Influence of E-cadherin expression on the mammographic appearance of invasive nonlobular breast carcinoma detected at screening.
OBJECTIVE
To determine whether E-cadherin loss causes nonlobular cancers (NLCs) detected at mammographic screening to have different mammographic appearances than do NLCs with normal E-cadherin expression.


METHODS
This study design had hospital ethics committee approval; informed consent was waived. Membranous expression of E-cadherin was assessed immunohistochemically in patients younger than 70 years from a consecutive series of 1944 operable invasive breast cancers. Of those, 276 NLC cases (age range, 45-70 years) were common to a prospectively collected database of breast cancer detected at screening. The mammographic features of 131 NLCs with reduced E-cadherin expression were compared with those of 145 NLCs with normal E-cadherin expression.


RESULTS
NLCs with E-cadherin loss were more likely to manifest as an ill-defined mass and less likely to manifest noncomedo microcalcifications at mammography than were NLCs with normal E-cadherin expression (47 [35.9%] of 131 vs 35 [24.1%] of 145, P = .03; and one [0.8%] of 131 versus 13 [9%] of 145, P = .001; respectively). NLCs with E-cadherin loss were significantly larger (>or=15 mm) than NLCs with normal E-cadherin expression (71 [54.2%] of 131 NLCs vs 57 [39.3%] of 145; P = .01). Both groups had a similar distribution of grade, tumor type, nodal metastases, and vascular invasion.


CONCLUSIONS
Invasive NLCs with reduced E-cadherin expression detected at screening are more likely to appear as ill-defined masses and less likely to manifest noncomedo microcalcifications than are NLCs with normal E-cadherin expression. NLCs with reduced E-cadherin expression appear to have mammographic features that make them difficult to detect at small sizes.
Doyle
Sarah
S
Department of Histopathology, Nottingham City Hospital National Health Service Trust, Nottingham Breast Institute, University of Nottingham, Hucknall Road, NG5 1PB Nottingham, England. sarah.doyle@nuh.nhs.uk
Evans
Andrew J
AJ
Rakha
Emad A
EA
Green
Andrew R
AR
Ellis
Ian O
IO
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D015820:Cadherins / Q000378:metabolism*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging
D015820:Cadherins