title: Ductal carcinoma in situ of the breast: a comparative analysis of histology, nuclear area, ploidy, and neovascularization provides differentiation between low- and high-grade tumors.
abstract: Ductal carcinoma in situ (DCIS) is a heterogeneous group of lesions that has been subdivided into three types: well differentiated (grade I), moderately differentiated (grade II), and poorly differentiated (grade III). Forty-five cases of DCIS were analyzed for image analysis: nuclear area, DNA ploidy, and vascularization in order to establish a more precise correlation between the histologic grade and these morphometric parameters. Our results confirm that the mean nuclear area, DNA ploidy, and microvessel density (MVD) progressively increased from DCIS grade I to DCIS grade III. The analysis of the nuclear area in relationship to DCIS grading demonstrated a progressive increase of values between grades I/II to grade III, but these data have no statistical significance. An analysis of DNA ploidy demonstrated significant differences between grades I/III (p < 0.05), but there was no statistical significance between grades I/II, grades II/III, or both (p > 0.005). The analysis of MVD was extremely significant between grades I/III (p < 0.001) and grades II/III (p < 0.001), but between grades I/II, these values showed no significant differences (p > 0.05). Based on this study, it can be concluded that image analysis techniques confirm how DCIS presents morphometric values that increase from DCIS grade I to DCIS grade III and that within this spectrum, DCIS grade III can be identified as a group of tumors presenting a large nuclear area, aneuploid DNA, and abundant vascular neogenesis, confirming that this neoplasm displays more aggressive patterns than the other two types. These criteria should justify a higher rate of tumor progression to DCIS grade III.
authors.affiliation: Department of Pathology, Medical School, University of Valencia, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Ruiz
authors.forename: Sergio
authors.initials: S
authors.lastname: Almenar
authors.forename: Miguel
authors.initials: M
authors.lastname: Cerdá
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Hidalgo
authors.forename: Alfonso
authors.initials: A
authors.lastname: Puchades
authors.forename: Antonio
authors.initials: A
authors.lastname: Llombart-Bosch
mesh_terms: D001943:Breast Neoplasms / Q000098:blood supply / Q000473:pathology*; D002278:Carcinoma in Situ / Q000098:blood supply / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009389:Neovascularization, Pathologic; D011003:Ploidies
chemical_list: D004273:DNA, Neoplasm