title: Multifocal/multicentric breast carcinomas showing intertumoural heterogeneity: a comparison of histological tumour type and Nottingham histological grade of primary tumour and lymph node metastasis.
abstract: Our study aimed to compare the histological tumour type and Nottingham histological grade of invasive tumour foci in multifocal/multicentric breast carcinomas with those in corresponding axillary lymph node (LN) metastases. We reassessed slides from consecutive multiple breast carcinomas surgically treated with axillary LN dissection (2007-2012). 155 (19.23%) of 806 cases had multiple breast cancer, of which 115 (74.19%) cases had identical morphology. Of these, 85 (73.91%) cases had axillary LN metastases morphologically identical to the originating breast tumours. 32 of the 40 (80%) cases with different morphology had axillary LN metastases; in most heterogeneous cases with differences in grade (87.5%), the grade of metastases was identical to the grade of the tumour foci with the highest histological grade, and in 33.33% of cases the grade in LN was concordant with the grade of smaller foci. Among the 18 cases heterogeneous in histological type with axillary metastases, 33.33% presented heterogeneous histological types in LN, and 22.22% of them were only concordant with the histological type of the smaller tumour foci. The morphological aspects of axillary LN metastases correspond to the highest histological grade and/or histological tumour type with unfavourable prognosis, which does not necessarily appear in the largest tumour focus.
authors.forename: Monica
authors.initials: M
authors.lastname: Boros
authors.affiliation: Cristian Podoleanu PhD, University of Medicine and Pharmacy, Targu Mures, Romania, Gheorghe Marinescu street nr 38, 540139 Targu Mures, Romania, e-mail: podoleanu@me.com.
authors.forename: Cristian
authors.initials: C
authors.lastname: Podoleanu
authors.forename: Rares
authors.initials: R
authors.lastname: Georgescu
authors.forename: Cosmin
authors.initials: C
authors.lastname: Moldovan
authors.forename: Calin
authors.initials: C
authors.lastname: Molnar
authors.forename: Simona
authors.initials: S
authors.lastname: Stolnicu
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000556:secondary; D001365:Axilla; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000556:secondary; D002454:Cell Differentiation; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D015409:Mastectomy, Radical; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness