Genetic and phenotypic characteristics of pleomorphic lobular carcinoma in situ of the breast.

Journal Article (Journal Article)

The clinical, pathologic, and molecular features of pleomorphic lobular carcinoma in situ (PLCIS) and the relationship of PLCIS to classic LCIS (CLCIS) are poorly defined. In this study, we analyzed 31 cases of PLCIS (13 apocrine and 18 nonapocrine subtypes) and compared the clinical, pathologic, immunophenotypic, and genetic characteristics of these cases with those of 24 cases of CLCIS. Biomarker expression was examined using immunostaining for E-cadherin, gross cystic disease fluid protein-15, estrogen, progesterone, androgen receptor, human epidermal growth factor receptor2, CK5/6, and Ki67. Array-based comparative genomic hybridization to assess the genomic alterations was performed using microdissected formalin-fixed paraffin-embedded samples. Patients with PLCIS presented with mammographic abnormalities. Histologically, the tumor cells were dyshesive and showed pleomorphic nuclei, and there was often associated necrosis and microcalcifications. All lesions were E-cadherin negative. Compared with CLCIS, PLCIS showed significantly higher Ki67 index, lower estrogen receptor and progesterone receptor expression, and higher incidence of HER2 gene amplification. The majority of PLCIS and CLCIS demonstrated loss of 16q and gain of 1q. Apocrine PLCIS had significantly more genomic alterations than CLCIS and nonapocrine PLCIS. Although lack of E-cadherin expression and the 16q loss and 1q gain-array-based comparative genomic hybridization pattern support a relationship to CLCIS, PLCIS has clinical, mammographic, histologic, immunophenotypic, and genetic features that distinguish it from CLCIS. The histologic features, biomarker profile, and genomic instability observed in PLCIS suggest a more aggressive phenotype than CLCIS. However, clinical follow-up studies will be required to define the natural history and most appropriate management of these lesions.

Full Text

Duke Authors

Cited Authors

  • Chen, Y-Y; Hwang, E-SS; Roy, R; DeVries, S; Anderson, J; Wa, C; Fitzgibbons, PL; Jacobs, TW; MacGrogan, G; Peterse, H; Vincent-Salomon, A; Tokuyasu, T; Schnitt, SJ; Waldman, FM

Published Date

  • November 2009

Published In

Volume / Issue

  • 33 / 11

Start / End Page

  • 1683 - 1694

PubMed ID

  • 19701073

Pubmed Central ID

  • PMC2783988

Electronic International Standard Serial Number (EISSN)

  • 1532-0979

Digital Object Identifier (DOI)

  • 10.1097/PAS.0b013e3181b18a89


  • eng

Conference Location

  • United States