title: Usefulness and limitations of E-cadherin and β-catenin in the classification of breast carcinomas in situ with mixed pattern.
abstract: BACKGROUND
  The distinction between lobular neoplasia of the breast and ductal carcinoma in situ has important therapeutic implications. In some cases, it is very difficult to determine whether the morphology of the lesion is ductal or lobular. The aim of this study was to evaluate the value of E-cadherin and β-catenin expression through the immunophenotypical characterization of carcinoma in situ with mixed pattern (CISM).
  
  
  METHODS
  A total of 25 cases of CISM were analyzed considering cytology/mixed architecture (ductal and lobular), nuclear pleomorphism, loss of cell cohesion, and presence of comedonecrosis. The immunophenotype pattern was considered E-cadherin positive and β-catenin positive, or negative.
  
  
  RESULTS
  Nineteen (76%) cases presented a mixed cytology and / or architectural pattern, two (8%) presented nuclear pleomorphism, two (8%) presented mixed cytology and nuclear pleomorphism, and two (8%) presented comedonecrosis and nuclear pleomorphism. A complete positivity for E-cadherin and β-catenin was observed in 11 cases (44%). In one case, the lesion was negative for both markers and showed nuclear pleomorphis. Thirteen lesions showed negative staining in areas of lobular cytology and positive staining in cells presenting the ductal pattern.
  
  
  CONCLUSIONS
  The expression of E-cadherin and β-catenin, combined with cytological and architectural analysis, may highlight different immunophenotypes and improve classification of CISM.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/ 1693384202970681
authors.affiliation: Breast Pathology Laboratory, School of Medicine, Federal University of Minas Gerais (UFMG), Av, Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Gomes
authors.forename: Simone S
authors.initials: SS
authors.lastname: Porto
authors.forename: Rafael M
authors.initials: RM
authors.lastname: Rocha
authors.forename: Helenice
authors.initials: H
authors.lastname: Gobbi
mesh_terms: D000328:Adult; D015703:Antigens, CD; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000737:chemistry* / Q000145:classification / Q000473:pathology; D015820:Cadherins / Q000032:analysis*; D002278:Carcinoma in Situ / Q000737:chemistry* / Q000145:classification / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry* / Q000145:classification / Q000473:pathology; D018275:Carcinoma, Lobular / Q000737:chemistry* / Q000145:classification / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008875:Middle Aged; D018193:Neoplasms, Complex and Mixed; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D051176:beta Catenin / Q000032:analysis*
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor; C513384:CDH1 protein, human; C495270:CTNNB1 protein, human; D015820:Cadherins; D051176:beta Catenin