Lobular phenotype related to occult-metastatic spread in axillary sentinel node and/or bone marrow in breast carcinoma.
To determine whether any histological trait was associated with regional and/or systemic spread of occult tumour cells (OTCs) in small size invasive breast cancer, we compared tumour characteristics, axillary sentinel lymph node (SN) and bone marrow (BM) status in a series of 287 pT1T2 cases. Surgery was the first step of treatment, associated with SN procedure and with BM aspiration for the detection of OTC. SN was histologically classified as negative, metastatic (>2mm), micro-metastatic (>0.2mm and 2mm) or involved by OTC detected by immunohistochemistry (Ni+, 0.2mm). BM specimens were analysed after immunocytochemistry and classified as negative or positive with atypical cytokeratin-positive OTC. Metastasis and micro-metastasis in the SN were correlated with size, grade and vascular invasion. In contrast, presence of OTC in both SN and BM was independent of these parameters but positively associated with lobular type. This correlation was also observed for BM status, which was similarly independent of the tumour characteristics. No association was found between SN status and BM status. Our data indicate that, in the course of breast cancer, OTC spreading is frequent and could be an early event, related to lobular histological type but independent of classical histoprognostic parameters, and that the loco-regional metastatic spread of OTC is not a prerequisite for systemic involvement.
Department of Pathology, Institut Curie, 75005 Paris Cedex, France.
Anne
A
Vincent-Salomon
Martial
M
Caly
Yann
Y
De Rycke
Paul
P
Fréneaux
Jerzy
J
Klijanienko
Marick
M
Laé
Frédérique
F
Viard
Claude
C
Nos
François-Clément
FC
Bidard
Séverine
S
Alran
Rémy
R
Salmon
Youlia
Y
Kirova
Jean-Yves
JY
Pierga
Brigitte
B
Sigal-Zafrani
Xavier
X
Sastre-Garau
D001365:Axilla / Q000473:pathology; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology; D001943:Breast Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D009389:Neovascularization, Pathologic; D010641:Phenotype; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy