinomas revealed that their noninvasive components were mainly composed by comedo architecture and high nuclear grade. Lymph node metastatic status was not different from pure DCISs. (2) Invasive micropapillary carcinoma, which is a spacial type of breast carcinoma with poor prognosis were examined. They were also showed high nuclear grade, higher number of lymph node metastasis frequently, and prognosis were not so good by more than 3 years follow-up. As this special type cancer is not expanding through the duct-lobular system extensively, this will be one of the model of invasive carcinoma with earlier event of distant metastasis. Cytological analysis revealed that some of the characteristic findings. There is a possibility that we can detect this type earlier by fine needle aspiration cytology. (3) We have done the LOH analysis by 13 of well known microsatellite markers to check the early event of carcinoma invasion. IDC had the same pattern of LOH with the s DCIS and atypical hyperplasia in the same operated material. Additionaly, there were the same LOH pattern between IDC and previously biopsied DCIS. Thus it may reasonable to consider the possibility that the genetic change of IDC had been occurred earlier than the early invasion of carcinoma.